Any point in clipping posterior tongue tie in 5 month old?

[beckington]

(I'm cross posting this in Breastfeeding and Health and Healing because I would like to look at benefits beyond just breastfeeding - hope that's OK.)

My 5mo son might have a posterior tongue tie. I say might because we've had one 'yes' and one 'no' with the diagnosis. We are seeing an ENT on Tuesday for another opinion. His weight gain has been very slow and we've looked at all sorts of possibilities to improve this but no luck. His latch is shallow and he also has an upper lip tie that could be impacting feeding, but again we don't know for sure. He has never been an efficient nurser and his suck isn't fantastic. I would love to fix this problem, but not sure that at 5 months clipping would  improve things anyhow - would he relearn a new latch at this point? Also, while not ideal and weight is very, very low, he's strong and otherwise healthy and happy, and solids could be coming soon so by adding in high fat/calorie foods we might see more weight gain that way. (Though ideally we go at his pace with solids, so I'd have to be careful I'm not pressuring him with solids to increase his weight gain!)  I'm wondering about other benefits to clipping, or other risks to not clipping? He has pretty good movement of his tongue (which is probably why we haven't got a diagnosis yet - and of course it's possible that he doesn't have tongue tie!!) so I don't think things like licking an ice-cream for him would be difficult when he's older. I worry about speech though - I have a speech impediment and hated speech therapy as a child. I'm not sure he can reach the roof of his mouth, though since he can stick his tongue out pretty far I would think he could. I also wonder if there'd be swallowing problems with food? Does anyone have any experience with this? I'm trying to get a broader picture beyond breastfeeding, though of course opinions on breastfeeding are important too!

My feeling is not to clip at this point - that if he has tongue tie it is mild and while maybe it has impacted his latch enough to cause weight gain issues that we are close enough to solids at this point to muddle through. (I understand about breast milk being the main source of nutrition for the first year though.) I guess what I'm asking is:

1. Do you think a 5mo can improve his latch? Anyone have any experience of this?

2. If you clipped and it didn't help with breastfeeding, are you still happy you did it?

3. What are the other benefits, beyond breastfeeding, to clipping?

(If clipping can only be done under a general we won't do it. Will talk to the ENT on Tuesday to find out how they would do it.)

Thanks so much! :) Sorry for the novel!

[blessedwithboys]

Saw you x-posted...short on time so didn't read every word, sorry...just wanted to say that I had ds1's clipped at 8 mos and again at 9mos and made all the difference in the world for us.

You can't bet on solids...ds grabbed at everything I ate but didn't actually eat much himself until after 12mos.  I'm glad I didn't bet against clipping in favor of solids.

I don't think it's too late to do it now, my vote is to go for it.  We did it in office with no anesthesia and ds was fine after about 30 seconds.

[beckington]

Oh wow that's good to know, thanks! That's a good point about solids. DS1 didn't get into solids much into he was about 9 months old - that's still a long ways to wait. I just don't want to put the little guy through anything unnecessary, you know? Was it a posterior tongue tie?

[Panserbjorne]

YES.  I had my two done at 4 and 6 YEARS and it made a huge difference.  My only regret is not knowing someone who could do it for the older of the two earlier.  That and messing around with scissors for the first two clippings my ds had (at 5 days and again at 4 months?)  I should have just done laser all the way, but again...I wasn't aware of anyone that was doing it.  This was years ago.

[beckington]

Originally Posted by Panserbjorne 

YES.  I had my two done at 4 and 6 YEARS and it made a huge difference.

What kind of difference? What are the issues it was causing?

[Panserbjorne]

Originally Posted by beckington 

My feeling is not to clip at this point - that if he has tongue tie it is mild and while maybe it has impacted his latch enough to cause weight gain issues that we are close enough to solids at this point to muddle through. (I understand about breast milk being the main source of nutrition for the first year though.) I guess what I'm asking is:

1. Do you think a 5mo can improve his latch? Anyone have any experience of this?

2. If you clipped and it didn't help with breastfeeding, are you still happy you did it?

3. What are the other benefits, beyond breastfeeding, to clipping?

(If clipping can only be done under a general we won't do it. Will talk to the ENT on Tuesday to find out how they would do it.)

Thanks so much! :) Sorry for the novel!

I'd not wait.  There is still opportunity for his latch to change, but it will take diligence on your part and I'd personally recommend structural support from a good pediatric chiro or CST.

Our revisions had nothing to do with breastfeeding and I couldn't be happier that we did it.  Neither can dh.

The implications extend far beyond breastfeeding.  Speech, digestion, sinus issues, dental issues, feeding, breathing (sleep apnea) the list really goes on and on. 

There was no general for any of the procedures.  If you haven't read up on the procedure I'd encourage you to do so.  www.kiddsteeth.com has some great information.

Beyond my kids, I've seen more than my fair share of kids pre and post revision in my clinic.  The differences are clear in any age bracket.  I even know adults who have had it done and report significant changes.

[Panserbjorne]

Originally Posted by beckington 

What kind of difference? What are the issues it was causing?

we had no idea the issues it was causing.  Dd was being evaluated for a genetic condition and the doc said that there could be skewed results because of the tongue issue (her diagnosis involves connective tissue) and that there was no way to know what to attribute to the condition and what was a result of the tongue tie (she had maxillary and lingual involvement.)  So, off we went.  She started sleeping better, breathing more deeply, her stance changed, she is no longer hypertonic (as assessed by a licensed practitioner within a few days of the procedure) her enunciation changed, though she never actually had speech problems.  Still, the way she said things changed.  She had a vocal tic that is almost gone since the clipping (she'd constantly clear her throat and make gutteral sounds.  this happened for years and was a daily occurance-sometimes a few times an hour.  this is a big deal.) 

Her changes were largely structural.  Having the structure release allowed for other things.  No one could have predicted how significant it was for us, for her.  A lot of it was subtle, but because she's been followed medically since birth there were very clear records for how things were pre and post revision.

For ds, 4 at the time of the revision (he'd been clipped twice before unsuccessfully) his speech was dramatically affected.  He still goes to speech therapy, but now it actually does something.  He also had significant softening of muscles in his neck and chest as he began to use the correct muscles instead of engaging compensatory mechanisms.  Again, it was a big deal.

I only conceded after I had seen a few years of kids regularly going and coming back with success in a variety of areas.  The one that made me lose hesitation was a 7 year old that had been discharged from speech because he'd made all the progress he could make.  You still couldnt' understand him.  He also couldn't hold his bowels.  At 7 that's traumatic.  Anyway, he got the revision and I saw him the week after.  He could say words he'd never been able to say before and he no longer has accidents.  He had the revision last year.  He's still doing great.  He was a major catalyst.

[beckington]

Wow Panserbjorne those are some major differences! That's amazing! So with the scissors for your son did it just reattach or was not enough clipped? Laser all the way eh? Good to know. Not sure how they do it here, which is why I don't know if they use general or not - have heard lots of different stories online - but we have an appointment with an ENT on Tuesday so should find out the details then. I have looked at kiddsteeth.com before but will look again, thanks so much!

It's so hard to know what the right answer is. Since he seems to have good tongue movement any tie would have to be minor. I hate to cause him any unnecessary pain or put him at unnecessary risk (all procedures carry some risk) but also hate to leave something that could potentially fix his weight gain problem and spare him grief from other issues down the road.

[Panserbjorne]

they can only go so far with scissors before blood clouds the field and they have to stop, so multiple clippings is common.

FWIW Lawrence Kotlow felt the biggest problem for both my kids was the maxillary frenulum (upper) which suprised me. 

[SubliminalDarkness]

YES. I would totally do it. My DS2 was tongue-tied. He was clipped when he was 9 days old, but that only dealt with the tip. Because he also had a posterior tongue-tie, it basically didn't fix anything. He fortunately never had issues with being able to breastfeed, it just hurt me like heck(really, it was bad). He ate solids fine. He had quite a bit of tongue mobility, I think because we continued breastfeeding so it did stretch his tongue.

But then we did have to deal with the tongue-tie. It was affecting his speech. He was intelligible, but it was clearly restricting his ability to enunciate. So this past January, at 4 years old, we had the posterior tongue-tie corrected, along with a mild upper lip-tie since they were already putting him to sleep and clipping the tongue. It has helped his speech tremendously!

Posterior tongue-tie can cause dental problems(generally rotting of the lower teeth because of food and liquid collecting around the tongue) and can cause speech problems. I would correct it sooner rather than later as the procedure is easier when they're small, and they are also less likely to develop speech problems that will later need to be corrected. Right now we're giving DS2 a 'trial' of time to see how much of his speech he corrects himself. So far, it's going well. But we'll see. He may need speech therapy as well. 

I would have gotten the tongue-tie resolved sooner, but I had a hard time finding someone who thought it was a real issue. 

[blessedwithboys]

ds looked like this, pulled from google images:

[blessedwithboys]

pic wont post, hate the new format!

[blessedwithboys]

ok, last try to copy in pics...

[blessedwithboys]

sorry, i cant post in pics, but if you google posterior tongue tie you'll see just what his looked like and also he had the one inside the upper lip, there are pics of one like that.  ds's upper lip busted on its own when he was a toddler and fell and smacked his face on the playground.

[beckington]

Thank you so much for all your replies and stories!! I really appreciate it!! Had the appointment with the ENT today who says no tongue tie but had never even heard of a posterior tongue tie so that doesn't seem very convincing! And they don't separate upper lip ties at all so no go there anyhow. Grrrr. Very, very frustrating. Have a name of a doc in the area that does tongue ties so am going to call them tomorrow to see if they know anything about posterior tongue ties  and if they clip upper ties. If not, I think I will let it go. I'm not even convinced he has a tongue tie and the upper tie may or may not be a problem. For my sanity I can't stay obsessed about this, you know? I'm pumping to supplement and he is starting to grab at my food so maybe solids are close and I can feed him lots of avocado! :)

[SdMadie]

Did you ever get your child's tongue clipped? I just read your story and I am going through the same exact thing. So weight gain, posterior tongue tie. My daughter is 3 months old and we already had her tongue clipped and now they think it's grown back scar tissue and giving her issues again. So now we have to get clipped again. I'm struggling with that since the first time we did it was at 1 month old and it was a week of hell for both of us. Just wondering what ever came of your situation and if you found an alternative way that helped your child gain weight, aside from solid foods. 

I noticed that you posted your issue on the exact day and almost the same exact time my daughter was born, so weird....

Thanks in advance for any advice you can offer. 

[beckington]

Hi SdMadie - no we never got any tie clipped - had so much conflicting info about it and whether or not he had one at all! He's now 8 months old and just starting to gain weight better - for some reason the last month he's been nursing HEAPS better plus I've been adding olive oil, coconut oil, avocados to his foods which I'm sure is helping though he's still eating small amounts. We've gone through a lot of testing for stuff because his weight was so low, way off the charts low, but nothing came up. It's been very stressful. I hope you find a solution quickly as I know how hard this can be! Maybe start a different thread about your particular situation because I know there's a lot of mamas on this board with experience on posterior tt! Good luck!