This article is courtesy of Mr. Ng Chee Eng, Paediatric Surgeon of a private hospital in Penang.

TONGUE TIE & NURSING

QUESTION

Mothers of babies with this condition have difficulties in breastfeeding because of sore nipples. This condition is diagnosed by lactation consultant and paediatrician. Currently, are paediatric surgeons still performing the procedure to snip the part of the tongue to enable breastfeeding? What are involves? Does the baby has to go under general anaesthesia (GA)? Other than breastfeeding problems, will the baby have problems with his speech later on?

ANSWER

Whether a tongue tie needs to be released / snipped depends on its severity and whether it is causing any problems.

Latching on to the nipple/breast and breast feeding can be difficult if not impossible with a severe tongue tie. Release is then clearly justified and during the first few weeks of life, it can be done without any anesthesia and without any distress to the baby. However if the membrane (frenulum) that holds the tongue down is thick, then release will need to be under GA because of the risk of bleeding. All older children are done under GA.

Regarding speech, again it depends on the severity of the tongue tie. Some of these children may mispronounce certain syllables. However it must be said that the vast majority of children with tongue ties speak normally. Tongue tie that is detected very early but did not cause any problems like breast feeding, should not be released until he/she is much older, maybe even at 2 to 3 years old. The tip of the tongue does become longer and the underlying membrane / frenulum may recede with the child’s growth. If there is still a speech problem, release is indicated but even then I always caution the parents that the speech may not improve. They are always advised to seek a Speech Therapist’s assessment and advice.

There is also another indication for release of a severe tongue tie even when there are no problems with feeding or speech and that is to allow the tongue greater movement and mobility within the mouth. This is important for purposes of mouth hygiene as they are able to sweep the inside of the mouth of food debris.

The Japanese / Koreans / Chinese – I think what is happening is that the the parents want their children to speak better English by lengthening the children’s tongues. These children have normal tongues to start with. I am very doubful if it works and I will certainly not do it even at the request of the parents.

In summary, release of tongue tie is only justified in severe cases especially if there are difficulties with it. Generally a severe tongue tie is one that the tongue is unable to protrude beyond the lips. In newborns, some of them can’t even protrude beyond the gum margin.

I hope I have answered your queries about this fascinating subject.

Ng C.E.

I remember that as children, we often complained about all the cumbersome things we had to do on our parents’ insistence. For example, the many dos and don’ts related to the Chinese New Year and other celebrations. However, as we grow older, we tend to reminisce about our childhood.

Things that we found insignificant when we were young remain in our memories and give us a sense of joy as we remember all the good times we had with our parents or long-lost friends. Recently, a group of mothers and I had a wonderful time comparing notes on how Chinese New Year was spent when we were children. There were fireworks blasting in the kampung, the gathering of the whole village to prepare Chinese New Year goodies and the elaborate meals dished up by our grandmothers. Each of us felt a certain sense of pride now even though it probably was not that exciting then.

This prompted me to map out a list of things that I wanted to inculcate in my four sons. For a start, they can help in the spring-cleaning prior to Chinese New Year, followed by the preparations for the New Year eve dinner. Though my sons are young, ranging in age from one to 14, I know it is never too early to plant in them the seeds of togetherness.

Over a simple home-cooked dinner, I fire their imaginations, challenging them to think of a future when they have their own families. My squabbling second and third sons were amused when I painted a picture of them as grandfathers, having their reunion dinner with the whole clan, and still bickering like they often do now.

Sometimes it is hard to draw the line between tradition and religious practices. For example, I still hold on dearly to the Qing Ming tradition of clearing the graves, sprucing them up with some new paint and spending a morning with the clan to honour our departed ones.

Being a new Christian convert, I had to find an acceptable way to show respect to our ancestors without burning paper paraphernalia and offering food and wine. I hope my children will faithfully hold on to the tradition of honouring their great-grandparents and grandparents every Qing Ming festival. I would very much like to see them going to every one of their ancestors’ graves, clearing them, placing some flowers there and offering a prayer to God.

Though I may not know many Chinese traditions, I shall treasure the ones my parents handed down to me and pass them on to my sons. One festival which I look forward to is the Chinese Winter Solstice or Dong Zhi Festival which falls on Dec 22.

It is a tradition for Chinese families to mark the occasion by making tang yuen or glutinous rice balls which are served in sweet ginger soup. My children enjoy shaping the coloured dough into marble-sized balls. As this festival falls just a few days before Christmas, it offers a unique blend of Chinese culture and our Christian faith. It is a season of togetherness and being with the family.

I hope every family, irrespective of race or religion, will instil a sense of tradition in their children. Children will grow up and leave the home and maybe even the country but these traditions will cement their roots. As Malaysians we have a myriad of traditional practices. Our open house hospitality, for example, is very much a Malaysian thing. Such traditional practices will also benefit our children and help create a harmonious society.
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The Star Online > Features
Thursday April 22, 2004
Passing on traditions
By CHAN LILIAN

ONE humble egg can evoke many warm memories. Whether it is the fragrant bunga telor which the Malays give to their wedding guests, the colourful Easter egg which signifies a new life or the traditional Chinese red egg that symbolises good luck, the story behind each of them ought to be treasured and passed on to the next generation.

As a child, red eggs were the only food item offered to me on birthdays. Those red eggs were bland, boring and stained my fingers. But my mother never failed to prepare red eggs on every birthday. My two older children who were under her care did not escape the mandatory red eggs on their birthdays.

The eggs bore little significance for me until my mother passed away. That year, my second son celebrated his fourth birthday and the absence of the red eggs was greatly felt. From there, I learnt the importance of tradition – that it is worth preserving because it weaves the memories of our past and blankets us with a sense of belonging and security in the present.

I then decided to instil tradition as part of my children’s upbringing. Though this sounds easy, it involves a lot of patience, some creative storytelling and a great sense of pride. You cannot perform a ritual without making it significant and memorable for the children.

While getting my fingers and palms all stained with the red food dye, I would recall the number of times my children had eaten the red eggs prepared by grandma.

Sadly, this Chinese tradition is dying out. If you ask a group of children to draw pictures of a birthday party, not many will include the red eggs. Instead, you will probably see pizzas, chicken nuggets and other food items that are alien to Chinese culture. It leaves a vaccum in our children’s childhood if there is nothing left for them to relate to the next generation.

When my children invite their school friends for a birthday party at home, the young guests have to eat or take back one mandatory red egg. One day, I hope my children’s friends will remember a certain aunty who forced them to eat red eggs or take one home during her sons’ birthday parties.