Baby on white bed in bedroom

Articol preluat cu acordul Melisei Luca de pe

Grupul de supurt Facebook-Fren lingual, fren labial Romania
“Imi este dificil sa dezbat acest subiect intr-o maniera concisa din cauza tuturor inadvertentelor din propozitia de mai sus. Dar voi incerca sa explic de ce este gresita:
⦁ Un studiu foarte interesant efectuat in Brazilia de catre Martinelli si colegii sai a preluat probe de la copii supusi procedurii de frenectomie linguala si a analizat bucatile de fren la microscop.

S-a descoperit ca acei copii cu fren restrictiv aveau o cantitate semnificativa de celule de colagen tip 1 in interiorul frenului, in timp ce copiii cu fren normal prezentau celule specifice membranei mucoase in loc de colagen.

De ce este acest aspect important?

Pentru ca celulele de colagen tip 1 nu se intind. O analiza histologica separata a celulelor de colagen de tip 1 a relevat faptul ca, colagenul se intinde pana la aproximaiv 3%. Si acesta e nivelul maxim.

Credeti ca o limba care se intinde cu pana la 3% va genera vreo imbunatatire semnificativa? Eu nu cred. Iar asta separa in mod clar copiii in doua grupuri distincte. Copiii cu fren normal au frenul normal nu doar din punct de vedere clinic (pentru ca limba poate efectua miscari corecte) dar si din punct de vedere patologic deoarece frenul lor nu contine colagen.

Frenul lor e practic mai flexibil.

Copiii care sufera de ankyloglosie au frenul limitat prin definitie deoarece contine colagen. Si colagenul respectiv nu se intinde.
⦁ Atunci cand cineva recomanda sa se astepte ca frenul sa se intinda, despre ce timp de asteptare vorbim?

Daca un nou nascut are probleme semnificative cu atasarea la san, cat timp anume ar trebui sa asteptam?

Daca bebelusul in cauza se intarca inainte ca intinderea frenului sa aiba loc?

Sustin cu tarie ca nu exista nicio alta parte a corpului uman de la care sa contam pe intinderea spontana. De ce ar trebui sa aplicam un standard diferit fata de nou nascutii si mamele care sufera de probleme in alaptare?
⦁ De regula, daca ceva se va intinde in cele din urma, nu e frenul cel care se intinde.

Se intinde partea de care este atasat frenul. In cazul unui fren lingual restrictiv pot fi afectate osul sau mandibula, facand ca dintii sa se curbeze spre interior.

In cazul buzei inseamna tensiune asupra osului ceea ce poate cauza o diastema, separand dintii respectivi. In batalia dintre muschi si os, muschiul va castiga intotdeauna si osul va fi afectat intotdeauna. Frenul restrictiv actioneaza ca o parghie ce transmite forta dintre muschi si os.
Nu exista nicio dovada care sa demnostreze ca frenurile restrictive se intind in timp.

Aceasta este pur si simplu o dogma transmisa din generatie in generatie si nu s-a bazat niciodata pe stiinta. Trebuie sa incetam sa transmitem mai departe aceasta dezinformare.
Tradus de Andreea Adela, Consultant in alaptare IBCLC, cu acordul autorului.
Sursa materialului original, in limba engleza:

“That tongue tie will stretch over time, so there’s no need to treat it.”

It’s hard for me to dispute this in a concise fashion because of all the inaccuracies in the statement. But I’ll try to explain why it’s wrong.

1. A wonderful study out of Brazil by Martinelli and colleagues actually took samples from children who had a lingual frenectomy and analyzed the piece of frenulum under the microscope. What they found was that children who had tongue tie had a significant amount of type 1 collagen cells inside the tie whereas children with normal frenula had mucous membrane cells instead of collagen. Why is that important? Well, type 1 collagen cells simply do not stretch. A separate histological analysis of type 1 collagen cells determined that collagen will only stretch by about 3%. And that’s the maximum amount. Do you think that a tongue that stretches by an additional 3% will actually cause any significant improvement? I don’t. So this clearly divides children into two separate groups. Children with a normal frenulum have a normal frenulum not only clinically because they have good movement but also pathologically because their frenulum does not have collagen in it. They are simply more flexible. Children with ankyloglossia have a tethered frenulum by definition because there is collagen there. And that collagen does not stretch.
2. When somebody recommends waiting for a tie to stretch out, what is the timeframe needed? If a newborn is having significant problems latching onto the breast, exactly how long do we wait? What if the baby weans before that stretching happens? I would contend that there is no other part of the human body where we count on stretching to occur spontaneously. Why should we apply a different standard to newborns and moms who are in distress when it comes to breastfeeding?
3. Typically, if something does stretch out, it is not actually the tie that is stretching. What does stretch is what the tie is attached to. For a tongue tie, that means that the bone of the mandible can be affected, causing the teeth to turn in. For the lip, that means tension on the bone which can cause a gap, separating those teeth. In the battle between muscle and bone, muscle will always win and bone will always be affected. The tie simply acts as a rope to transmit the force between the muscle and bone.

There is no evidence to demonstrate that ties will stretch with time. This is simply dogma handed down from generation to generation and it has never been based in science. We need to stop passing along this misinformation.

Contacteaza-ne

Comentarii

comentarii