Monday 18 November 2019

Tongue tie treatment and Q10

Dr Nina Byrnes
Dr Nina Byrnes

Dr Nina Byrnes

My baby has been diagnosed with tongue tie. I'm not really sure what this is and everyone seems to have a different opinion about what needs to be done about it. Can you explain it?

Tongue tie occurs when the small piece of tissue, the frenulum, that attaches the tongue to the floor of the mouth is short or tight. This can restrict movement of the tongue, potentially making it more difficult for a young baby to feed correctly, or it can affect speech in older children.

Tongue tie is normally picked up by the paediatrician, public health nurse or GP in the first few months of life. Many babies with tongue tie feed fine and have no difficulty latching on to the breast or a bottle. However, for some babies, creating the correct seal can be difficult as the tongue can't protrude or lift correctly. These babies may have difficulty gaining weight or be unsettled.

The mother may notice particularly sore breasts and nipples, reduced milk supply or episodes of mastitis.

In older children, untreated tongue tie may lead to speech difficulties or a lisp. Feeding may remain difficult as they may struggle to push food to the back of the mouth. Oral hygiene may be affected as it is difficult to sweep food debris from the teeth. Activities such as licking ice-cream, playing a wind instrument or kissing may also be difficult.

Tongue tie is thought to occur in 3-10pc of babies. It is more common in boys and can run in some families, but the exact cause is not known.

Treatment of tongue tie is somewhat controversial. Some doctors and nurses recommend treatment straight away, others advise a wait and see approach. If the frenulum is thin, there is a chance that this may stretch or snap itself in time. Thicker frenulums are less likely to resolve themselves.

The UK NICE guidelines in 2006 advised that children who have feeding problems should have release of tongue tie. One study showed that 19 out of 20 mothers, whose children had release and support from a lactation consultant, felt their babies fed better post release versus one out of 20 mothers whose baby just had feeding support.

The procedure to release a tongue tie is called a 'frenulotomy'. In babies younger than eight months, this can be carried out with no anaesthetic or a simple local anaesthetic. In those older than this, the procedure may differ and is carried out under general anaesthetic. During the procedure in young babies, the baby will be swaddled or restrained. The baby's head is held steady while the doctor examines the frenulum and snips it with a sterile scissors. This takes a matter of seconds.

There may be little or no bleeding and the baby can feed again straight away. It may seem like a traumatic procedure, but discomfort is minimal as there are few nerves or blood vessels in the frenulum. Complications are very rare but can include bleeding, infection, or damage to the tongue or salivary glands.

In older children or adults, the procedure is called a 'frenuloplasty'. It involves separating the frenulum, then sealing the resulting wound with dissolvable sutures. There are a number of GPs, dentists and specialists who are happy to perform a frenulotomy.

If your child has tongue tie, talk to your doctor or nurse. If he/she is thriving and feeding well and the tongue can move within the mouth, no treatment may be required. But, if you are concerned, ask to be referred to a doctor with an interest in the procedure.

My baby has been diagnosed with tongue tie. I'm not really sure what this is and everyone seems to have a different opinion about what needs to be done about it. Can you explain it?

 

I am taking cholesterol and  blood pressure tablets. Someone suggested that I try taking  Co-Enzyme Q10 as this may help  reduce my blood pressure and any side effects from my medicine.  Is this safe and what does it do?

Co-Enzyme Q10 is a vitamin-like substance found throughout the body. We consume small amounts in meat and seafood. Our natural levels of Q10 start to decline from our 20s, while poor lifestyle habits, such a smoking, can also cause a decline in Q10 levels.

Co-enzyme Q10 helps produce ATP, a substance that allows the transfer of energy in cells. It has been reported as helpful for many conditions, however, clinical studies backing up its benefits in many of these are lacking.

Co-Enzyme Q10 is likely effective for the treatment of Co-Enzyme Q10 deficiency. This is a rare condition that may cause fatigue,weakness and seizures. It is also likely effective for a group of inherited conditions called mitochondrial disorders.

Co-Enzyme Q10 is possibly effective in several cardiac conditions, including congestive heart failure, high blood pressure, heart attacks, and around the time of bypass surgery. It is not advised that it is used instead of conventional treatments, but rather alongside them.

The substance is also possibly effective in age -related macular degeneration, diabetic nerve damage, preventing migraines, and in some neurological conditions.

More research is needed in its use in asthma, various cancers, gum disease, dry mouth, fatigue, skin ageing, and male infertility, though early studies have been promising in a number of these.

Q10 has the potential to interact with other medicines, but it is considered a safe supplement to take in most cases.

If you are considering taking it, talk to your doctor or pharmacist who can guide you.

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