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.

Op, your sister's problem is that she has had a baby with a lazy, useless man. Maybe snip him out instead?

Depends which HCP, most aren't trained in it, even paediatricians.

My child’s tongue tie was missed by 3 HV and a midwife who claimed she was a tongue tie specialist. They’re not always easy to see.

Also they can’t do the procedure if they don’t have a tongue tie so I don’t understand this point???

I'd get it checked. It's often missed and it isn't always obvious. But I think he's being a wanker to say he won't help her with nights because she won't get it looked at.

I also cannot see what painful procedure would be carried out on the baby if it doesn't have a tongue tie

@CarterBeatsTheDevil snipping of the lingual frenum

My little one had a severe tongue tie which was incredibly obvious and also silent reflux. She didn’t thrive to begin with but I was told that because she latched it didn’t need sorting.

I eventually got a referral through the HV to the local specialist, but there was a bit of a wait. I actually paid to go privately and because the consultant was local he came to my home, checked it, confirmed it and sorted it all out. He wouldn’t have done the procedure if not necessary. I was confident using him as he was who I would have seen in the nhs. Maybe do some investigation rather than going to a generic company?

I'm sorry OP but you've come on here to ask for opinions & the majority agree that whilst your DSis Husband is being a dick about nights, he isn't being unreasonable in waiting to get a professional opinion on the tongue tie.

As stated by many people, tongue ties are routinely missed as most HCP will be looking for the incredibly obvious tie to the front of the tongue.
DH had a tongue tie till he was 10. When DD was born we specifically asked for it to be checked due to the increased possibility of her having one. Was assured by several midwives & HCPs in hospital that there wasn't one. Upon discharge one midwife suggested we could go & see the lactation specialist if we we're concerned. When we got to the first midwife home visit & DD had lost over 10% of her birth weight we were referred to the lactation midwife & low & behold DD did have a tongue tie. She cut it there & then.
Fast forward a few weeks, horrendous problems with feeding, settling etc & went to see another lactation expert who found the tongue tie had reconnected so I had to take her to a hospital miles away to get it recut. Thankfully it didn't regrow again.

If your DSis Husband needs that validation of an expert opinion why not get it? As long as they can afford it, the appointment won't be an ordeal for the baby. & then one way or another they have their answer. Either there's no tongue tie & he doesn't have any reason not to pitch in at night; or there is a tongue tie, it's dealt with if necessary & again he has no reason not to help. Seems a no brained to me 🤷‍♀️

I worked as a BreastFeeding counsellor for 6 years and I referred many babies to have a tongue tie looked at. Not once did I hear of a baby where they had been suggested to do it if it was not severe. In fact, quite the opposite Private referrals would err on the side of caution. I more than once had a parent say on returning the private consultant had suggested they see if the baby would grow out of it as it was not severe enough to be done right now.

If he is concerned (even if it is to fix a non-fixable issue) I would take the child. If there genuinely is no tongue tie. Then even a private one won't suggest a snip to be done. Like many here I have had many examples of HCP who claimed no tongue tie when one was present especially with the posterior ones.

OK, thanks everyone. I think it's clear on balance that my Dsis (and I... It doesn't take a genius to work out that I'm on my her side on this one ) is the one being unreasonable here.

It's reassuring that a lot of you say that there's no chance they'll cut a tie if there's no need for it to be cut. Thank you.

DS also had a missed tongue tie, finally picked up by his dentist when he was about 6. I then took him to see a private consultant who confirmed he did have one.

He was a nightmare feeder, in fact we were kept in hospital for 5 days because he simply couldn’t latch. I asked multiple HC workers including the doctor who did his newborn checks, as I was convinced that was the issue. They all dismissed me. They were wrong.

The private consultant advised me to leave it, as by that point, it would mean a general anaesthetic (as opposed to a small snip if it had been picked up as a baby). He said it might become an issue when he starts kissing girls (!), if it did, to get it corrected then.

I’d get it checked out by an expert, personally and not rely on HC workers.

To the people saying you won't get a tongue tie procedure if the tongue tie doesn't exist, everyone has a lingual frenum with different levels of attachment. You can quite easily snip a frenum that would never have caused any problems. Of course you can have an unnecessary procedure

I agree that assessment is highly subjective and here in Australia some people are making a whole heap of money out of it.

Everyone’s tongue is attached to their mouth so all have a “tie” to some extent. Whether an anterior attachment is problematic should be done on the basis of a good feeding assessment with a speech pathologist, midwife or lactation consultant.

Because there are so many charlatans making money off it in Australia in private settings - because anyone can look in a baby’s mouth and deem where the baby’s lingual frenum is is wrong - the Australian and NZ Dental association has introduced some guidelines.

They include:

• any baby who has TT procedure needs a dynamic assessment with a speech pathologist, lactation consultant or midwife
• many will self-resolve so shouldn’t be done in a baby in anticipation of future issues ie speech
• no need to do lip-ties in babies, can be reviewed at one year if still present
• no need for “posterior” TT resection (the tongue has to attach somewhere in the mouth)

It’s true it’s usually a straightforward procedure but there are case reports of severe blood loss, infection and some babies become aversive with feeding afterwards.

Everyone here has faith that a clinic won’t do it if the baby doesn’t have one, but anyone can look a mouth a decide that a baby does have one, especially when the “symptoms” include poor sleep and being unsettled. Every single baby has their tongue attached to their mouth somewhere which means that charlatan clinics can look in a mouth, declare an issue has been “missed” and can make money off any parent.

Ababy who can latch onto a bottle and is feeding well doesn’t meet the Aus/NZ criteria for snipping and it doesn’t seem like the NHS staff were worried either.

Be interesting to see the stats for the clinic your sister’s DH wants to go to - do any babies not get the procedure done?

If it's not broken, don't fix it.

There is an old saying: if all you have is a hammer, everything looks like a nail. Tongue tie clinics tend to say that just about every baby they see has a tongue tie. Some of them do...others, not so much.

If you look in the mirror and lift up your tongue you’ll see your lingual frenum. Everyone has one. Ascertaining whether its “tied” should include a dynamic assessment with an infant feeding expert (speech, lactation consultant, midwife).

Well my midwife, gp, and a breastfeeding consultant all said my ds2 didn't have a tie. I insisted on a referral. The maxilo facial consultant took literally a three second look in ds's mouth and said "That's a pretty severe tie, at least 75% sealed" and snipped it there and then. I'd never once fed without pain until that day, 3 weeks old, and once feeding him about ten minutes after the snip, it was miraculous.

There's no harm in getting it investigated.

DDs tongue tie was missed by several professionals, eventually one said her tongue was tied but it was tiny and it wouldn't affect feeding. Finally saw a specialist after pushing and she said her tongue was 60% restricted and it would have caused ongoing problems if it was left. She was snipped at 11 weeks and it was the best thing we did, it transformed our lives! I just felt guilty that I hadn't pushed earlier before breast-feeding failed altogether.

As others have said if there is no tie then nothing to be snipped.

Ours was an NHS specialist so money didn't come in to it.

4 midwives told me that I was feeding DD just fine, but she wasn't putting on any weight. She was 8lbs 1oz at birth and from leaving hospital to the first midwife visit on day 2 or 3 she had lost 12.4% of her weight (they are only happy with 10%).

We were given a program of breastfeeding, expressing and topping up with formula for a week and this still didn't work.

I was referred to a specialist breastfeeding nurse who instantly saw that DD wasn't latched on properly, because she was tounge tied. from the front and top, the latch looked fine, but her bottom lip was on my nipple as opposed to under it, this was hindering my milk coming in and stopping DD from feeding properly.

The tounge tied was cut there and then, and yes it was horrific, but it was literally 10 seconds. We were given new positions to feed in, but she was so used to feeding in the way that she was used to and I was so desperate to get some weight on her, I decided to put her into the bottle - it broke my heart! 😢

Anyway, what I'm trying to say it's another opinion can't hurt, don't forget that tounge ties can also affect speech in later years.

A note re later treatment - My DS had his tongue tie and his both his gum/lip (don't know the proper name, sorry) sorted at a clinic under local anesthetic at 7. It took about 15 mins and was pretty gruesome (more for us as parents than for him). He wasn't bothered, but then he's fascinated by blood. It really does depend on the child, and how they are with the consultant. There are options.

The only person I would trust to diagnose a tongue tie is an international board certified lactation consultant (IBCLC). Not a midwife/HV/GP/paediatrician. Tongue ties can cause a whole range of symptoms, including colic and reflux. Dividing a tongue tie is very quick and heals quickly and can make a big difference. It would not be possible to diagnose a tongue tie that does not exist. Your sister is being unreasonable.

I had a number of midwives tell me my latch was fine and there was no tongue tie. I asked for a second opinion before discharge and was told - ok there is a slight tie. 2 weeks of agonising breastfeeding and nearly giving up I sought advice from a breastfeeding specialist who told me it was a severe tie, she was surprised id managed to feed and she couldn’t really advise how to make it better as it needed dividing ASAP. We paid privately to do so as I was in pain feeding and baby had colic, reflux signals and wasn’t effectively feeding.
If in doubt there’s no harm in getting baby checked - it’s often missed.

Some links to share with your sister

Helpful info on tongue tie here www.tongue-tie.org.uk/tongue-tie-information/

Directory of registered practitioners here www.tongue-tie.org.uk/find-a-practitioner/

Just to share my experience. I had twin boys, one had a tongue tie (very obvious, I'm a dentist). He was a poor feeder and very unsettled, eventually ended up on ranitidine for acid and off cow's milk for a bit. I got the tongue tie cut. Made no difference, he was just that baby. A lactaction consultant I hired after the event told me he had a tongue tie and suggested I get it released. I explained he had had it released already and his tongue was fine. She actually suggested I take him back ( to one of the best oral surgeons in my city) and ask him to cut it back a bit more! She then diagnosed him with a bubble palate, whatever that is.
Some babies are easy, some aren't. Some lactaction consultants are great, some aren't
.

I’d get it checked, for the father’s peace of mind if nothing else. My grandma noticed I was tongue tied when I was born but the doctors, nurses, health visitors all told my mam she was wrong. She wasn’t. It doesn’t affect my speech, the only issue I have is I can’t stick my tongue out.