"will anyone check this baby for oral restrictions...?"

Disappointed would be a understatement....

My younger sister has just given birth to a beautiful healthy baby girl. 37 weeks, scheduled emergency c-section, a great set of lungs. My job as big sister was to help take care of the baby until my sister was out of surgery.

Tongue and lip ties, tethered oral tissues, it's what I do for a living. I'm a dental practitioner, an 'oral specialist', one of the few Orofacial Myofunctional Therapists in Australia.

My job is to assess oral dysfunction and then to treat it. This requires lots of rehabilitation of underused, poorly toned oral muscles as well as 'calming down' overworked facial muscles. The tongue, lips and cheeks should work in symphony with each other, taking equal shares of the daily burden to eat, swallow, speak, and assist with breathing. Unfortunately in our dysfunctional modern world, this doesn't happen naturally.

The first breastfeed for my niece was awkward. My sister was totally relaxed, the baby was hungry and willing. The midwife assisted the baby to latch but she 'couldn't stay on'. After several attempts the midwife decided 'a different hold might work'. This baby had been out of her mothers womb for less than 45 minutes and was thrown into 'how can we compensate' mode already!! Shocked. The football hold didn't work either, so the midwife started to 'hand express' my sisters breast and gather her colostrum with a syringe.

I had already made my diagnosis. I had checked my nieces mouth as soon as I met her. I knew she had lip and tongue restrictions. I'm the 'oral specialist' in the room watching this chaotic 'first feed take place. Nobody but me has looked inside this baby's mouth.

Why would you not do a 'suck test' and feel that her tongue cannot extend to latch into the nipple? I'm not a lactation consultant or a midwife but I can feel the power of those gums grabbing my finger and can tell that's not a baby who will latch.

So I ask, 'will anybody check this baby for oral restrictions?'. Blank stares all round. Three midwives, two of which just look away and the third tells me, "oh, the paediatrician will do that tomorrow". Tomorrow. Tomorrow?! After a whole sleepless night with a baby who cannot latch and no feeding specialist in sight?

Tomorrow came and the paediatrician said, "there's no ties, she just needs to learn to feed". Confusion starts right here. The SPECIALIST said there's no ties, my sister chose to hear what he said because her baby's health is in his hands. He knows all about babies right? He's a paediatrician, baby doctor, they know everything about babies right? Then there's the midwives, they are all helping my sister, they now have 'a plan' to feed this baby. This is the plan;
1. Express every couple of hours attach a hospital grade breast pump for 10 minutes on each breast, then 5 minutes on each breast.
2. Give the baby 40mls of formula to keep her belly full and so she doesn't get 'too upset' when we try to latch her onto the breast.
3. Give her the 1ml of colostrum that the 30 minutes of being attached to the pump produced, then compensate again with formula.
4. We'll only do this until 'my milk supply gets better', and by then baby should have learnt how to attach to the breast.

If I'm confused by this 'plan', how must my 30 hour old niece feel? What does her little brain make of the 'difficult to attach to the breast', but oh so easy to down 40mls of formula from the bottle, do to her? How do her Orofacial muscles know what to do?

Sucking from a breast and sucking from a bottle require VERY different muscle movements. Sucking from a breast, without oral restrictions, is how the perfect symphony of Orofacial development begins. Sucking from a bottle, COMPENSATING, is how DYSFUNCTION begins.

I'm the oral specialist but I usually only get a say once dysfunction has occurred. People bring their dysfunctional children to me for rehabilitation. Adults come to me for oral rehabilitation. People on the verge of suicide come to me for Orofacial rehabilitation, because THAT muscle dysfunction that began at birth, has impacted their whole life and caused pain in their heads that NOBODY could 'fix' until they came to me.....to US....I'm not the surgeon, the surgeon is another oral specialist, a dentist with a piece of equipment that cost over $100k. A laser that removes a lip tie or a tongue tie in 30 seconds without a drop of blood. A 'surgery' that requires no anaesthetic on a 26 hour old baby. A 'surgery' that ALLOWS that baby to attach uninhibited to the breast so she can suck in a functional manner.
Her palate can now grow to the shape of an unrestricted tongue that can latch freely to her mothers nipple. A lip that can flange to allow the breast to be tightly sealed so that she doesn't gulp air whilst feeding, causing 'reflux' or 'colic'.

Accountable. Who is accountable for the hundreds of thousands of undiagnosed babies that are thrown to COMPENSATION so soon after their births? Why is there no 'oral specialist' involved in this primal instinct to feed? Why do we get baby after baby who is 'failing to thrive'? Who is responsible for the path of muscle dysfunction that occurs at birth?

I'm upset. I'm angry. I'm frustrated. I'm the oral specialist and it's my niece that it's now happening to.

Paediatricians need to be educated in tethered oral tissues. They need to be accountable for this path of dysfunction and the ongoing lifelong effects. They are the 'gods' to these vulnerable young mothers. They need to become oral specialists if they are given this power to change the trajectory of a humans growth, a humans lifelong journey to the path of dysfunction, malocclusion, muscle imbalance, chronic pain.

This is my specialty. This is the reality I see every day and it's become personal now. I see the path my sister will travel because she's been given poor advice from someone, from many professionals, who are not oral specialists.

Postnatal depression, anxiety, the days, weeks and months of grief because nobody identified an oral restriction that could have been released in 30 seconds. I have the right to be mad because I'm the oral specialist but nobody is listening to me.