To insist on a proper tongue tie assessment?

[JonathansNextCreak]

My 6 months old DC has just had the health visitor out for a review (it's about 2 months late, was meant to be a 4 month one but my health visitor was on long term sick and no one covering unless intervention/struggling).

We've had continued problems with latching/bf and although none of the staff in hospital mentioned tongue tie despite our issues, I'm not sure if anyone explicitly checked at birth?

I asked her to assess for tongue tie but she listened to my description of the tongue then said "it's probably fine" since my nipples aren't shredded and bleeding raw like in the first few weeks of bf...

Here is the heart shape: ibb.co/MBbTSx0

I hate to crowd source this type of thing but my HV really didn't make me feel better ("probably") now that I've been reading it may interfere with speaking, dental issues, breathing in some extremely bad cases!

Should I go to my GP to ask for a second opinion (well, a first opinion since HV didn't actually look)?

Clicking link:

ibb.co/MBbTSx0

You need a referral to a maxillofacial surgeon for a potential tongue tie. The consultant in our department ships them even if they are very slight if he thinks it will help.

Do you have any local breastfeeding advisers you can ask as opposed to the HV?

There's a local bf support group but it was more mental than actual hands on practical / troubleshooting. Fine for social chit chat but not useful for hands on literal stuff - they helped but not in the tangible way. In fact the troubleshooting I did re positions was mostly helpful on YouTube

I assume a gp could refer to the specialist consultant then. So seeing the GP might be a sensible step to "go around" the HV (again, it felt more like a coffee and catch up with a friendly neighbour , I needed this 1 specific practical thing out of the visit and just wasn't reassured at all.)

(la Leche League is not in my area, unfortunately)

Looks like a tie to me but at 6 months you'll need to be referred to a specialist as most local hospitals or private practitioners won't cut after 4 months

If your local area has one, it would be worth getting a referral to the Infant Feeding Coordinator. We have hospital based ones who can see babies up to 6 weeks old and a community based one. But all are able to fully assess for tongue tie. I would phone the HV service and ask them to do the referral for you. Another avenue would be a private lbclc lactation consultant, many of them assess tongue tie. Or as has been suggested, seeing the GP.

I agree with the above. Likely tongue tie, but at 6m old it’s a bit more complicated than the little snip that happens as a newborn, mostly because baby is more alert and aware of what’s going on and might already have teeth. I’m wondering if GP is the best option and if you have private healthcare it might not take that long. An NHS referral for this age group could be quite a while but you could look up the consultant who does it in your area and call their secretary for advice

You will need to go private. Very few people in the NHS are qualified to spot it, they have limited training.

My first daughters was missed and picked up at a breastfeeding support group and we sorted it privately.

I knew there was a genetic link so I specifically asked at the hospital the second time. I also asked a second midwife to double check. I then mentioned it to the GP after feeding issues. I ended up at the breastfeeding support group again, and they said they thought there was an issue but were no longer allowed to diagnose. So I went to a qualified tongue tie practitioner. And when she said there was a fairly severe TT I cried, for all the times I struggled and didnt have to (I think it was a posterior TT so harder to spot). I got it corrected.

So a midwife or doctor will have a look in their mouth. A qualified TT practitioner will do 7 or so separate checks and only one is appearance - they will put a (gloved) finger in their mouth and poke about, see how strong their suck is, rub different parts of their gums and see how they move their tongue around to try and touch it. Appearance is only one part of it.

This is one area where I have found the NHS to be poor considering they are trying to improve breastfeeding rates and it seems to be fairly common and makes breastfeeding more difficult.

Something else to consider - my daughter found it much easier to feed on one side than the other and it turned out she was having muscle issues from being stuck in the same position inside me (very long birth), intracranial osteopathy really helped with this. I am not 'woo' at all (science degree etc) but when she pointed out that my daughter couldn't actually lie straight and was bending her legs and neck over to one side and struggled to move her head the other way, it was so obvious. I still get a bit upset looking at pictures of her when she was young as she was obviously struggling with her head / neck and I needed someone else to point it out for me. So might be worth visiting a cranial osteopath as well if any of this rings a bell.

DS1 was diagnosed with TT at birth, we were sent down to hospital in Southampton where the doctor cut it with scissors! not to say you should do this though

It looks like one to me but I’m no expert! I can see why they might not bother come 6 months as they’ll be on solids fairly soon.

I had my ds tongue tie snipped at 5/6 weeks so am a fan in general - it did work wonders. My dds wasn’t spotted at the time (spotted by lactation consultation when she was 5 and ds was being assessed) and apparently both exh and I have one - exh quote severe - he couldn’t bf as a baby so makes sense.

None of us have speech problems and can all eat ice cream fine if that helps!

The NHS are extremely poor in tongue tie identification in my experience (2 babies and both unable to breastfeed). Even the community midwife said that they are not trained to spot it even though it was visibly obvious with our second. We had ours cut with a private practitioner in the end as the nhs wait was 4 weeks and she was struggling to even feed from a bottle. I know our local practitioner does it up to 9 months. Have a look at www.tongue-tie.org.uk/find-a-practitioner/ to find someone private in your local area as they will be quicker than waiting for a referral but it will depend individually whether they treat after 6 months. And the NHS wonders why breastfeeding rates are dropping?? Good luck, hope you get it sorted

This is an interesting read.
I'm. 39w pregnant and my 4d scan showed baby with heart shape tongue
I didn't notice or click to. Be honest but when I showed my mw the pic she said she's convinced it's tongue tie.

Now I'm not planning, to BF but wondered how this would affect bottle or speech

@piercedmyfootonaspike
How. Much was it privately

Go straight to your GP and ask for a referral. I had this with both of mine (plus they both had lip ties too). The HVs hadn't got a clue what to look for, neither had the midwives nor the GPs. I did my own research, went in and asked for a referral, got it and then got it sorted via a specialist at the hospital. It is quite honestly a game-changer. Get this sorted as soon as you can because the longer you leave it the more complicated it becomes to administer treatment!

It's about £200 privately. Are you in the North West by any chance OP. There's a superb clinic in Liverpool.

My DD3 had the heart shaped tongue, it's a really big giveaway. She's two months old and we had it cut because although she doesn't hurt my nipples she takes in a lot of wind. It was someone from the feeding team at hospital who did it and they were contactable via the labour ward. At 6 months though I'm not sure whether he'll need anaesthetic.

@ChocolateCoins19 It was £175 in the south east. We were very fortunate a family member paid for us otherwise we would have had to use a credit card but it has made a big difference to her bottle feeding although she was still unable to breastfeed

Hm yes that’s a pretty classic tt. All 3 of mine had it attached all the way down and all 3 were cut one at 6 weeks and 2 at a couple of days.

A midwife told me to ignore what they would tell me about not getting it cut and to insist

My tongue tie was diagnosed & cut under a GA just before I started secondary school, after years of speech problems. My DM told me recently that she’d struggled to breastfeed me, but nobody had noticed my tongue tie.

After having it cut I had to have lessons for quite a while to learn to use my tongue. I still can’t blow balloons up or whistle and have trouble licking ice creams.

I wish they’d noticed it when I was a baby.

MY DS had tongue tie. He's 30+ and the practice when he was a baby was to give it a year to grow out. His didn't. I took him to my GP who referred him for a simple procedure to release it. No ill effects. It completely altered the way he'd been used to eating and drinking though and he had to relearn.

I’ve not long been through hell with my baby who had a very restrictive posterior tongue tie. I cannot even begin to put in to words how utterly useless the 7 different health professionals I saw were. They just aren’t trained to assess, diagnose and deal with them (They don’t tend to bloody listen to a Mother’s instinct either but that’s another story)

I had to go private and it was the best decision I ever made. My son’s wound did keep “sticking” and he needed a fair bit of Cranial Osteopathy and aftercare but he is doing brilliantly now and is a different baby.

I went to Milk Matters in Huddersfield and can’t recommend them enough. Honestly they are absolute experts in their field.

I paid privately £160. In Kingston, Surrey.

I phoned up, they gave me an appointment next day, on the same day, the doctor assessed and did the job in 5 minutes :)

If you need details, pm me :)

And oh my dd was 6 weeks at the time!

We're in the extreme north of Scotland, Surrey etc might as well be Siberia we'll head to the GP.