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Controversial surgery could change the way babies breastfeed

(WDBJ)
Published: Apr. 25, 2017 at 9:05 PM EDT
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PART ONE:

Tongue Ties have been around forever but some doctors do not believe these exist or that these affect breastfeeding.

Becky Maupin has been breastfeeding her son Caleb for almost a year now but it wasn't always easy. Maupin says it was extremely painful because Caleb had trouble latching properly.

"It felt like electricity surged through my body. Every muscle in my body got tense, it hurt literally from my head to my toes. I was sweating because it hurt so badly," explained Maupin.

Maupin said she tried everything her pediatrician and lactation consultant recommended but nothing worked.

“My pediatrician told me that it was not a tongue tie. At the time I didn't know any different so I completely trusted her judgment and believed that was true," Maupin said.

The tissue beneath Caleb’s tongue was too tight and too short, therefore breastfeeding, or any type of feeding, was not successful.

Mandy Irby and her son had a similar story. He not only had a tongue tie, but he also had a lip tie. The tight tissue made it difficult for him to latch.

"I talked to my pediatrician about symptoms, that now I know are associated with tongue tie, and it was never acknowledged that it could be associated with anything in the baby's mouth," Irby said.

Whether bottle feeding or breastfeeding, some of the symptoms associated with tongue and lip tie are low weight gain, or even babies who are far above the average weight. An unsatisfied baby that wants to feed frequently, colic or gassy babies, and reflux.

Moms may also experience pain if breastfeeding. Irby explains what happened to her breast during this time.

"They can bruise, bleed, crack, get yeast which is a burning sensation, redness, rawness, and they can blister."

After several trips to local doctors around the region, both Mandy and Becky had no luck so they went outside the area for help.

Now, there's a dentist from Northern Virginia who packs up and travels to our area to perform these surgeries in Roanoke.

But why is that needed if our area has doctors who say that they too treat tongue and lip ties?

PART TWO:

Two mothers from Roanoke traveled to Northern Virginia for tongue and lip tie surgery on their baby.

WDBJ7 wanted to know why out of town treatment was needed if we have doctors in our area who say they treat tongue and lip ties.

Dr. Brian Gross is an ear nose and throat doctor, or ENT, at LewisGale. He treats both tongue and lip ties in babies but admits it's a controversial procedure. "There are a lot of people out there that don't believe in tongue ties.and there's plenty of literature that has been published that tongue tie doesn't really exist, anterior or posterior, especially posterior tongue tie though," explained Dr. Gross.

Dr. Anita Jeyakumar is a Pediatric ENT with Carilion. She sees parents bring in their babies for ties several times a week. "My heart breaks for my moms. They're beyond exhausted, they're distraught and they're in pain. They're really not experiencing what its like to have a newborn, the good stuff," said Dr. Jeyakumar.

In order to see a specialist like a Pediatric ENT, you usually have to have a referral. But what's a parent to do if their child has a tie but their pediatrician doesn't believe it exist? Dr. Jeyakumar says it's important for parents to educate themselves and do what they feel is best for their child. Dr. Jeyakumar says a referral isn't always needed but it is preferred. "If they want an appointment we try to reach out to the pediatrician," said Dr. Jeyakumar.

We have doctors in our area that treat ties but many parents WDBJ7 spoke to traveled to Maryland, North Carolina, and Northern Virginia for the surgery.

Dr. Lynda Dean-Duru is a Pediatric Dentist with Ashburn Children's Dentistry. Many parents in Southwest and Central Virginia travel to her office in Northern Virginia for help.

But Dr. Dean-Duru also travels to Roanoke every couple of months to set up shot at Pediatric Dental Care of Virginia of Starkey Road. It is here she performs surgery to fix tongue and lip ties on babies.

Becky Maupin's son Caleb received surgery from Dr. Dean-Duru. Maupin explains why she chose this dentist. "Not only were they there to serve me and my family but they were knowledgeable. They were absolutely current on all the research and the latest evidence about tongue ties."

Mandy Irby also used Dr. Dean-Duru for treatment on both of her children. Her first child was treated locally but it did not fix the problem. The third treatment was with Dr. Dean-Duru. "He never threw up again and we were able to clear up the thrush. We successfully breastfed for two and a half years after that," said Irby.

Irby's newborn was actually just treated this week by Dr. Dean-Duru.

But using Dr. Dean-Duru, and some other dentist, most likely means you pay out of pocket for the procedure. Both Irby and Maupin paid several thousand dollars.

Dr. Dean-Duru gives paperwork to the patient to file the claim themselves with their insurance. But the likelihood of getting it covered can be tough.

Here's what Dr. Jeyakumar with Carilion had to say about the insurance coverage. "I bill insurance so there's not a fee to the parents, out of their copay. I think most of the providers who do this locally, bill insurance."

PART THREE:

Over the past several months, WDBJ7 investigated the controversy surrounding tongue ties in babies.

Some believe tongue ties make breastfeeding impossible but others disagree.

WDBJ7 discovered parents in Roanoke were seeking an out of town dentist to treat tongue ties, even though we have local doctors who perform the procedure.

The reason tongue ties are so controversial is because some can be hard to see. A posterior tongue tie is hidden under the mucosal lining.

An anterior tongue tie though is easy to see. That's because it can cause the tongue to appear heart shaped.

Dr. Anita Jeyakumar is a Pediatric Ear Nose and Throat doctor or ENT at Carilion. She says posterior tongue ties tend to be more controversial. "The phenomenon of posterior tongue tie is a relatively new phenomenon in the medical community."

Dr. Brian Gross is an ENT at Lewis Gale. Dr. Gross says some doctors don't believe ties exist or effect the way a baby breastfeeds. "There's just not enough evidence to prove that it’s a problem and prove that intervention helps.”

Controversy on tongue and lip tie surgery also stems from the methods used.

Dr. Lynda Dean-Duru is a Pediatric Dentist with Ashburn Children's Dentistry in Northern Virginia. Every couple months, she travels to Roanoke to Pediatric Dental Care of Virginia to treat tongue and lip ties. "We use lasers instead of scalpels and when you use a laser it's a lot gentler," explained Dean-Duru.

But doctors based in our area do not use this method. Dr. Gross says lasers are expensive. “Most of the literature states there is no advantage of laser over scissors."

“There are lots of methods by which you can release a tongue tie. There's no one right method. The important thing is you need to understand the anatomy of the area," said Dr. Jeyakumar.

If you choose to use laser with Dr. Dean-Duru, or most dentist, expect to pay thousands out of pocket. Many insurance companies do not cover the procedure through a dentist.

Dr. Dean-Duru does provide her patients with all the necessary paperwork to file the claim themselves. But it can be tough. "Insurance companies want to decide how you should treat, it's a big problem for us. We don't want to spend our time fighting with insurance companies versus spending time with the patient.”

Dr. Jeyakumar with Carilion and Dr. Gross with LewisGale bill insurance. “I bill insurance so there's not a fee to the parents, out of their copay,” explained Dr. Jeyakumar.

Local mothers who paid the money out of pocket for laser treatment say it was worth every dollar.

Dr. Jeyakumar was just hired on with Carilion a few months ago and she is the only Pediatric ENT in our entire region. Her team will be expanding this summer.

Dr. Gross with LewisGale does not specialize in pediatrics but treats children with tongue/lip ties often.

The Pediatric Dentist out of Northern Virginia, Dr. Dean-Duru, says she hopes to educate and visit Roanoke as long as her services are needed.

Dr. Anita Jeyakumar, MD MS FACS FAAP

Section Chief Pediatric Otolaryngology

Director, Carilion Clinic Cochlear Implant Program

Virginia Tech Carilion School of Medicine

asjeyakumar@carilionclinic.org

Dr. Brian C Gross, MD, Ear, Nose & Throat (Otolaryngology)

Brian.Gross@HCAHealthcare.com

Dr. Lynda Dean-Duru

Pediatric Dentist

Pediatric Dentistry Specialty Training: Children’s National Medical Center, Washington D.C.

571-252-7077

Tongue Tie Animation Video provided by www.FaquierENT.net