TONGUE TIE
There has been a considerable increase in the number of children being diagnosed with Tongue Tie (Ankyloglossia).
Tongue Tie is being blamed for Feeding issues – improper milk transfer, poor flow, early cessation of breastfeeding and failure to thrive of the infant. Cracked nipples and Nipple pain Delayed speech Sleep disturbance It is felt by experts that this is more driven by an increased awareness, social media use and demand from parents rather than an increase in the incidence of Tongue Tie.
WHAT IS A TONGUE TIE?
The lower front free surface of the tongue (responsible for latching on to the nipple and for some speech sounds) is tethered to the floor of the mouth by a tissue called the Frenulum. If the Frenulum is short it prevents the anterior (front) portion of the tongue from moving freely thus causing problems with feeding and speech. Sometimes there may be a ‘Lip Tie’ – the same process happening with the upper lip. Boys get it more often and there may be a family disposition. INDICATION FOR SURGERY FOR TONGUE TIE
Persistent feeding difficulties
Speech impairment
CLINICAL SIGNS : Unable to protrude tongue to the Incisors or lips Unable to raise the tongue to the roof of the mouth because of physical restriction of movement
SURGICAL TREATMENT OF A TONGUE TIE : If it is felt by all concerned – Lactation specialist, speech therapist, Paediatrician and the ENT specialist that the Tongue Tie is severe enough to warrant surgical correction, it can be done in the following ways .
- Below 6 months- simple snip without general anaesthesia. No sutures are placed. Base may be cauterized with a bead of Silver Nitrate.
- Above 6 months – requirement of brief general anaesthesia
For significant Tongue Tie a formal surgical procedure with suturing may be required.
There may be complications of the procedure including bleeding, damage to salivary ducts, aversion to feeding on account of the pain and stiffness.
One aspect of this condition is certain – much more research needs to be done for proper guidelines to be established regarding the condition and its treatment.
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