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PEDIATRIC PROCEDURES (Ankyloglossia)

Newborn Care services offered in Fresno, CA


TONGUE TIE : An abnormal attachment of the membrane that fastens the tongue to the floor of the mouth interfering with normal mobility and function of the tongue. A tight anterior tongue tie  may  appear as a heart shaped tongue when the tongue is elevated. This can result in an inability to get the tongue under the nipple to create a suction to draw out milk. Long term,  tongue ties can cause speech problems and/or issues later with transferring food in the mouth for chewing. Depending on the location the ties can be classified into anterior or posterior ties.

LIP TIE: A tight upper lip frenum attachment may compromise full lip flanging and appear as a tight, tense upper lip during nursing. This can result in a shallow latch during breastfeeding. Additionally, the tight upper lip may trap milk, resulting in constant contact of the milk to the front teeth. This can result in decalcification and dental decay can develop when the milk is not cleaned off of these areas. This same issue can occur with bottle-feeding. If the frenum attaches close to the ridge or into the palate a future diastema (gap between the teeth) can also occur.

Tongue and Lip ties (Ankyloglossia)

SYMPTOMS:

Breastfeeding requires the synchronized coordination of the jaws, tongue and lips and of course mother’s breast.

Depending on the severity  of oral tether, Tongue and Lip ties may or may not be symptomatic:

PHYSICAL SYMPTOMS

Moderate to severe pain when infant attempts to latch

Lipstick shaped nipples after infant latches

Flattened, blistered, cut or bleeding nipples

Plugged ducts

Infected nipples

Engorged or unemptied breasts

Mastitis

Premature self weaning

EMOTIONAL SYMPTOMS

Exhaustion

Frustration due to lack of answers

Lack or decreased infant-mother bonding

Premature weaning due to pain and frustration

Family conflicts and adjustment issues

COMPLICATIONS:

Infants who struggle to achieve a good latch develop a series of major and major complications. Some of these symptoms can also be seen in bottle fed infants:

Short, shallow, ineffective latch

Unsustained latch and nursing episodes

Sliding off the nipple

Prolonged episodes of non-nutritional breastfeeding attempts

Falling asleep while attempting to nurse

Poor weight gain and possibly  failure to thrive

Prolonged and chronic crying episodes

Can only sleep when held upright or in a carrier

Morning congestion and gastroesophageal reflux

Clicking and swallowing air when latched-aerophagia

High arched palate 

Sleep apnea

PROCEDURE AND CONSENT: All infants are assessed, diagnosis confirmed and indication for release confirmed prior to frenulectomy. Risks and benefits are reviewed and  informed consent  obtained from respective parent/guardian. 

All procedures are done by Dr.Anila C.Thampy in our outpatient setting. During treatment on small infants, it may be necessary for your infant to be swaddled or placed in a  protective appliance to control undesirable movements. In most instances, there is a need for Dr.Thampy  to numb the surgical area using a small amount of local anesthetic as a gel or injection .Older infants may require some type of oral premedication, which if needed, will be discussed in advance of the procedure.

The purpose of this procedures is to successfully breastfeed, reduce maternal discomfort  to gain and maintain good oral and reduce health future problems like speech and sleep issues associated with Ankyloglossia

 Treatment modalities:

   Laser assisted release

   Excision

   Electrocautery

Treatment options include surgical release or NO intervention. Parents have options after consultation. Our office performs Tongue tie release only on newborns and Lip tie up to 1 year of age.

COMPLICATIONS:

Bleeding: minimal

Pain: very rarely need a dose of oral OTC analgesic the day of procedure
Infection: extremely rare/none.

We will demonstrate post-procedure exercises for parents to perform on the infant, it is crucial for optimal outcomes.

Dr.Thampy has been successfully performing Frenotomies for 15+ years with great outcomes .Our goal is to provide safe,painless surgical release of Ankyloglossia for infants who absolutely meet criteria. Our goal is successful  breastfeeding  and help to restore anatomy, function, and/or possibly prevent commonly associated future speech,feeding and dentition issues.

COST OF PROCEDURE:

 If we are in network with your insurance carrier we can bill your insurance accordingly.  For out of network and self pay costs please call our office at 558-437-9024 

ACCOMODATION: If you are coming from out of town our office staff can assist with accommodation recommendations

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