Suppose a child is born with his tongue attached on the bottom all the way to the end. When the child is three days old and the parents have noticed that he is having difficulty swallowing, the family doctor cuts some of the tissue at the bottom of the tongue releasing the end of the tongue. Would the child have received anesthesia or would he have had to go through all of the pain of the operation? I am asking this; because, I was that child in a small town in North Carolina in 1949.
My 4month old daughter is tounge tied, but not to the extent that you were at birth. When the procedure was explained to us there was no anesthesia involved. They claimed that if done early enough the operation caused minimal pain to the baby.
The procedure is called a frenulectomy and in neonates is probably not going to involve anesthesia.
Wouldn’t they at least apply a topical? (Now. Who knows in 1949.)
The reasoning I always heard for routinely NOT using anesthesia on infants was that the thinking of the time held that the infant wouldn’t consciously remember the pain (which is true, so far as it goes), so there was no reason to incur the added (and not insubstantial) risk of anesthesia as well as the surgery itself.
Now, of course, we know that it isn’t the memory of pain that can cause problems, but the stress hormones, but it’s not entirely fair to blame people for mistakes made in good faith caused by lack of research or knowledge.
Just for curiousity’s sake, why are you wondering about this now?
My daughter had a similar procedure, but with her top lip rather then the tongue. They applied a topical and snipped with surgical scissors. The entire procedure took about two minutes.
Frenulectomy may involve no anesthesia, local numbing gel, or even general anesthesia. It depends on the age of the child, the thickness of the tissue that needs to be cut (thicker tissue is more likely to have nerves in it), and if it appears that stitches will be needed to prevent excessive bleeding.
For most newborns, it’s a simple snip of tissue that’s so thin you can see through it, so general anesthesia is not needed. Many researchers now recommend a local numbing agent, with or without some sugar water, which minimizes the pain felt by infants during painful procedures. This is probably as much for the parent’s comfort as the infant’s.
If you watch it being done, the infant cries while being restrained, even before a cut is made, and then stops pretty much immediately when released from the restraint and cuddled. It’s not so much that it’s painful, it’s that babies hate having their heads held still and fingers and instruments put into their mouths.
The baby can eat immediately afterward, and the aforementioned sugar water or breastmilk soothes them completely most of the time. A little Tylenol may be given if it appears the infant is in pain, but again, this is mostly to reassure the parents.
Adults get their tongues pierced and even split without anesthesia, and those are far more invasive than a frenulectomy.
In 1949, I can pretty much guarantee you were not given anesthetic. We used to think babies couldn’t feel pain at all, and wouldn’t give them anesthetic even for more invasive and painful procedures. We’re better about that now, but frenulectomy isn’t terribly painful most of the time.
ETA: Page 4 of this pdf describes the procedure and anesthetic considerations: http://halavm.co.il/AllSites/400/Assets/tongue%20tie.pdf
Lasciel, I am thinking about it and want to know what I may have experienced with the operation; because, I am writing a book about my childhood: traumas and various forms of abuse.
This sounds, medically, essentially what occurs in a bris, a circumcision of a Jewish baby at eight days.
This doesn’t. Even for an adult bris done for a convert, where a pinprick is given to the area just under the head of the penis, which probably has a name.
Also, regarding calming the fussing infant, I have seen a number of bris’es where the Mohel let the baby suck on his, the Mohel’s, wine-dipped pinky.
Nm
Correction to my bad writing above:
The adult conversion bris pinprick thing (yes, a redundancy in this case) is in the end not the fear-induced peeny-shrinking affair that it sounds like. The anticipatory fear will not end until the microsecond it’s over, but you can hardly feel a thing. I’m a satisfied customer.
My son had a tongue-tie at birth, and it was snipped (actually, one of my daughters had a tie too, but it didn’t seem to bother her, and we kind of didn’t notice till much later)
I don’t recall any sort of anaesthetic being applied. However, it bothered him less than his vaccination jabs. That membrane is very thin in newborns.
I’m pretty sure it would be less traumatic than getting your ears pierced. Which I recall as exceedingly un-traumatic.
I had a frenulectomy of the upper lip 3 years ago. A little topical and it was over before it started. It bled for a couple minutes, then hubby took me to lunch.
The anticipation was way worse then the procedure.
My older daughter had a very extreme tongue tie, which was snipped at 8 days with no anaesthetic. As above, she cried while being held still, stopped once we released her head. I found the procedure more distressing than she seemed to. It wasn’t done early enough to allow her to learn to breast feed, though, although maybe there were other factors at play.
More anecdotally, I was told by one of the health visitors (in the UK a midwife comes to your house to check on you and the new baby daily for the first few days, until they’re happy with everything, then you get ‘signed off’) that ‘in the old days’ a midwife would typically have one slightly long fingernail, and if they spotted a tongue tie in a newborn they would quietly cut it with the nail, without necessarily mentioning it to the parents. Now THAT I find a bit disturbing and, just, eeew. However, I guess it supports the expectation that any associated pain is brief and insignificant.