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.

Absolutely get it checked. It might have been missed. A reputable private clinic won't do any unnecessary procedures if the baby doesn't need it.

Hmmmm... interesting second wave of responses.

I know that the procedure itself is usually very straightforward and 'painless' (as said before, my DD had it done when she was a newborn so I know it's not some distressing, barbaric ordeal) but it does still carry some risks (of blood loss, of infection, of mistakes in cutting, of scar tissue that causes more issues than the original tongue tie itself, etc) and, as my sister is very much convinced that there isn't an issue (like I said, the baby is feeding and growing well), she's understandably reluctant to put her baby at risk, even if that risk is very small. Especially as she'd have to travel about an hour to get to the clinic, in lockdown when there's a global pandemic going on. And, I suppose most importantly, she'd only be doing it to 'tick the box' that her DH so desperately wants to tick. I 100% understand her reservations, given all of this.

And, whilst lots of you have been very reassuring that the private clinic wouldn't suggest a division if none were needed, a few (@nolongersuprised in particular) have said that it's perfectly possible for a non-problem causing frenulum to be cut unnecessarily. Which is worrying, given my sister's (and mine, and 4 hcps) pretty strongly held belief that there isn't a tongue tie/problem to be fixed.

I suppose that the only solution is to accept that she has to get her DD seen by the private clinic, even if it's just to placate her DH who can't accept that a newborn gonna newborn.

Has anyone done a proper tongue tie assessment like in the video on the link I shared?

Our daughter has been in paediatric care since she was 2, prior to which she had all the usual assessments. Multiple dentistry visits etc..And we have just discovered that she has a tongue tie. It’s obvious (now that we’ve had it pointed out) if they have one...so I’m not sure I understand the disagreement?

I would get it looked at. As a former breastfeeding peer supporter I saw babies that had been assessed by hcps as not having a tt that were severely tied.
Sometimes symptoms signed off as what this baby has can be relieved by a tt cut.

Especially as she'd have to travel about an hour to get to the clinic, in lockdown when there's a global pandemic going on.

Would she have to do anything? Could she just say, OK then, and leave the ball in his court. Chances are he’s be far too lazy to do take the baby himself.

DS1 had TT that went undiagnosed until he was 6. His was a posterior tie which was not obvious from looking in his mouth. He also had a high palate. The two often go together.

He had no end of problems. In short, it was affecting his ability to eat, breathe and sleep which are the basic requirements for good health.

Releasing his tongue and some early orthodontics sorted every single ongoing health problem he had.

If I had known about tongue tie when he was a newborn, as well as the long term problems it can cause, I would have been getting him checked out by a specialist pronto.

It has to be someone who has a specialist interest in tongue ties.

And also, depending on the type of tie, it is often not the instant fix that people hope it is going to be.

The baby will be compensating for the restrictions in tongue movement any way it can. It may take a bit of time for them to adjust to doing the optimum movement

So after having a TT baby there are several things I would say for the argument

1: It is very difficult unless a specialist to identify a posterior TT it's very often that this is missed by many HCP

2: Baby is bottle fed so currently not a issue but TT can cause weaning issues and further down the road speech issues. My son had a TT and reattachment he struggled moving food around his mouth

3: It is much much easier to sort early on then later (requires GA surgery after around 6 months). As other PP have said a clinic won't cut for the sake of it. So actually it's a lot better to get checked now then to wait

I'm in the USA - where medicine is for profit and it feels as though procedures are often recommended unnecessarily because why not - the patient is paying.

When my DD was born the lactation consultant came around just hours after the birth and recommended that her frenulum was snipped in case of any tongue tie problem. No sign of any problem at that point. I refused and was made to feel really guilty about it - this was all just on the evidence of a visible frenulum - at the time my Mum, Dad and I all examined our visible frendulum in the mirror and couldn't see why DDs was any different.

She has always been fine. Breast fed like a champ - very strong sucking technique and was actually feeding like that during the visit from the lactation consultant.

Now at 10 years old she has as full a movement of her tongue as anyone.

It would have been a totally unnecessary procedure. And from the shocked reaction of the lactation consultant when I refused, one that most other parents must just agree to.

I was told my baby wouldn't feed properly, would never be able to lick an ice cream, would have speech issues. It was horrible.

I wouldn't assume a private clinic wouldn't recommend it just because they can.

Having had 2 kids with tongue-tie, I would definitely get it checked. And I would get it divided whether it was affecting feeding or not. I'm not convinced by the idea that it doesn't affect speech. And there's a chance it could affect solid food. Far easier to get it solved at an early age.

My DD tongue tie was missed by by doctors and midwives. It was picked up by a trainee midwife when she was readmitted to hospital after losing too much weight because of trouble feeding.

@mawbroon - that saddens me to hear this, although I’m pleased your child’s issue was spotted when it was. Our child’s issue was not picked up until she was 11...and now faces not just tongue surgery, but major jaw surgery. She’s had a lifetime of related issues - feeding problems, choking on her food as a baby, breathing problems from her tongue blocking her airway in her sleep, speech problems which are still an issue, major orthodontic issues caused by her jaw not being able to develop as it should have. To say I’m angry that not one HCP or doctor or dentist..spotted what should have been obvious - is an understatement. It was a private orthodontist who spotted it in the end; and he was the 3rd one we had seen. Just lifted her tongue and went...Ah. I expected that....

I was told over and over again by HCPs that DS definitely didn't have TT. He did and ended up having years of waking, was a nightmare to wean into solids and had to have several courses of speech therapy.

Wish I'd had it investigated properly by a Tongue Tie Practitioner instead of trusting the HCPs who obviously couldn't have spotted a TT if it was staring them in the face.

No harm checking everything thoroughly. Both my DC had an upper lip tie which was totally missed, both had a horrendous time feeding and sleeping, I'd and DC1 had been checked over by feeding specialists, allergy doctors etc etc. Nobody ever noticed. I had no clue until my eldest was around 18 months and suddenly pointing at his mouth showing me it was sore, and it was a tiny piece of dangling skin and a bit of blood where it had pulled and broken. He's fine now, but I wish I'd known when we struggled all those months.

Tongue ties are very frequently missed by HCP including registrars. I speak from bitter personal experience. It is something to do with the level of tongue tie that Drs seem to pick up on being ones which would impact speech whereas a lesser tie can impact feeding and Drs don’t routinely pick up on those. Even through the clinic is private they will still have to comply with ethical standards so I’m not sure that private necessarily equates to them being willing to perform an unnecessary medical procedure on an infant I’d have it checked and then it’s something which can be ruled out

1. He's being a dick to refuse to care for his child because he has a disagreement with her mother about medical care. He's basically having a tantrum that comes with a mightily convenient side order of extra sleep for him.
2. Both parents are trying to do what's best for their child and protect her from harm and this is just a case of a reasonable difference in opinion. However, my two cents on the subject is that just because it's a private clinic doesn't mean that the people operating it don't still have to abide by an ethical medical code, so it's less likely that they'll just snip away at something that isn't there and risk doing harm for the sake of it.

Also, from a personal perspective, my son's quite severe tongue tie was missed my the hospital and several GPs because he was a champion eater and gaining weight excellently until he was just over 2 months old before he started to struggle. Whether it just presented itself as his mouth grew or his appetite finally overtook pure suction power, I don't know! But he started to really struggle to feed on the breast at which point our HCP took a look and saw it. The nurse we then went to to get it investigated and snipped couldn't believe he'd actually been able to feed with it at all. So worth a look, from my point of view!

@cabingirl It's not like that here in the UK. US and UK medicine is incomparable. Mostly the private doctors here work for the NHS too or have retired from it, they're held to the same standards. They do not perform unnecessary medical procedures on infants for profit! It goes against every ethical standard that they're held to. If they did this they'd be struck off. They'd charge you for the consultation, certainly.

I'm sorry that happened to you. I'm frequently shocked by stories I hear coming out of the US about how medicine works over there!

I think her DH is being a bit ridiculous, they’ve been told there’s no TT, does he think if she does and it’s fixed she’ll
miraculously sleep 12 hours a night?
Tbf he sounds like a bit of a selfish twat, the baby is 11 weeks old there’s no magic fox to have long quiet nights and refusing to help out, I’m not sure I could put up with him.

I'd get it checked. Most clinics are a basic fee to be seen and have a chat about feeding if you need help, and an extra fee if anything needs to be done. Your OP implies that he'll get babies tongue cut no matter what, that's not how it works. If no tongue tie, nothing to cut.

Tongue tie can also affect speech as it restricts movement. Some research that it affects digestion too (something about tongue movement triggering digestive process, but I'm not sure I could find it now).

DS had tongue tie. It was incredibly painful. It was also missed by the postnatal staff who I explicitly asked to check. We spent a week in pain until I found a private practitioner to help me. A different midwife did later confirm that he had it but told me the waiting list for a division was a month long, so I went ahead privately.

I think dad sees the baby as a problem to be solved rather than a high needs baby to be managed and coped with.

My DS a severe tongue tie which was not initially picked up. He has it separated at 2 weeks old and feeding really improved. I have an untreated tongue tie and I really wish it had sorted when I was a baby as I still find it hard to move my tongue for dental exams. If there’s no tongue tie they won’t be anything to separate so makes sense to get it checked out. It only takes a second and baby it handed to you for a feed immediately.

I too thought tongue tie was only an issue for breastfed babies? I remember the newborn days well. I felt panicked about sleep and ended up doing loads of research / buying unnecessary things! My son did have severe tongue tie which we addressed (struggled to BF baby, medical professionals all agreed he had tongue tie). However, in your sister's case, it sounds more like the husband has just read something online about tongue tie and has convinced himself it's a cure all. Which it isn't if medical professionals say baby don't agree, and if baby is thriving on the bottle.
Not cool that husband won't help until he gets his own way. Not a good start with baby IMO.
YANBU. It sounds as if baby is doing well. Besides, sleepless nights at 11 weeks are completely normal.

When you say get in investigated, it is just a matter of looking. It takes 2 seconds. If there is no tongue tie, there is no procedure.

@Bopping298 my son never had a problem feeding, but he was bottle fed. We didn't discover the tongue tie until much later (at 7). But it was a necessary procedure because it was really affecting his speech (all Rs were Wahs). Took years to relearn how to talk properly.