“Your baby has a tongue tie.” There was a silence in the hospital room as I stared blankly at the pediatrician. After an overnight labor and delivery at 6:29 a.m., I wasn’t sure I had heard correctly. “A what?” I asked.
A tongue tie, she explained to me, is when the frenulum (the membrane that connects the tongue to the floor of the mouth) is short and thick, decreasing the mobility of the tongue. “She might have problems breastfeeding, and it could lead to speech problems later in life,” the doctor said. They could clip the tongue tie easily in the hospital. It was a simple procedure, and the newborns that had it were barely affected. But sometimes babies could stretch their frenulums on their own. She recommended that we wait and see how my daughter did with breastfeeding. So we waited.
At two weeks we were back at the pediatrician for another weight check. My daughter had been nursing well and gaining weight. I had some pain at first, but it had receded. I thought we were in a good place, so I was surprised when our pediatrician told me to stop at the desk on our way out and have them make us an appointment at Children’s Hospital. She wanted them to snip the tongue tie. I made the appointment, and we went to see the specialist. Because we weren’t having any trouble with nursing, the doctor at Children’s again recommended that we wait. Speech could be affected, but the tongue still might stretch itself. “If we did the procedure prophylactically, we’d be doing hundreds of them each week,” she told me. I’m not one to go against a recommendation from an expert. So we waited.
We got off to a slow start with solids. My daughter couldn’t quite seem to figure out how to push the food around with her tongue and swallow, and I was convinced it was because of the tongue tie. Based on fellow blogger Caitlin’s suggestion, I took my daughter to see a chiropractor. At that appointment, I learned that the position of the tongue tie matters a lot in terms of the severity and the treatment. Tongue ties can be posterior, middle, or anterior. The more anterior the tongue tie, the less mobile the tongue will be. My daughter has an anterior tongue tie, and after a number of chiropractic sessions, we were told that she may still need surgery to clip the frenulum. So we waited.
At our nine-month checkup, I mentioned to the pediatrician that I was worried about how the tongue tie was affecting my daughter’s eating solid foods. So we went back to Children’s. At that appointment, we learned that after six weeks of age, the frenulum thickens and is no longer easily snipped. Babies who undergo the procedure have to be put under general anesthesia, which Children’s won’t do until at least age 1, and preferably 18 months. So we waited.
My daughter is now almost 13 months old. She’s doing better with solids but still seems to struggle slightly with finger foods. Imagine eating a handful of popcorn, sticking your tongue out to catch the kernels and draw them into your mouth. My daughter can’t do that well, and handfuls of puffs sometimes fall right back down onto the tray of her high chair. I can see some progress, though, and it does seem as though she is able to stretch her tongue further than she used to. The thought of putting her under anesthesia for even this simple procedure is terrifying to me, and so we will continue to wait. She is just beginning to say words, so it will likely be a year or more before we know if the tongue tie is affecting her speech.
I prefer to avoid medical interventions, if possible. But I can’t help thinking about the stress that could have been avoided if we had just clipped the frenulum in the hospital. I don’t feel I had all of the necessary information at the outset; but even if I had, I’m not sure I would have gone against the initial recommendation. Our pediatrician had a different opinion from the specialist, which left us in an awkward position. We will continue to wait — and to hope my daughter’s tongue will stretch on its own. She loves to stick it out at us. And, given the situation, we encourage it!