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Monday, 28 January 2008

Tongue-tied babies and how they and their breastfeeding mothers can be helped

Breastfeeding: The kindest cut of all

Extracts from the Telegraph:

"Babies who have tongue-tie are born with a very short lingual frenulum, the piece of skin that joins the tongue to the bottom of the mouth. In my son's case, the tip of his tongue was anchored so firmly he couldn't move it at all, even when he cried. It looked extremely painful but I was assured it wasn't.

As the child gets older, this lack of movement can cause problems with speech and eating. In the short term it can cause severe problems with breastfeeding. It did for me. Having breastfed my daughter perfectly happily, I came to dread "the boy with the barbed-wire gums" latching on - or rather, failing to latch on. I got mastitis, he got hungry. We were both miserable."

"Prevailing medical opinion says, as my midwife did, that tongue-tie will usually right itself by the end of the baby's first year as the tongue grows. If the baby still has a problem after that, a paediatric surgeon might consider a frenulotomy - a procedure that divides the frenulum from the base of the mouth. Others will not perform surgery unless the child develops speech problems and has not responded to speech therapy. By that time, the child will require a general anaesthetic for the procedure.

However, some doctors believe in a more pro-active attitude, including Shailesh Patel, consultant paediatric surgeon at King's College Hospital in south London. "My view is that these cases are emergencies," he says. "If someone is referred to me, I try to fit them into my clinic that week. I believe that if a mother has to wait even another week, she will give up breast?feeding because it is too awful to carry on."

Given that Britain has one of the lowest rates of breast-feeding in Europe - only 21 per cent of babies are breastfed until six months, the age recommended by the World Health Organisation - you can see why he's so determined."

"The trouble is that attitudes towards treating tongue-tie appear to be lagging behind those towards breastfeeding. However, Mr Griffiths, something of a pioneer in the field, is optimistic. "Ten years ago, other paediatricians said I was doing dangerous things to babies," he says. "Now some of them are doing divisions themselves. We have done 10,000 procedures with only one case of mild infection and not one baby has had to have treatment for bleeding.

"We're training one lactation consultant every fortnight, from different parts of the country, to carry out division. After all, it's a really simple procedure - a few seconds of work resulting in a happy mother and baby.""

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