Breastfeeding 101: Tongue Ties

Disclosure- I am not a medial professional, a nurse, a lactation consultant, etc. I’m a mother who struggled with breastfeeding and tried everything in my power to make it work and I want to share what happened, what came up, and how I got the right help.

Tongue ties? Lip ties? Check out my other post about Lip Ties here.

Do you have breasts? A baby? Are you trying to breastfeed? Is it going smoothly without hiccups (pun intended)? Or have you hit a few snags? I know I did! I have breasts (in case you didn’t notice), I had a brand new, wrinkly newborn, and we were attempting to breastfeed– ok we were more than attempting– we were knee deep in trench-warfare-style breastfeeding and I had the bloody nipples to show for it. *I just love saying “bloody”, makes me feel british!

Our Experience

Anywho…it wasn’t going so hot and I’m sure some of you have been in the same boat. I don’t want to say I was fortunate, but in a way I was lucky to have a pretty clear idea of what the big issues were, my daughter was born with an adorable, heart-shaped tongue. When they handed her to me, I could see it clear as day. Her tongue was attached to the bottom of her mouth all the way down to the tip and when she cried the edges of her tongue would lift up and make a sweet little heart. I thought, Hmm…that’s not normal. What do we do about that? The doctors and nurses could see it clear as I could and they all seemed to think it wasn’t a problem. I had a sneaking suspicion they might be wrong. I mean…my mom is a speech and language pathologist and my dad is a periodontist. I knew that tongue would cause issues. I just didn’t think about breastfeeding.

Until we actually started nursing regularly. When you have a newborn that’s only a few days old they sleep a lot! Like all the time. So it took me a while to realize how hard this whole things was going to be. I should also note that Boba was born using 2 sets of forceps. She got mighty stuck and we had to transfer from the cozy home birth we planned to Vanderbilt to get that little bean out! So her head was super sore and I had a rather harsh nurse grabbing my daughter’s poor head and smooshing my sore, tender breasts into her mouth like a hamburger. Eventually I told her to hit the road because my baby was wailing so hard and I was about to join her. Have you been there mama? Shesh…sometimes those well meaning nurses and lactation consultants need some courses in bedside manner. New mamas and babies are sore, tired, kind of in shock, and very vulnerable. BE GENTLE DAMN IT! Ahem…

Obviously, I had wanted a quiet birth at home so I wanted out of the hospital as soon as they would release me. I think I was only in for less than 24 hours. Them: Pee diaper? Vitals? Ok…I guess we can let you go… Me: GREAT! See ya!

Then we were home. Mommy. Daddy. Baby. Grandma. All of us finally settling in with this new addition to our family. Then came the hard part. Healing. Breastfeeding. Pediatrician visits. Lactation Consultants. Chiropractors. Craniosacral therapists. Aye! It makes me tired just remembering it. No wonder I didn’t blog about this until I could have a healthy amount of distance from it. That time was tough and beautiful (brutiful, like I’ve said before). By the end of the first week home I had blisters, scabs, and a hungry baby! I was also fortunate that Boba was a very interested nurser. She was determined and sucked with her awkward latch as hard as she could. Yes, it caused major injury for me but at least she got some milk and it allowed my supply to come in and kept her from losing too much weight.

One thing I know I did right, I took an awesome birth class with an amazing lactation consultant/advanced practice nurse and home-birth-loving, mama of 4! She’s like the wonder woman for mommies. Her name, Kate Cropp, APRN, IBCLC, MSN and if you live near Nashville, TN- you have her on speed dial and you go to her! Like the day after your baby is born. I mean it. Do it. It will save you! Believe me. *Steps down off my soapbox.*

Notice how I took a birth class to prepare for several weeks for the labor and delivery but never took a breastfeeding course? Yeah. I read a book…which is more than some do but still I was NOT prepared! Take a class. Take a few breastfeeding classes and find a few good lactation consultants and have them ready and waiting for you. Best piece of advice all post.

I went to Kate right away, like a few days after Boba was born. Luckily I had already had Boba adjusted by an amazing Chiropractor that works magic with pregnant ladies (I had seen her throughout my pregnancy) and babies (she came to my house the day after we got home!!!). Her name, Dr. Kristen Walkerwicz, DC, FICPA, and she’s also incredible to have on speed dial. I truly believe that all babies (not just ones who have a difficult birth) need adjustments. It helps with sooooo many issues like gas, bloating, reflux, pain, nursing/latch issues, nursing positioning, sleep, etc! Mommies, you go too! It helps with EVERYTHING (too much to list, right??)!

Kate checked us out, helped me with positioning, made sure Boba was taking in milk by weighing her before and after feedings, and was a huge Mary Poppins-bag-of-info! Thank you, Universe, for women like her. She easily diagnosed Boba’s tongue tie and lip tie and recommended we try and revise it. We went to a pediatrician close by to have it clipped first. They numb it topically and clip to tissue using sterile scissors. The whole procedure is done in a regular pediatric office and lasts less than 5 minutes.

**BIG FAT NOTE: Ok…so we lucked out because we surrounded ourselves with very knowledgable people who were very familiar with tongue ties and lip ties but I’ve been on forums and I’ve heard horror stories. There are women who go to countless lactation consultants who tell them everything is fine, meanwhile they have cracked, bloody nipples and a newborn losing too much weight. This can be incredibly heart wrenching and infuriating. I’ve also heard of people going to pediatricians who basically verbally abuse women over this kind of stuff. I’ve even heard of rare cases were babies have been taken into protective custody over nursing issues and losing weight. I don’t say all this to frighten you but it can be hard to find helpful people and get the help you need QUICKLY. There is a timeline here because we all know our babies need to eat and gain weight, etc. So please, do everything you can to prepare and then don’t stop looking for helpful help until you find it.

We did have issues with many pediatricians who pushed us and told us she didn’t need a revision, that it wasn’t impacting the nursing. Um, really? I had horrible pain, vasospasms and blanching due to compression (painful restriction of blood flow to the nipple due to shallow and incorrect latch), blisters, bleeding, mastitis, plugged ducts, etc. But of course, they knew best. You can feel alone and scared. Keep looking and searching.

After Boba’s tongue tie was clipped we still had issues. To be fair, the pediatrician who did the clipping was very conservative during the procedure and I guess I’m glad she landed on the side of cautious rather than heavy handed but her tongue was not released enough to make much difference. Boba also had a pretty significant lip tie which she said we didn’t need to revise. I DID NOT STOP LOOKING! I knew in my heart that we needed more help and that we had to keep searching. Kate recommended a pediatric dentist in Dayton, OH that was the closest person to us that performed laser revisions on lip ties and tongue ties in babies. HARD TO FIND, let me tell you. We were 6 weeks into our nursing warfare and I was pumping full-time at this point and trying to nurse during the day with a nipple shield to protect further injury to me. Poor Boba was still battling with nursing blisters and we were both battling thrush infections (mouth and nipple) by intravenous antibiotics during delivery. To say I was close to giving up is an understatement. I was beaten, bruised, exhausted, and scared! I had never thought of surgery so early in Boba’s life and I worried that maybe it wasn’t the right decision. I worried that maybe I was pushing this too far and that maybe this was just a sign that we couldn’t nurse. I mean, we gave it a good go, right? Who could blame us for throwing in the towel at this point and turning to formula. If I hadn’t had my own conviction (I am serious stubborn, like Irish-stubborn) and the support of my husband, my mom, Kate, and an active forum of nursing mommies going through the same thing (search FB and online), I would have given up. After a few conversations, my husband and I decided to go forward with the laser revision.

BEST DECISION EVER! We went to Dr. Greg Notestine, DDS in Dayton, OH, the man Kate recommended to us. He got us in within the next week. We drove up there and had it done on the way home from staying with Daddy Bear’s family. Dr. Notestine was amazing. He explained all the issues we’d been having, checked her latch, explained the success of laser revision and what to expect. He explained how the laser works and that lasers are so successful because it’s near painless and cauterizes the wound on contact, easing recovery. They had us swaddle her in one of those velcro swaddles, they put these adorable pink baby goggles on her and I held her on the big patient chair while they swiped under her tongue a few times and under her lip with the laser. It was amazing! Did she cry? Yes! But seriously, I think she cried more from being swaddled, held down and having to wear those glasses than anything else. The whole procedure lasted under a few minutes and I had her out of the swaddle and in my arms immediately. She stopped crying as soon as I held her. Then Dr.Notestine took us into a private conference room where we had her latch on and….I can’t even express how overwhelming that moment was. For the first time, she was able to flange out her upper lip over my breast the way all the books showed a baby latching. She could lift her tongue in full-range of movement right after the procedure and nurse correctly and painlessly! I cried. Like a baby. Holding my baby. I can’t put into words how happy, tired, and overjoyed I was that we had arrived here. The place I knew existed. I pushed through and it worked out and I was just so relieved. Were we done? No. But it was the first BIG step towards lasting success.

10100467166511560
Boba swaddled
10100467166466650
Boba’s goggles
10100467166551480
This is a photo of Boba’s lip tie (her tongue tie was too difficult to photograph)
10100467166606370
Post Revision
10100467166641300
Boba sleeping on the way home after revision!

Next steps…

  • There were exercises we needed to do in order to keep her lip and tongue from reattaching. Many people revise tongue and lip ties and don’t do the exercises for fear of hurting the child or because they don’t believe it’s necessary. IT IS! You have to swipe under the tongue and lip several times a day before nursing, in a firm way, to prevent reattaching. Give baby tylenol is pain is significant. Boba seemed fine and was happy to nurse.
  • We had a few more chiro appointments to help ease her positioning issues and digestion.
  • We saw a craniosacral therapist, Mary Beth Crawford, LMT, here in Nashville, TN who helped tremendously once we had the revisions. I can’t recommend craniosacral enough. It sounds hooky and weird but it just works. She used feather-light touch to help position the plates in her head, the plates in her palette and it just helped so much.
  • We had to work out positioning because at this point I had an oversupply issue. Which doesn’t sound like an issue to most women who struggle with undersupply but it has it’s downsides. Boba literally couldn’t keep up with the let down and supply and would choke and gag if I held her in a cradle hold. We eventually found that side-lying nursing was our only option until she gained more control and got a little better at handling the flow. Try lying down and nursing in a Nordstrom bathroom! Thank God they have chase lounges in there!!
  • Like I said above, we also battled thrush for a few more months after the latch was perfected. So we still had some pain…but nothing compared to what we had before!

It seriously takes a team before and after revisions. It takes a team that you surround yourself with and you will still feel alone sometimes. Was it all worth it? Absolutely. Would I do it again? Do I have to?? Yes, if/when I have another and we were faced with the same issues, yes, I would do it all again. Except this time I know the most direct path to the same end result! I would make an appt with Kate for the day the baby is born, maybe the next day. I would have the baby adjusted by Kristen the day we get home. I would set an appt with Dr. Notestine for only a few days after birth and I would have craniosacral appts set up for directly after revision. DONE. Kinda. You get the idea.

IMG_0723
Boba and I nursing in Ohio!

 

Information About Tongue Ties

Tongue ties and lip ties are very common, more common than most would know. You may even have a tongue tie or lip tie and not know it. Do you have trouble licking ice cream cones? Can you roll your R’s like in Spanish words (perro)? Can you roll your tongue like a taco? Did you have speech issues as a child? Are your front teeth very far apart with tissue between? Did you require orthodontia as a kid? Can you french kiss? These can all be signs.

What to look for when nursing-

  • Lipstick nipple (the nipple will look like the end of a lipstick because of the tongue tied latch)
  • Split/cracked nipples
  • Blisters
  • Bleeding nipples
  • Baby might have puffy, blistered lips
  • Pain and discomfort with nursing (beyond the initial adjustment)
  • Baby is losing weight (note: newborns lose weight after birth, this is normal. It also takes time for milk to come in naturally, this is normal too! But you will know when something isn’t right- get help then- trust your instincts!)
  • A couple weeks in and your supply isn’t coming in or is very low
  • Obvious skin holding down your baby’s tongue
  • Large web like skin all across the back of baby’s tongue (posterior tongue tie) and most difficult to diagnose and under treated

lip blisters

Lip blisters (nursing blisters on baby) Image posted with Dr.Ghaheri‘s permission. He provides lip and tongue revisions in the Oregon area.

Here are some slides from Dr.Larry Kutlow, posted with his permission. He provides laser revisions of lip ties and tongue ties at his pediatric dentistry office in Albany, NY.

Tongue tie classificationspotential-problem-dari-tongue-tie

 


Make sure to keep an eye out for an ebook I’m writing about breastfeeding, my experience, common issues that come up and home remedies, and a long list of resources!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s