Tongue Tie in New Born

One of the requests that mothers make when they visit a doctor is that the base of the tongue be cut because it is tied to the floor of the mouth and therefore the baby will not be able to talk when it grows up. Usually in the village setting the frenulum is cut with a sharp razor ‘to free the tongue from the base of the mouth so that the baby can talk.

Although tongue tie can occur, it is a very rare occurrence and makes it practically difficult for the baby to suck on the breast because the tongue is needed not only to hold the breast firmly but also to swallow effectively. Most of the babies that mothers request this operation to be carried out on are really normal babies feeding well from birth and therefore do not have tongue tie

It should be noted that most children are dumb because they cannot hear. Speech is acquired when a baby naturally tries to mimic what he hears adults around him speak.

The second reason is that the part of the brain that controls speech has been damaged much earlier by conditions like meningitis and jaundice. Cutting the frenulum is not necessary, causes the baby unnecessary discomfort and is a potential route of introducing infection including tetanus.

Mothers should seek medical advice if they feel strongly that the tongue has a problem.

JAUNDICE

Jaundice is the yellow discoloration of the skin and the sclera (the white of the eye) that occurs in some disease conditions. It can occur in all age groups especially in diseases involving the liver. However here we are considering jaundice in the new born. Jaundice occurs in a high proportion of babies within the first week of life. It is usually as a result of the accumulation of the breakdown products of blood in the circulation of the baby.

Under normal conditions the human blood cells are broken down and reproduced every three months. In other words the lifespan of a red blood cell is about 120 days. The product of this breakdown of the blood cell is called bilirubin and has a yellow colour. The liver excretes this product into the intestine and it is passed out in the stool, hence normally the healthy person does not have jaundice.

In the new born baby the liver is not mature enough to handle bilirubin in the first few days of life and it accumulates in the body of the baby making it to have a yellow skin colour. But that is not the major problem; bilirubin when the levels are high enough can enter into the brain causing irreversible damage. Some of the affected babies die while others are left with some handicaps that medical science has no way of reversing or curing. Other causes of jaundice include infections, some blood abnormalities especially in the males, ingestion of some types of drugs, use of camphor balls to store babies and mothers’ clothes and a combination of some types of blood groups.

Some of the mentally subnormal people that beg along our streets, cripples, and handicapped children in our special schools were babies that had jaundice early in life. This means that jaundice should be treated with all seriousness till it is cleared. Jaundiced babies can be treated with exposure to the proper type of light that can clear the jaundice if it is still mild. This is called phototherapy and is carried out in many of our hospitals in Nigeria.

I have seen many babies being treated by exposure to early morning sunlight as a form of treatment. This is NOT advisable and actually endangers the life of the child. A child receiving light treatment (phototherapy) needs to be under the light 24 hours a day except when feeding. This of course cannot be achieved by the use of sunlight.

Babies with more severe jaundice can be treated by exchanging their blood with a donors’ blood in a procedure called Exchange Blood Transfusion. This reduces the level of bilirubin in the baby’s blood and also drastically reducing the likelihood of brain damage. Most babies do well if they present early for treatment. Mothers are advised to see their doctor preferably a paediatrician as soon as they notice the baby has jaundice. This will also help to carry out investigations early enough for the other causes of jaundice and treat accordingly.

Professor Adimora is the medical director of Favoured child Clinic, Enugu. A Consultant Paediatrician with the University of Nigeria Teaching Hospital, Enugu and Senior Lecturer in the department of paediatrics, college of medicine, University of Nigeria Nsukka, Nigeria. A bible teacher. He is also the author of the book 'Anxieties of a young mother'. Author’s website: www.authorsden.com/gilbertadimora E:mail: [email protected] [email protected]