Breastfeeding the Second Child Part 3: Tongue Tie Clip and Recovery

We left off last post with a confirmation from a specialist that Cricket’s tongue, upper lip, and lower lip were all tied.  We left the specialists office with a referral to an oral surgeon.  He was located in Beverly Hills.  Quite a drive, but if he was really good, it was certainly worth the gas money to me.

First thing Monday morning, I called the oral surgeon.  I expected to have to beg them to get me in quickly enough, but as soon as she heard the words newborn, tongue tie, and nursing, the receptionist said, “How quickly can you get here?”

That’s right.  A Beverly Hills surgeon was willing to see my daughter the very same day!  It was clear that he placed a high priority on helping babies to be able to nurse!

Our appointment was scheduled for 1 PM, so my Sister-in-Law and I packed up the car and Baby Cricket and headed south into LA.

I wasn’t sure what to expect during the appointment.  I was nervous and afraid.  I knew that clipping the ties would help her to nurse effectively. I knew that the pain would be really temporary for her.  But I also knew that the short moment of pain would be really intense for her and I hated the thought of my baby hurting.

The doctor came in and examined her briefly.  He agreed that the tongue and lips were tied.  He explained that he wouldn’t be able to clip much on the tongue without going under the tissue and having to use stitches, something he wasn’t going to do at that time.  He would clip what he could, and we would go from there.

He explained that he would inject a tiny drop of numbing agent into each site.  He said that the clips happen so fast that it really isn’t completely necessary, but everyone feels better knowing that the baby’s mouth is numb.  As an added bonus, the injections generally make the baby cry. “The louder the baby cries, the more open his or her mouth and the more visibility I have to do the clips correctly,” he explained.

He offered to let me sit in another room if I wished saying that some moms feel a little faint during the procedure.  I declined.  I knew my baby would be hurting and scared.  I did not want her to be hurting, scared, and alone.

He prepped for the procedure, we strapped her into her carseat to hold her still, he injected the numbing agent (yep, it made her cry), and in less than 5 minutes he was was finished and handing her over to me.

He said that the most important thing to ensure proper healing was to nurse immediately and then to nurse as often as possible over the next few days.  His nurse showed us to a comfy recliner in a private recovery room and told us to stay as long as we needed.

I could feel a difference in her latch right away.  It didn’t hurt!  In fact, I wondered if she was even latched at all.  I had to look closely to make sure.  I was so used to pain of some sort that the absence of pain was surprising.

She wasn’t too hip to nursing much right then.  She was exhausted from crying, her mouth was numb, and everything just felt weird.  We nursed as much as she was willing to, and then she crashed out into the longest nap ever.  By the evening, she was back to normal.

Since the tongue tie clipping, I’ve noticed a major difference in our nursing.  She seems better able to handle my very strong let-down.  She still breaks suction a lot, but it seems like she’s able to transfer milk better.  She gained 8 oz in 7 days, which is pretty good.  The IBCLC I’m working with things that she breaks suction to try to control the flow of my milk.  Above all, nursing is no longer painful.

So what’s the lesson in this?  Listen to your gut.  If the answer you are getting doesn’t seem right or if the information doesn’t seem complete, keep digging.  You are your own and your children’s best advocate!

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Breastfeeding the Second Child Part 2: Tongue Tied or Not?

When we left off last time, Cricket and I were nursing better, but something still wasn’t working quite right.

The IBCLC I had been working with, was puzzled.  What we were seeing mimicked a tongue tie: the slower growth, the loss of suction, the odd shaping of my nipple after a feed…  But Cricket could very clearly stick her tongue out.  What was going on?

She referred me to the director of breastfeeding medicine at one of our local hospitals: a pediatrician and an IBCLC all rolled into one.  unfortunately, she wouldn’t be able to get me in for another two weeks.  If there was a tongue tie, I needed to get it corrected immediately.

I called her pediatrician back.  Her regular pediatrician was in Africa providing medical care to orphans.  His partner, who happened to also be a lactation specialist, could see us that day.

Again, poor Cricket had to deal with people poking around in her mouth.  And again, we were told that there was no tongue tie.

That night, on my twitter feed, I happened to see some tweets regarding tongue tie that were a part of an #LCchat.  One in particular stood out to me:

http://twitter.com/#!/NurturedChild/status/126850705125425152

This was what was going on!  I tweeted back to @NurturedChild and she sent me this link with pictures of the much more difficult to diagnose posterior tongue tie.  This, especially the cupped tongue when she cried, really helped solidify my belief that we were dealing with a tongue tie.  I just had to find a medical professional who would really listen and take my concerns seriously.

I called my IBCLC back and explained the situation.  She told me that she had previously encountered one other really difficult case like this.  She had referred this case to the breastfeeding medicine doctor who, in turn, referred them to an oral therapist who then referred them to a surgeon to get the tie clipped.

What if we skipped the middle man and went straight to the oral specialist?

That’s exactly what we did. She was able to see us the very next day, which was a Saturday.

This is what she saw:

Posterior tongue tie
Posterior tongue tie
Cupping of tongue as she cries indicating posterior tie
Cupping of tongue as she cries indicating posterior tie

She very quickly agreed that the tongue was certainly tied.  The posterior tie meant that she couldn’t lift the back of her tongue to squeeze milk out of the breast.  Instead of using her entire tongue to nurse, she was using the front of her tongue and her gums to scrape the milk out.

That explains the pain!  It also explains why she was breaking suction.  She couldn’t lift her tongue to maintain suction.  She was having to break suction in order to swallow the milk and control the flow.

But there was more:

Tie on the lower lip
Tie on the lower lip
Tie on the upper lip
Tie on the upper lip

The ties on the lips were also interfering with nursing.

When a baby nurses correctly, her lips should be flared out in almost a trumpet shape.  Cricket couldn’t flare her lips out because of the ties.  This added to the chewing action that she was having to use to get milk.

No wonder I was in pain! No wonder she was struggling to latch and nurse properly!

So what do we do now?

We get the tongue ties clipped, that’s what.

Next Up: Breastfeeding the Second Child Part 3: Tongue Tie Clip and Recovery.

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