To not get a tongue tie investigated privately if the baby doesn't have a tongue tie...

[Tonguetied]

My sister is having a disagreement with her DH and I suggested she put it to the mumsnet jury. She's too bogged down with it all so asked if I'd do it for her (I've NC'd because I'll be sharing this with her).

She has an 11 week old baby who is bottle fed. She was fairly unsettled at the beginning - colicky, not easy to get to sleep, crying etc. They think she may have a CMPA and silent reflux and the baby is now being treated for these things (prescription milk, meds for the reflux etc). They are also seeing a cranial osteopath to see if that might help with the various issues.

Now that she is used to the new milk, she seems to be settling down into everything - napping better, happier when awake, feeding well. She still wakes throughout the night for feeds and to be resettled but is slowly beginning to go for longer stretches.

The problem is that my sister's DH wants to take the baby to a private tongue tie clinic to have her assessed as he thinks she's got a tongue tie that, if divided, will help her to feed better, sleep better and be more settled generally. He has seen something on the NCT website with a list of symptoms and he thinks the baby has these symptoms. He thinks there's no harm in trying it as it might help and the clinic won't do the procedure if they don't think it's necessary.

My sister, on the other hand, is pretty sure the baby doesn't have a tongue tie and this has been confirmed by 4 different HCPs, including a paediatric registrar (who has been seeing the baby about something unrelated). She thinks that as the baby doesn't have a tongue tie, it's unreasonable to put the baby through an unnecessary procedure that would be painful and have risks of complications, when the baby is bottle-fed, gaining weight, eating to expectation and is arguably as unsettled as a newborn baby is. She's also worried that, as it's a private clinic that makes money from performing tt divisions, it won't necessarily give an unbiased assessment.

He thinks she is being unreasonable because she won't try something that he thinks might help (and is saying that, seeing as she won't try it, he's reluctant to help her out with the nights). She thinks he is being unreasonable because the baby hasn't got a tongue tie and she doesn't think it's right to subject her to an unnecessary medical procedure for no reason, when she's just being a newborn baby and he needs to deal with the difficulties, stresses and lack of sleep that comes with it.

Who is being unreasonable?

YABU - get the tongue tie investigated, you never know.
YANBU - don't get the tongue tie investigated, the baby doesn't have one.

YANBU, why does the DH think there's a tongue tie? Does the baby's tongue look normal?

He is incredibly unreasonable to withhold night time care because she won’t agree with him. Total arsehole behaviour - the baby is as much his responsibility as hers, and it’s completely wrong to refuse care because of a spousal disagreement.

In terms of the dispute itself, it depends. Non-specialists aren’t always the best at diagnosing tongue-tie, so it can be worth seeing an expert privately. But if the issues now seem to be resolved then I agree it’s not worth the bother or expense.

Tounge ties are often missed.

I didn't realise they affected bottle feeding though?

At the end of the day she is only half the parents, if her husband wants to get this investigated he should be allowed to. Its hard in the beginning to cede some of the responsibility to your partner when you've been taking care by yourself for 9 months.

If the baby is doing better, why would the tongue tie need to be snipped even if there was one?

Many health professionals believe that most tongue ties shouldn't be corrected anyway. A lot of the time they can just reattach and of course it can affect their feeding directly after its done.

I'm pretty sure I read a post on here last week from someone who felt awful because her baby's tongue tie had been missed by numerous health professionals. I can't see the harm in getting it checked out by someone who specialises in this

If he wants to have it checked, why should she have the final say in stopping him? They won't snip a non-existent tongue tie.

Tongue ties are frequently missed by HCP, so I wouldn't rule it out on that basis alone. Tongue ties can affect breast and bottle feeding, my last little fosterling had a tongue tie and spilled milk at every feed, was unsettled, colicky and vomited lots after each feed so yes, I would get it checked just for peace of mind. If there is no tongue tie there will be no procedure because there will be nothing to release.

I don’t see the harm in having it checked on the agreement that they will then discuss if the procedure is necessary. I think it’s unlikely that they would do the procedure just for the money if she doesn’t have it. That would be like a private hospital treating someone for a broken arm when they don’t have a broken arm; unethical and probably illegal or at least legal implications.
I know that if I thought there was something wrong with DD then my DH would agree to it being checked even if he didn’t agree.

Tongue ties can affect bottle feeding if they’re severe enough. They can also affect speech.

My daughter had a tongue tie, caused no end of breast feeding issues which resulted in me giving up due to extreme pain. Midwives and GP all said there was no problem, saw a private lactation consultant who said there was an issue. She offered to write a letter to give to GP to get it treated on the NHS. Took letter to GP, who rejected it, so we went back to the private specialist who put us in touch with a lady who did them privately. 2 days, and £120, later it was done.

Just be warned that if it is later identified that there is a tongue tie it is much harder to deal with in older babies. I think after 9 months of age it has to be done under general anaesthetic.

1. Either of them doesn't get to withdraw help for the baby because they have had an argument. Grow up.
2. He is half responsible for this baby so he gets a decision. If he wants something checked out he has that right.

My DS tongue tie was completely missed. I didn't have a clue to look for it. Luckily my relative advised us. I don't think any reputable private clinic would cut a baby just to make money.

If there isn't a tongue tie then there can't be a procedure, all you'd be putting the baby through is someone looking at it's tongue. They can't snip something that isn't there.

Well your sister is a bit U for thinking a private clinic would do a division if there is no tongue tie... and her husband has got a point that it is often missed in the public sector. So it may be worth seeing a private tongue tie practitioner and get a view, no harm done, they won't divide something that isn't there to divide..

@DrFoxtrot

YANBU, why does the DH think there's a tongue tie? Does the baby's tongue look normal?

If only it was that easy to diagnose..

This was my son exactly!! Unfortunately majority of HCPs actually know very little about tongue tie.. my son was checked by several people, HVs, midwives, GP, paediatrician who all said there was no tie.
I saw a feeding specialist who took one look and said he has quite a severe posterior tongue tie. We were referred to get it revised and it changed everything.

Ask to see a feeding specialist, not your normal HV etc.. a proper feeding specialist and they will be able to tell if there is a tie or not. You won't have to pay so no worry about being conned, although I don't think a professional would do that anyway. They wouldn't advise a revision if it wasn't required.

There is no right or wrong here really, just a difference of opinion but I'd lean more towards getting it investigated. It isn't true that bottle fed babies don't need ties revised. My son was bottle fed due to his tie making breastfeeding almost impossible but his tie made bottle feeding very difficult for him too. he couldn't form a proper seal around the teat and so swallowed lots of air which caused him pain.

My son was fine with having it revised, he cried more when they pinned him down.. it was very quick, he cried but he came straight to me for a feed and then he was fine the second he started on the bottle and the difference in how he fed was instant. It isn't quite as horrendous as you think it's going to be.

I didn't realise they affected bottle feeding though?

Definitely does - most of a feed used to just spill out of my twins mouths as they couldn’t make a proper seal, this was after breastfeeding failed. Got much better about 7 Or 8 months.

My twins are 4 now and both non verbal with ASD but one literally can only make 2 sounds. I do wonder whether having it sorted would have made a difference to that.

What’s the harm in getting it checked? If there’s no tie there’s nothing to divide. They can be very hard to identify and need a proper examination which in my experience paeds and HVs etc don’t do

"She still wakes throughout the night for feeds and to be resettled but is slowly beginning to go for longer stretches".

You do know a baby is supposed to wake up frequently at that age don't you? They aren't meant to sleep through the night at 11 weeks..

I wonder if your sister and her husband are getting a bit too...worried..anxious...about everything. Is she breastfeeding? Try co sleeping and breastfeeding.

As a Speech and Language Therapist I wanted to say it is a bit of a myth that tongue ties affect speech. If a baby has got adequate movement to feed, they have adequate movement for speech.

It doesn't sound like this baby has a tongue tie, however if the father is that adamant, I don't think it would do much harm to have a consultation. 99% it will be a waste of money and they will be told all is fine. They could look for recommendations of someone reputable do they don't feel they will operate for no reason.

@Tonguetied if a potential case of tongue tie is assessed by a qualified professional in that area, they have certain criteria that they score the babies tongue movement against. If the scoring hits a certain level then it is the parents decision to have the procedure carried out or not.

I have an untreated tongue tie. It was identified when I was a baby, but as it didn’t seem to cause an issue with feeding, it was left.
However, I do now have a slight issue with saying certain sounds in English, struggle more noticeably with sounds in French/Spanish which I noticed when I was doing my GCSEs.
It’s definitely worth getting a second specialist opinion. As PP have said, they can’t ‘correct’ an issue that isn’t there, and the sooner it is looked at, the easier it is all round.

Whilst I think the DH is being unreasonable to support with the difficult nights, why shouldn’t he have equal say in what medical checks the baby may not need?

Tongue ties are often missed. Only a qualified tt practitioner can pick them up, and they train just for this. Doctors and nurses have no training. A tt practitioner does 7 tests to check for tt and rate how severe it is and only one of these is visual, the rest are feeling how the tongue moves around the mouth, strength of suck etc. Also they wouldnt recommended cutting it for only a minor tie, it has to have a certain score of severity before they recommend the procedure.
I did think it only really affected breastfed babies as bottles make it much easier to feed and you can get teats with very easy flows.

I think they are both a bit right. The possible tt is unlikely to be the cause of issues, babies tummies are just getting used to digesting milk and lots of them are windy and sleep shit. Nothing to do with tt. However if they are desperate and want to look into all possibilities (which sounds like they are if they are doing cranial osteopathy etc) then it might not hurt to get a second opinion from a qualified tongue tie practitioner. I wouldn't just jump straight to getting it cut though. And they need to be aware if there is an issue that even when its cut the baby will need to re learn everything and at 12 weeks this will take a few weeks and will almost be at the weaning stage anyway. Also some wont see older babies so if they do want to see someone the sooner the better.

As a Speech and Language Therapist I wanted to say it is a bit of a myth that tongue ties affect speech. If a baby has got adequate movement to feed, they have adequate movement for speech.

I’ve been told the same by some SALTs and totally the opposite by others. I can see that DT1s tongue moves strangely when he’s vocalising so possibly a coordination issue rather than anything else, but I wish I’d had it done because it would have made feeding easier and because I’d know now that it’s not a potential source of additional difficulties for him.

My kids tongue-tie was missed until he was 7. It was our dentist that pointed it out. They can be missed, so maybe take the child along to her husbands healthcare professional if it will put minds at ease. It's a private appointment - so it's their money they'll be spending. I can't imagine any surgeon would perform an unnecessary operation for a tongue tie that doesn't exist, so surely once they've had the appt and nothing is found, they'll be the end of it?

*that'll

My baby had a tongue tie so bad he couldn't eat solid food, it just fell out of his mouth. We couldn't get it sorted until 7 months of age. I wish we had done it sooner instead of looking at it as optional.
They can't release a tongue tie that's not there (and it's not a painful procedure if they do need to release it), so they won't do a procedure if there's no TT. If your sister's DH wants to get it checked he should do. Getting a TT sorted can be life changing for everyone involved. It feels like you and your sister are pushing DH out of being involved and making it impossible for him to help or have an opinion, I'm not surprised he's getting fed up. If you were men doing this to a woman everyone would be fuming. Are you both always this controlling?

My DD had a tongue tie. I asked every professional we came across to check it- midwives, health visitor, 2 separate members of infant feeding team we had to keep going
to due to feeding issues. All said no tie. Eventually the nursery nurse who worked alongside the HV saw how I was on the verge of a breakdown over
Feeding issues and suggested she refer us for it to be checked by the specialist tongue tie team. Turns out yep Dd had a 50% posterior tie and we were told by the team that none of the professionals previously we saw would have had any training in how to identify a tie as part of their standard training. So none of them would have truly known what to look for. Dd has tie cut then and there- was v traumatic but mainly for me and DH. She stopped crying 30seconds after as soon as I put her on the boob. I do think it’s worth your sis getting it checked.
Her DH is being awful though by refusing to do other care until it is checked.