Tongue Ties To Cut or not to Cut? 082 674 2770 Dr Gershun Mostly genetic Some with facial-related syndromes Mostly in males Some are non-symptomatic, therefore base it on the mom. - Feeding problems Later food clearing Dentition Cosmetics Speech: l/r/th/s How do they present - Cracked, bleeding nipples Breast pain Lipstick shaped nipples Clicking of the tongue (baby has to suck and pull the nipple in and out, if tongue is too short, will slip and tear/wear nipple away Baby will bite with the gum If the above 2 fail – baby will get lips involved Mom is exhausted and baby is tired and aggravated Baby’s Symptoms - Restricted tongue movement Poor weight Dribbling during feeds Long/frequent feeds Colic/wind/hiccups Reflux Difficulty staying latched Small gape resulting in biting/grinding behaviour Unsettled behaviours Reflux: thinken feeds/keep baby upright for 45min after Development of the Tongue – NB Frenulum – joining of left and right – natural join Under ¾ months – don’t risk GA Some are membranous, some vascular, some muscle – range in thickness Cannot stretch a tongue-tie Find that the nipples will change not the baby’s tongue/tongue tie Posterior tongue tie – hardest to find Problems: - Cracked nipples Reflux Problems latching Classification: 1 – short tongue tie – close to the base 2 – almost half-way 3 – almost at the tip 4 – at the tip [heart-shaped tongue] [abraded/cut tongue tie] [blanching of tongue] Frenotomy / Frenectomy Baby must be relaxed (milk-drunk or use sucrose) Local anaesthetic – baby can feed later in the day Complications - bleeding Pain Failure of procedure Reattachment (recommend exercises and massage – wound does go yellow) Infection is very rare Association of tongue-tie practitioners IATP – international association of tongue tie professionals
