Tongue tie release

Another backdated post about breastfeeding - I am writing this on 4/30/14.  This is the story of a major turning point in breastfeeding, when Eden was diagnosed and treated for posterior tongue tie.




So, as of over a month after Eden was born I had managed to exclusively breastfeed her (no supplementing after we got home from the hospital), but I was in absolute agony.  I suspected her latch wasn't very good -often it looked "shallow," and pain while breastfeeding is a typical sign of a poor latch.

You see, they tell you at the beginning to position correctly and not let the baby latch poorly, to take the baby off boob if you see she's not on right.  I say to that, COME ON.  It was so difficult and time-consuming and traumatic to get her to latch at all, there was absolutely no way I was kicking her off once she did so.  I just hoped she'd learn to latch better over time.  They also tell you, don't put baby on the boob until she opens her mouth really wide.  Just wait until she does it, they say.  Again, I scoff at this.  Eden never opened her mouth very wide, and sitting there waiting for her to do it was entirely futile, I assure you.

With all the latching issues and pain this many weeks later, we really had to figure something out.  On our visit to Virginia, we visited my mom's lactation consultant friend on her L&D floor where she works as a nurse.  She was the fifth or sixth lactation consultant I had seen (at least three in the hospital and one a few days afterward), so I was somewhat skeptical that I was going to get any new/helpful information from this visit - but I was desperate.

It was a very pleasant and productive visit.  She gave several pieces of advice that I had never heard before:

-gerber probiotic drops for colic/gas (we ended up using a different probiotic)
-recommended one boob per feeding (ultimately not a good strategy for me because of supply issues)
-nipple shells for pain in between feedings and to keep lanolin off clothes (helpful to some extent but I could never get these to stay in place, and they'd always end up slimy from the lanolin)
-nipple shields for pain during feedings (tried this for the first time during this visit, and it did indeed prevent the pain but felt weird and didn't want her to be reliant on it, so never used this again)
-priming the baby for a deeper latch - one of the problems was that Eden would never open her mouth really wide.  So the LC advised, right before you want her to latch, take your forefinger and thumb and start with these placed on her forehead and chin, and then trace them together meeting at her mouth. Repeat a couple of times, then do the same thing on the sides (thumb and forefinger on her cheeks next to her ears). Finally, take one finger and trace a circle around her mouth.  This tip was fantastic and helped us a lot, and after going to a bunch of breastfeeding support groups later, no one else had ever heard of this idea.

Finally and most importantly, the LC reached into Eden's mouth and told us that she had a posterior tongue tie that could be affecting her latch, and that we should look into having it clipped.  She referred us to a local pediatric ENT that could probably do it within the next couple of days.  The procedure would basically involve snipping the tie with scissors - very simple and allegedly nontraumatic.

I knew about tongue tie before, and the previous lactation consultants had all looked for it but told me she was fine because there was nothing visible and because she had the ability to protrude her tongue outside of her mouth.  None of them had actually FELT for a posterior tongue tie though--and after scouring the internet, I realized that all the symptoms I was having were prototypical for this condition: nipples flattened and pointy like lipsticks after nursing, clicking sounds, pain.  I also learned that posterior tongue tie is even more likely to affect nursing than "regular" tongue tie, even though it is not obvious from a visual examination!
I pondered what to do, but not for very long.  My internet research revealed basically no downside to this procedure, other than the possibility it would not improve nursing.  There is some slight controversy in that in many cases of tongue tie, the primary benefit of clipping it is to lessen the mother's pain (in other words, little or no direct physical benefit to baby).  But as most breastfeeding advocates would say, if the mother is otherwise going to discontinue breastfeeding, then releasing the tongue tie definitely benefits the baby--who would otherwise lose out on the immunities and other benefits of longer breastfeeding.  Plus, it seemed much less traumatic than a circumcision, which I would definitely have done if she had been a boy.

The big decision was really whether to let this local guy do it, or wait several weeks until I could get an appointment with the main guy in Atlanta who does it.  In the amount of pain I was in, this was also not too difficult of a decision.  We decided to at least go in for the consult, see if the pediatric ENT agreed that it should be clipped, and then if we wanted to wait we could keep our appointment with the guy in Atlanta.

Long story short, the ENT also felt the tongue tie, snipped it minutes later, she cried for a few seconds (but no more than during, you know, a change of clothes), bled a teeny bit, and then nursed afterward.

In terms of pain, it wasn't GONE immediately, but there was no sobbing and wailing after that.  And within a few weeks, nursing was no longer something I dreaded.  Several months later, I barely remember what it was like to be in such pain during breastfeeding.  And you know what?  This experience actually inspired two of my friends to get their babies checked out, and they both had tongue and/or lip ties released, and breastfeeding vastly improved for them as well.

One last note - ironic that I live in a major city, one where healthcare is in fact a main industry, and I had to go to my small hometown in order to get my breastfeeding issues resolved!