to wish babies were checked for tongue tie routinely before leaving hospital?

[MixedBerries]

Now I don't want this to descend into a slinging match about feeding choices (which usually happens whenever bf or ff are mentioned) but is it really unreasonable to expect that this is something that should be checked for by the paediatrician before leaving hospital? It would take about 1 minute.
According to NICE and UNICEF (who I assume know a thing or two) it affects 3 to 10 per cent of all babies yet at least 5 midwives, one health visitor and one paediatrician failed to check or notice it in my DS. It's not even a "hidden" posterior tongue tie. Once it was diagnosed (at 2 weeks following bleeding nipples, weight loss and failure to latch), we had to wait a further 2 weeks to see the lactation specialist as she was on holiday and is the only one in the area qualified to clip it. They we waited a further week to have it clipped. That didn't work so we had to travel half way across the country to see another specialist who clipped it again at 7 weeks. By this time DS had lost interest in boob feeding so I've been trying to get him back on and expressing in the meantime.
Now at 13 weeks, he completely refuses the breast and I don't have the time to express every 3 hours so essentially, once my freezer stash has run out, it's the end of bf. IF anyone had checked, I've been told it could have been sorted the day he was born and all this could have been avoided.
So in the light of "breast is best" being repeated over and over by the health profession, don't you think it's something fairly fundamental that could be checked for by people who are supposedly here for the best interests of our children? I'm so bloody angry. (Yes, I KNOW ff won't kill him but we really wanted to bf, particularly since asthma and allergies run in the family on both sides. And my point is that this could have been avoided so easily).

I had to be referred by a breastfeeding counsellor, and fill in a questionairre with a nurse to confirm that my reason forwanting to have it snipped was to try to improve breastfeeding, and confirm I was intending to breastfeed for at least a month after the proceedure. They were quite careful. They would not snip a newborn for potential later speech issues at that clinic, so if you gave that as your reason they would ask you to get your child assessed as a toddler to see if it was affecting speech. I think it should only be done at birth if it is a feeding issue.

But fivehourssleep, if the tts had caused feeding or speech problems for any of your children, then by not snipping routinely and waiting until the baby was over a few months old, your children would have to undergo a GA procedure. The tt snip with a newborn is really no traumatic or complicated than an injection (midwives used to do it with a fingernail).

It seems a no brainer to me to check for and correct routinely in newborns (with parental consent of course).

I definitely think that it should be checked for in the hospital and dealt with there and then. I am a maternity support worker and work on the postnatal ward and have seen so many women get really understandably upset at why their babies are not latching. We support women with b/f and the other week I spotted a tounge tie in a baby, it wasn't mild and it was obvious that baby was, at day 4, not getting enough and had become jaundice from not having enough hydration but I was not surprised by my colleagues' reaction which was to be very much underwhelmed by the whole thing. I tried, as we are under midwives' supervision to explain that I thought it was tongue tie and she came and checked and said she thought so too, so I said what should we do? Shall I bleep the paed to come over and snip it?(I said this because I know from previous experiences that she wouldn't say yes of course, let's get on with it, which I also know from experience is all that baby needs in order to get on the breast and stimulate the supply, but thought I'd try) She just said if it's causing problems in a month then that's when to do something about it. That's when I normally feel like saying, 'oh you mean when mum is completely at the end of her tether and has given baby a bottle (im not anti ff) because she got no support?' Totally frustrating part of the job, totally. And really avoidable too, just SORT IT OUT FFS, MATERNITY UNIT= PAEDIATRICIAN

here is the NHS page on it

yet again, plainly what NICE thinks is being widely ignored in practice,...

research basis...80%-100% found improvement in feeding

Its pants. I don't have any children yet but having read various threads on MN its something I am genuinly scared of. Having a problem breast feeding seems tortous due to breast is best messages but v little help or acknowlegment of real problems.

People in the know, is it worth getting a private check if you can afford it? How much would it be?

A private TT snip is about £80 though I guess it might be higher than that in some areas, so it can't be much more than a call out fee from a IBCLC (highly trained bfing consultants - top level of bfing training and TT snipping training is extra work on top of ordinary IBCLC education). Try looking up the IBCLC UK website as they have a list of TT IBCLCs.

We were very lucky with DD as our midwife checked before she was even a couple of hours old. She was born in early hours on a Saturday and we had the choice of either staying in until Monday when the 'Tongue tie lady' could snip it or go home and wait for a referral. We chos to stay because we could have been waiting up to two weeks for a referral. She bf like a different from after the snip onwards. It DEFINITELY should be checked for at birth because I would have struggled to maintain bf whilst waiting for a referral.

This topic makes me so angry, as if it hadn't been for reading stuff on the MN breastfeeding boards I wouldn't have known my DS had TT and I would have probably given up, thinking I was crap at bfeeding and blaming myself for 'failure'.

My DS had a 'mild' tongue tie which I noticed a couple of hours after he was born (his tongue was heart shaped when he cried), feeding was agony for the first 10 days and the only reason he didn't lose much of his birthweight was because I was doing up to 40 feeds a day. Day 10 it was snipped. Although feeding wasn't great for a few weeks after it was snipped I can now, at 14.5 weeks, really appreciate the difference and now things have settled I really enjoy bfeeding. I had so many people assume it was just my attachment that was lacking, I had to convince several mws, breastfeeding support workers and councillors that it was TT - a simple check at birth might have saved me shredded nipples and having to use shields for three months, and saved money on all the support I needed to keep me going.

I do think there needs to be a reassessment of attitude amongst the support personnel though - I spoke to an experienced LLL leader who had bf all her 4 children and she said that a lot of people were jumping on the TT bandwagon and blaming it for poor attachment as not all TTs affect feeding. She had to concede when she saw him that the attachment was fine, that it didn't matter what position he was in, and that it was simply that his tongue was not long enough to get enough nipple in, so he was a spaghetti sucker!

Please MNHQ, its a worthy cause!!

Oh and DD was more bothered about the nurse holding her arms out of the way than the snip. I don't even think she noticed it. I couldn't believe how quick (less than two seconds) and simple it was after we'd stayed in so long to wait for it.

They need to check for it and train all midwives to do the procedure asap when it is spotted in newborns. It takes no time at all and will really help mums who are trying to bf. It seems so obvious to me that I can't believe it isn't routine and that more midwives aren't trained to do it.

I absolutely agree with the comments about about support personnel - it seems to be so hit and miss. During the 11 weeks until DS's TT was snipped I felt like I went everywhere for help, and got none. I was constantly referred to the local breasfeeding clinic, which was run by a HV who supposedly was a trained bf supporter. I went every week and never once heard her offer anyone anything but the most basic 'nose to nipple' type advice. Anyone who had an actual problem was advised to switch to formula! I am in no way against formula, but it was disheartening for all of us who were struggling and looking for help to be told to stop bf instead.

Until I hired a private LC, not one of the (many) HCPs I went to for help knew anything about tongue ties, and there was nowhere in my county (Herts) to get them divided. I also struggled with an awful oversupply, and again the breastfeeding HV was worse than useless. She told me oversupply wasn't something she had ever had to deal with as undersupply was a problem, not oversupply. I could go on and on about all the dreadful advice I heard her peddle.

I know from talking to others in RL and on here that there are some excellent HCPs around, and that some people have better access to TT diagnosis/treatment than I did. Sadly, they seem to be the minority. I am scared of having to go through it all again. It's amazing to me that something that can be dealt with so easily should be so hard to access on the NHS. Today, many private TT divisions are carried out at home with blunt-ended scissors and gauze - not so far removed from the midwife's fingernail.

This is my first posting on MN. Having been a follower for sometime I feel so strongly about TT that I felt I had to sign up now.

My DS (11 months) was in hospital for 4 days following birth as he wasn't feeding well. After one day at home and a home visit from a lovely midwife, we were sent back to hospital as he had lost 15% of his birth weight and still wasn't feeding well (I was B'feeding). He had to have a nasogastric tube insterted, which was botched first attempt and traumatic for us both, and this was used to top up his feeds for 24 hours until he put on weight and was discharged.

During our 4 days in hospital he was not weighed again since he was born, and no one checked him for TT. The first time it was mentioned was by the lovely community midwife. He had been seen by 3 diferent paediatricians and numerous midwives and none of them had spotted it or even checked for TT. How could HCPs not even consider this when a baby lost so much of his birth weight and wasn't feeding well?

Once the TT had been noticed we were offered a referral to a neighbouring hospital as they did not do it at the hospital we were at (due to centralisation of health services) but were told it would take 3 weeks or so. In the meantime the lovely midwife gave us a referral to a private midwife who was able to visit us the next day and asses DS. After discussion we decided to get the TT snipped, a one minute job using sterile gauze and sissors in our living room, which cost £150 and 30 seconds of crying. I fed DS immediately afterwards, and he immediately latched on better. He began putting on more weight and feeding greedily.

I think that it is such an easy thing to check for and takes no time at all. HCPs should be trained to consider this as a contributing factor whenever a baby is losing weight, not feeding well or the mother is uncomfortable BFing. My SIL is a BF counsellor and has recently been on a course to identify TT. Why doesn't the NHS do this as a matter of routine?

Hi catyloopylou. Welcome to Mumsnet! My story with DS was so similar, except that his TT was not spotted until he was over 4 months old and our b/f by then was totally done for. I've posted extensively about it on MN in past years and can't really bear to go over it again - it still hurts alot. To cap it all I was told that even if the TT had been spotted much earlier their policy in that area was not to snip - even if it was causing agony for the mother apparently - so like you I expect we'd have gone private.

I'm very glad things worked out for you in the end.

Welcome to MN Cataloopylou. I'm sorry to hear about your awful experience but very glad to hear that you worked through and got breastfeeding established regardless. I'm absolutely gutted about it failing for us and having to stop so much sooner than we wanted and envisaged.

From what I can see in the hospital I work at, TT is not taken seriously and the very poor feeding that results from this is simply put down to early days bf troubles which is shocking.
I actually now have taken to giving mums who are struggling with this a private number which I got from one of my colleagues for a woman who does the procedure just so that they can get some help with it fast rather than wait a month or more often a lot more.

Thanks for your welcomes MixedBerries and gaelicsheep.

I'm glad to say that we did manage to BF successfully and in fact am still doing so, although have different issues now, with teeth... (DS's, not mine!). But without the support I had from DP and the lovely community midwife we may have had a different outcome. It makes me sad to read your stories and to think how simple it may have been to have had a happier ending.

Thanks catyloopylou. I'm happy to say I am still breastfeeding my DC2 who's now over 19 months . That was not without it's severe struggles however and I remain convinced that she too has/had a TT (she certainly, along with DS, has an upper lip tie) although GP and HV have denied it. It's only down to nipple shields that I managed to get through it this time - plus the fact that she couldn't drink from a bottle so there really was no choice.

Just found a petition about training midwives to diagnose and treat tongue tie...not many signatures but worth a try!
www.gopetition.com/petitions/midwives-to-diagnose-and-treat-tongue-tie.html

I've signed it and posted the link on FB and twitter

Great. Thanks!

Bump
www.gopetition.com/petitions/midwives-to-diagnose-and-treat-tongue-tie.html

After signing the petition, it give the option of sharing on FB/email/etc so if everyone forwards it on to other mothers then hopefully we can get more signatures.

done & shared & BUMP

yes, please share the link on facebook and twitter if you have either.

bump