Wednesday, 5 February 2020

BABY: Our Experience of a Private Tongue Tie Consultation and Discovery of a High Palette

When it came to breastfeeding my third baby I thought I had enough experience (over 3.5 years in total) to overcome any challenges we may face. This, however, wasn't the case and after talking to various health professionals we decided to go down the private route for support and guidance. The story behind why we ended up looking into having a private tongue tie and breastfeeding consultation is here. It certainly isn't for everyone, as it can be quite expensive, however the waiting time with the NHS was around three weeks and we felt like that was too long for our situation. 
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After deciding to go private I started by searching 'tongue tie specialists' in our area and it quickly became evident that there were a few different specialists to choose from. I am by no means an expert in any of this or have any previous experience, but the key aspects I looked at when researching who to go with were:
  • Checking that they were a registered midwife with the Nursing and Midwifery Council (NMC)
  • If there were a member of the International Lactation Consultants Association and the Association of Tongue Tie Practitioners 
  • Their pricing structure if a tongue tie division is not needed
  • Timings of when appointments can be made
  • Their previous experience 
You obviously want someone qualified and experienced to be looking at your baby, so that you can get the necessary support. We also really wanted to find someone who had appointments at the weekend, so that I didn't have to go by myself with two children. I also found that a lot of practitioners had a pricing structure that provided a reduction if the tongue tie division wasn't needed, which was ideal for us as we weren't sure if Rory needed anything to be done. It is a lot of money to just have the meeting (which are usually an hour), so ensuring you are paying for what you need is really important. 

The Tongue Tie Practitioner we decided to go for had appointments at the weekend, so we could organise childcare for Isabella and Poppy, offered a £50 fee reduction if the division wasn't needed and within the consulation breastfeeding support/advice would be offered too. The consultation was to be around an hour long and would cost £150 with division and £100 without. A lot of practitioners charge between the £150 and £200 mark for this service when you're going private, so it is worth weighing up the pros/cons of waiting for the NHS if you're in the UK or going private. 
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When it came to the day of the appointment we were told to take a swaddle blanket, Rory's Red Book and Calpol for if he needed the division. To begin the consulation I was asked about my breastfeeding history with Isabella and Poppy, then with Rory, whether he'd had the Vitamin K jab at birth, the feeding issues that led us to making the appointment and whether there was any family history of tongue tie on either side. We then lay Rory down on the bed ready for his tongue movement to be assesed, which involved the practitioner putting her gloved finger gently into his mouth to feel his suck, whether he could move his tongue side to side, stick it out and finally take a picture of his lingual frenulum (the tight piece of skin connecting the underside of the tongue to the floor of the mouth). 

After the assessment it became evident that Rory didn't have a tongue tie as previously suspected, however he did have a high palette. Essentially the roof of his mouth is higher than normal, which explained the clicking sounds when feeding as it is more difficult to create a tight suction. It also explained why when we try to give him a bottle (very unsuccessfully) he would gag because his high palette is very sensitive. Although it was reassuring to rule out tongue tie it was hard to hear that the issue causing him all this wind related discomfort isn't something that can be fixed.
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The practitioner gave us some advice on how we can help to make feeding better for him, which were:

  • Try to desensitise the palette gradually by placing a clean finger just inside the roof of your baby's mouth about three times a day. Over weeks work the finger backwards, a little at a time, with the aim of making the palette less sensitive and prone to gagging.
  • Try a range of different teat lengths if you do want to introduce a bottle. We have been trying to give Rory a bottle since he was four weeks old, however despite trying almost every single day he still won't drink from one and often gags when we try to feed him. We have been trying a range of different bottles, but not specifically for the length of teat. A lot of them have longer teats, so next we need to try some shorter ones to see if that helps.
  • Lay back to feed, so that gravity helps create a tighter suction seal. The aim is to try and get as much breast in their mouth as possible, so that the high palette is filled and therefore suction is better, in turn reducing the clicking/air intake. 
We were also warned that having a high palette can cause issues when weaning because of the tendcy to gag, which is helpful to know and expect when the time does come. In the meantime we are going to be doing all of the recommendations and hope that they help in the long run. 

Have you or anyone you know got any experience of a baby with a high palette?

Feel free to leave a comment - I love reading every single one :)

Helen x
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8 comments

  1. I have no experience of a high palette. My son did have a tongue tie though, it was only my Mum pointing it out to the doctor discharging us that it was confirmed... then brushed over.

    I wish I’d gone private as the hospital didn’t see it as enough of an issue to do anything with it!

    It really hampered breastfeeding and even 12 years later that upsets me x

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  2. Sounds like a great idea to go private if you can. Sounds like a good idea if you don't want to wait too long.

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  3. Very helpful and informative. It's always a little sad when forced to go private but on occasion it is the only way to get the support needed or peace of mind.

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  4. No experience of a high palette but my youngest had a tongue tie. He was born in France and when less than 24 hours old was being examined by a peaditrician who asked the nurse for some scissors and without saying anything or explaining anything to me, he'd simply cut the lingual frenulum! I had no say, my baby barely seemed to notice what had happened and it was all over. Obviously a very different approach!

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  5. I have never had any experience but have heard a few stories. I know in some cases it is a quick and simple procedure but I guess it all depends on the severity. Must have been so tough for you when trying to breastfed, can't say I blame you dodging the NHS waiting lists

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  6. It sounds as though you have been given some great advice and steps to take to help the situation. However, it's sad that you had to go Private to get this.

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  7. This sounds really helpful, I have heard of a tongue tie but not a high pallette

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    ReplyDelete

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