Monday, November 3, 2008

To Clip or Not to Clip

The pediatric appointment I had scheduled for tomorrow has been cancelled. Apparently, Nate isn't due for another well baby visit until the ripe old age of 4 months. They said I could still come in if I wished but since we'd probably have to pay out of pocket for an unsubstantiated visit, I decided my concerns about reflux and sleep regimens could wait another few weeks.

I'm not sure if I mentioned it before but we were told way back at his newborn inauguration, Nate has a frenulum. Basically, my baby is tongue-tied. The pediatrician said it was "significant" and we should consider having it clipped by an oral surgeon, but referred us to a lactation consultant for a second opinion. The L.C. seemed to think it was minor and since it wasn't interfering with his breastfeeding (i.e. no pain with latching, gaining weight properly equalling efficient sucking), she saw no need to clip it. She said that while it does cause them to work a bit harder at the breast, this overcompensation allows many babies to work around the frenulum. Some even break the frenulum naturally as a toddler from taking numerous spills and tumbles. Having already succumbed to circumcision, I couldn't bear to put him through more surgery at just one week old. So, I decided to shun the clippers.

DH, however, is second guessing this decision. He feels we should clip to prevent a possible speech impediment in the future. And that it would be best to do the surgery as soon as we can while he is young, able to heal quickly and easily, and unable to remember any pain associated with the event.

It's quite the quandary. I don't want Nate to suffer with unessential surgery, regardless of how simple the procedure may be, but I also don't want him to suffer in childhood should he endure malicious ridicule for having a slur or lisp. I would hate to feel like I put him in harm's way needlessly but I'd also hate to regret not acting sooner on a potential problem.

Tell me: what would you do? I guess I have a few more weeks to arrive at a conclusion so your input would be valuable.

I also now have a few more weeks to get some reading done and arm myself with knowledge regarding my sleep dilemma. They say knowledge is power. In time, we shall see.

11 comments:

Fertilized said...

Only because you asked ... Here is my minimial exposure. My friend bf her baby and was told the same thing. At age 2 she was barely speaking or making noise and was referred to a speech therapist who advised them to clip the problem. A few weeks later she was making lots of words and noises.

BUT you have to do what is best for you ..I am about to have to deal with an infant needing surgery myself and it feels aawful

Erin said...

I am a teacher and last year I had a student with an extreme speech impediment. In talking with the mom she mentioned exactly what you're talking about and she expressed regret that she didn't have it clipped at an early age. This child was very quiet and would often be embarrassed when asked to speak aloud.

I think you should do what is best for your son, though. I could see how it would be hard to put your infant through surgery.

Kathryn said...

regarding the sleep issue: every baby learns to self-soothe at a different age, just like every other milestone. So if Nate can't do it yet, try again in a week. He'll eventually get it, but in the meantime enjoy cuddling with him! Most sleep books don't even recommend taking their advice until 4-6 months anyways.

Re: the frenulum. I've seen it done (I'm a family doc) and it takes less than a minute (as opposed to a circumcision taking 15-20 minutes) and babies recover from it so quickly that it seems easier to do it now than later.

Geohde said...

One of my girls has a tongue-tie. She can get it out of her mouth well enough to yell blue bloody murder and she eats just fine. If it isn't interfering with function I personally wouldn't clip one on a patient of mine's. And I shan't do it to my daughter. :)

J

mo*reezy said...

amalah just posted the other day about having her son's done - she said it wasn't that bad, although of course as a mom she was terrified. Read her post about it and maybe her experience will give you somethings to think about.
http://www.amalah.com/amalah/2008/10/click.html

alison said...

You'll come up with the best thing for Nate, I'm confident of that. But because you asked, if it were me, knowing only what I know, I would probably elect to have the surgery done sooner than later. Yes it's another surgery which may or may not be ultimately necessary, but I think I'd rather deal with a screaming 3 month old than a screaming 3 year old, given the situation. He's young and resilient and he won't remember it right now. But decide what you may, we're all here to support you whatever you choose! :)

Road Blocks and Roller Coasters said...

Because you asked for assvice...I would do it if there is the chance of their being a speech issue. As a teacher of middle school kids, I see the way some of them get teased and its not fun. At all. If this is something that will be relatively easy, doesn't require anesthetic and won't be terrible painful then I there isn't much to lose in doing it.

Good luck with you decision! ((HUGS))

Shelby said...

Since you asked, I'd probably clip it. First, because he's young and won't really remember the pain. If there's any chance it will effect his speech, it's easier to do it now, before he starts trying to form words, and has to relearn to do it properly. It may not be affecting his feeding now, but if he has to overcompensate for it, why not do something to make it easier, so he doesn't have to over compensate? Just my thoughts. And as everyone else said, you really have to do what is best for you. And if your DH is having second thoughts, it might be worth considering it. I've always tried choosing my battles...if his concerns are significant, it's an "easy" fix.

Two Hands said...

http://journals.indexcopernicus.com/fulltxt.php?ICID=13254

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1949218

Maybe see if your pediatric society has anything to say on the issue....

docgrumbles said...

I can'r say what I would do personally, but it seems that if it doesn't interfere with functioning, why clip? Good luck with getting educated and making that difficult decision.

Amanda said...

Well, I'm glad you asked. We have been through this as well. Bryce had the same issue with his frenulum. I was just going to leave it, but when he was 6 weeks old I was at the ENT with Ryan (who has a speech delay, but not because of his frenulum). Bryce had also had failed his newborn hearing screening so I had the ENT look in his ears while I was there. Bryce was crying and the ENT saw he was tongue-tied. He asked me about clipping his frenulum and said he recommends doing it and doing it young so it doesn't interfer with speech.

I agreed, since I know the struggle of a child with a speech delay. The ENT clipped it right there with a big sterile pair of scissors, I nursed Bryce, and that was it. No big deal at all. I could tell a difference in the way Bryce nursed immediately. It was much easier for him. He loves playing with his tongue now. He is able to stick it out now and he wouldn't have been able to do that had we left it alone.

So as a mother of a 6 year old who struggles with a speech delay for no known reason and the mother of a son who has had his frenulum clipped, I would highly recommend doing it now while he is little. Ryan's speech delay is so hard on him and I didn't want Bryce to go through the same thing for something we could take care of now.