Tongue-tied babies and how they and their breastfeeding mothers can be helped

Breastfeeding: The kindest cut of all

Extracts from the Telegraph:

"Babies who have tongue-tie are born with a very short lingual frenulum, the piece of skin that joins the tongue to the bottom of the mouth. In my son's case, the tip of his tongue was anchored so firmly he couldn't move it at all, even when he cried. It looked extremely painful but I was assured it wasn't.

As the child gets older, this lack of movement can cause problems with speech and eating. In the short term it can cause severe problems with breastfeeding. It did for me. Having breastfed my daughter perfectly happily, I came to dread "the boy with the barbed-wire gums" latching on - or rather, failing to latch on. I got mastitis, he got hungry. We were both miserable."

"Prevailing medical opinion says, as my midwife did, that tongue-tie will usually right itself by the end of the baby's first year as the tongue grows. If the baby still has a problem after that, a paediatric surgeon might consider a frenulotomy - a procedure that divides the frenulum from the base of the mouth. Others will not perform surgery unless the child develops speech problems and has not responded to speech therapy. By that time, the child will require a general anaesthetic for the procedure.

However, some doctors believe in a more pro-active attitude, including Shailesh Patel, consultant paediatric surgeon at King's College Hospital in south London. "My view is that these cases are emergencies," he says. "If someone is referred to me, I try to fit them into my clinic that week. I believe that if a mother has to wait even another week, she will give up breast?feeding because it is too awful to carry on."

Given that Britain has one of the lowest rates of breast-feeding in Europe - only 21 per cent of babies are breastfed until six months, the age recommended by the World Health Organisation - you can see why he's so determined."

"The trouble is that attitudes towards treating tongue-tie appear to be lagging behind those towards breastfeeding. However, Mr Griffiths, something of a pioneer in the field, is optimistic. "Ten years ago, other paediatricians said I was doing dangerous things to babies," he says. "Now some of them are doing divisions themselves. We have done 10,000 procedures with only one case of mild infection and not one baby has had to have treatment for bleeding.

"We're training one lactation consultant every fortnight, from different parts of the country, to carry out division. After all, it's a really simple procedure - a few seconds of work resulting in a happy mother and baby.""

TONGUE-TIED - Short Story by Margaret Wilde

TONGUE-TIED

The plaintiff was being extremely irritating. How awkward can you get? Why wouldn’t she give her evidence?

“Speak up, please. The Court hasn’t all day. We have your written statement but we must hear you give your evidence and you must be cross-examined by Counsel.

“This really is too bad: - making those grotesque noises and poking her fingers into her mouth in that disgusting way! I suppose we’re intended to conclude that because she’s got no tongue she can’t speak. Well it won’t do. She’s prejudicing the evidence.

“Her statement says that the dentist cut off her tongue while performing a minor operation in her mouth. Well we’ve only got her word for it, and only in writing at that! The surgeon says there was no tongue in her mouth when he started to operate and of course he is an expert. I feel we ought to accept his clinical judgement on the matter. He would have noticed a tongue if one had been present.

“The heavy bleeding afterwards, despite necessitating a massive blood transfusion, could well have been spontaneous. ‘Nervy’ people often get nosebleeds, and this could well have been something of that sort.

“In view of the stubborn refusal of this lady to give evidence I sentence her to seven days’ imprisonment for contempt of court.

“Case dismissed! Costs against the plaintiff!”

© 1988 Margaret Wilde