The increasing frequency of "Posterior Tongue Tie" diagnosis

[homemademom]

I know that a lot of us here have dealt with this. From the literature I've read, it's only now being recognized (as in the past 5 years) as a real problem.  With more and more women breastfeeding compared to the past, it stands to reason that it would be recognized as more of a problem now than before. However, I can't believe that it was this prevalent in the past.

Sure, the classic, anterior tongue tie was observed and midwives used to clip them with their fingernails, but since posterior tongue tie is not as easily recognized and because it would normally take more than a quick swipe of the fingernail, I have to think that posterior tongue tie is actually occurring more frequently now than in the past. The alternative would be that more babies died of FTT due to ptt.

What do you think?  Could it be a nutritional deficiency?  Maybe like folate or something else connected to midline abnormalities (for example, cleft palates).  My ds with the posterior tongue tie also has some odd(ish) features like a slight sacral dimple and a thickened line between his scrotum and rectum--all midline issues.  Thoughts?

[OSUvet]

I have not looked at the literature myself yet, but the dentist who clipped my son's posterior tie on Monday (and who claims to have seen/treated around 3000 in his career) said there has definitely been speculation that nutrition during gestation plays some role. I would like to do a little research when I get a chance, but I have a feeling there isnt a whole lot out there.

[Marissamom]

It might also be that before formula there was a knowledge of how to do suck-therapy to deal with the tongue-use issues. I was born with a posterior tongue-tie and was FTT until receiving occupational therapy. now I have close to full movement of my tongue, and it's never been clipped. there are also cases like my DD. the only sign of posterior tongue-tie she had was nipple soreness for me. she gained weight fine until she was about 5 months, then she slowed down until her solids intake increased, but she remained healthy until then. her tongue was never clipped either. so a posterior TT wouldn't always mean FTT.

[homemademom]

Originally Posted by Marissamom 

It might also be that before formula there was a knowledge of how to do suck-therapy to deal with the tongue-use issues. I was born with a posterior tongue-tie and was FTT until receiving occupational therapy. now I have close to full movement of my tongue, and it's never been clipped. there are also cases like my DD. the only sign of posterior tongue-tie she had was nipple soreness for me. she gained weight fine until she was about 5 months, then she slowed down until her solids intake increased, but she remained healthy until then. her tongue was never clipped either. so a posterior TT wouldn't always mean FTT.

That's true, too. Depending on the severity of the tie and/or the mother's supply, a baby with posterior TT could manage to get enough milk.  

[OSUvet]

Originally Posted by homemademom 

That's true, too. Depending on the severity of the tie and/or the mother's supply, a baby with posterior TT could manage to get enough milk.  

Yep, my DS was growing fine but causing some serious nipple trauma.

[bignerpie]

My son has a posterior tongue tie. There was some controversy between the IBCLC at the hospital and our pediatrician about it. The IBCLC wanted me to see an ENT for an evaluation, but the ped said that it wasn't a problem. Her reasoning was that my son could extend his tongue past his gums, which meant it wasn't bad enough to warrant having it cut. She said that cutting it unnecessarily could lead to speech problems. At the time, post c-section and in the hospital, I wasn't able to research it myself, so I went with the ped's recommendation, and we never saw the ENT.

We never had any breastfeeding issues past the initial latch-on. I didn't have any more nipple irritation than what I would consider normal, my supply was more than ample, and he gained weight well. However, when my son sticks out is tongue, he has a pretty large notch in the end. I just hope we made the right decision by not having it cut.

(I was just about to post and remembered something. I had my nipples pierced when I was younger and still have the holes. Milk pretty much poured out of them, so maybe my son didn't need to work very hard to get enough? Maybe if I hadn't been pierced, he could have been FTT? I guess we'll never know.)

[ILoveMyBabyBird]

perhaps pairing the tongue/lip tie with a mom with low supply issues would = FTT babies in that past, but maybe those moms relied on sisters, cousins etc to help feed their babies and they survived and so did the lip tie/tongue tie trait...?

i was taking vitamins well before pregnancy and lots of other supplements. I also know a lot of babies in my family had lip ties, not sure on the tongue ties though, but they were all formula fed, so any issues they had were overlooked. Now here is me with my second, and I have low supply, suspected IGT, ds had to take about 50% formula, he had a lip tie, not sure about a posterior tongue tie, but dd is having more issues, her suck is just not right, it hasn't been really this whole time. When she drinks from a bottle a lot of milk will come out of her mouth, and when she nurses, it is mostly spit coming out of her mouth, she even gags sometimes when nursing and I have low supply, so I am definitely looking into this posterior tongue tie thing a bit more as it is definitely not anterior, but she does have a lip tie.

[ShwarmaQueen]

I have a feeling that it could be a midline defect, as DS also has the sacral dimple and high palate. But I must say that my diet was stellar with and before conceiving DS so I don't see how I could have avoided it in that way.

Also, this is what gets me. In breastfeeding, the tongue also has to be free to raise up to support the breast with the mouth fully opened, which is the big difference between bottle feeding and breastfeeding. If the tongue is posterior tongue tied it might be able to extend out of the mouth (like DS) but not upward where it matters (especially in his case because the roof of his mouth is so high). I find that pediatricians are the worst at diagnosing ptt.

Originally Posted by bignerpie 

My son has a posterior tongue tie. There was some controversy between the IBCLC at the hospital and our pediatrician about it. The IBCLC wanted me to see an ENT for an evaluation, but the ped said that it wasn't a problem. Her reasoning was that my son could extend his tongue past his gums, which meant it wasn't bad enough to warrant having it cut.

[homemademom]

Originally Posted by ShwarmaQueen 

I have a feeling that it could be a midline defect, as DS also has the sacral dimple and high palate. But I must say that my diet was stellar with and before conceiving DS so I don't see how I could have avoided it in that way.

With regard to nutritional deficiencies, i'm thinking more along the lines of one's genetic need for more or less of a nutrient or a genetic ability to utilize or not utilize a particular nutrient. I guess I'm just curious about that part of development and what makes it "happen."  Two of my other babies have high palates and sacral dimples and almost all of them (I just checked!) had a labial tie that tore or stretched (without me ever noticing). None of them had problems bfing and I never had supply problems that I knew of (though one dd was significantly smaller than her sibs, despite being a big newborn, but she was always happy and healthy, so. . .) However, my most recent babe is the only one with the posterior tt and all the problems associated with it. FTR, even though his frenulum looked so slight to those who checked him, he couldn't raise his tongue OR extend it.  Just that small clipping (laser) made his tongue so amazingly mobile. It's very strange! His labial tie was also extremely thick and extended so far down his gumline (imagine his upper lip glued to his gums), that I doubt it would have ever resolved itself.

[ShwarmaQueen]

Well since you mentioned genetics, I must add that I have a high palate and am posterior tt (though my mom switched to bottles very quickly because i was inconsolable ) so maybe it is genetic, or like you said, maybe it's specific nutritional deficiency. Personally, I've poured over every syndrome or medical theory out there, but haven't been convinced that it's any one thing...

DD was fine, no palate/tt issues at all.