FEEDING DIFFICULTY & SPEECH IMPAIRMENT: CHILDREN WITH TONGUE TIE 

´Ankyloglossia commonly known as “tongue-tie,” is a congenital oral anomaly characterized by an abnormally short lingual frenulum and may result in a varying degree of decreased tongue tip mobility.

´in children, it can lead to a range of problems, such as  feeding difficulties, speech impairments, poor oral hygiene, and being embarrassed by peers during childhood and adolescence.

Diagnosis of  Ankyloglossia/Tongue tie 

(Lauren MS, Randolph S, Martin D & Perle F 2007)

  üPhysical characteristics of oral anatomy. A commonly employed criterion was the frenulum being abnormally short and thick, which caused the tongue to become heart-shaped upon protrusion.

  üFunctional impairment, such as an inability to protrude the tongue past the gum line, and other indications of decreased tongue mobility

´All studies used different outcome measures to assess the effectiveness of frenotomy (tongue tie release), including reduce nipple pain during breastfeeding, infant growth, tongue mobility, speech pronunciation,and successful breastfeeding…..

Given the evidence currently available, propose that frenotomy may be viewed as a safe, effective, and practical approach to treatment of breastfeeding difficulties in infants with ankyloglossia in whom alternative explanations for poor feeding and failure to thrive have been properly assessed.

Causes of inadequate intake (Joan C. Arvedson 2006)                   

´Decreased appetite/hunger drive

´Disordered parent child interaction

´Inadequate suck swallow skills

´Learned aversion due to pain or discomfort following feeds

´Tongue tie related issues

´Inadequate suck swallow skills

´Learned aversion due to discomfort/tired following feeds

OUTCOME OF TONGUE-TIE RELEASE PROCEDURE

´Allow full compliance of oral motor function

´Does not mean immediate change of tongue movement, feeding skills & speech production

Other contributing factors : Habbit, retraining, developmental issue