Dealing With Tongue-Tie
By Joni Niedert
Kenner LA USA
From: NEW BEGINNINGS, Vol. 13 No. 2, March-April 1996, pp. 41-2
We provide articles from our publications from previous years
for reference for our Leaders and members. Readers are cautioned to
remember that research and medical information change over time.
When I discovered I was
pregnant for the third time, I didn't give much thought to breastfeeding.
I would just care for the baby the way I had taken care of her two older
brothers. I would breastfeed on demand, cuddle, and treat this new member
of our family as the special, delicate gift that she certainly would
be. I did reread my copy of THE WOMANLY ART OF BREASTFEEDING to refresh
my memory about certain things, but after all my experience with Jason
and Matthew, I didn't believe that there was anything I would run into
that I wasn't prepared for. I thought about going to an LLL meeting,
but I couldn't muster up the energy to go.
During my pregnancy, there
was no indication that Lindsay was going to have problems after birth.
But when we were discharged three days later, we had a horrible time.
Lindsay woke up crying, wanting to eat. I tried to nurse her, but it
didn't feel right, and I did not have any let-downs. She had only three
wet diapers, and no messy ones in twenty-four hours. I didn't want to
give her a bottle as I had been told to do, but she kept on crying,
so I did. This went on through the night. By the next morning, I was
crying constantly, feeling like a failure, and did not know what was
wrong.
I called Sarah, the lactation
consultant at the hospital, and she made time to see me. At first, she
thought that Lindsay was just a sleepy baby who wasn't interested in
nursing unless the milk was flowing. I had to work hard, she said, to
keep Lindsay interested. In addition, Sarah suspected that Lindsay wasn't
latching on properly, but it wasn't until Lindsay was screaming that
Sarah discovered the major problem. When her mouth was wide open crying,
Sarah could see that Lindsay had a short frenulum. The frenulum is the
membrane that attaches the tongue to the floor of the mouth. A short
frenulum prevents a baby from extending the tongue to grasp and milk
the breast properly. Many refer to this condition as tongue-tie.
Sarah helped me to nurse
Lindsay in her office, using the supplemental nursing system (SNS).
When Lindsay tasted the formula, she started sucking vigorously. I still
did not have a let-down. Halfway through the feeding, I switched sides,
and let Lindsay finish nursing, still using the SNS. Afterwards, Sarah
had me pump my breasts to see how much milk was left. It turns out I
did have mature milk, not colostrum, but my supply was low.
Sarah recommended that I
do several things if I really wanted to breastfeed Lindsay. First, she
recommended that we take Lindsay to our pediatrician for his advice
on her tongue-tie. We went later that same day, but the doctor didn't
feel her condition was severe enough to warrant clipping the frenulum.
Besides, I didn't want Lindsay to go through the pain of having this
operation. I didn't think the situation was as serious as Sarah had
made it sound. Second, I had to use the SNS every time I nursed so that
Lindsay would get enough to eat while I was building up my milk supply.
Third, I had to pump after each nursing. But most importantly, Sarah
said that I must be determined and strong in my belief about how good
breastfeeding is for a baby. She would give me the support, but I had
to do all the work.
I was willing to do a lot
of work, but I didn't know what to do about Lindsay's frenulum. I really
wanted to nurse my baby, but I wasn't sure if I was up to the task.
I was so tired and upset. "What's the big deal if I just give it all
up and bottle-feed her?" I asked myself. I couldn't do it, though. I
wanted the closeness of nursing. I wanted to feel Lindsay's tummy next
to mine as she nuzzled my breast. I wanted to love her through breastfeeding.
My husband, Denny, knew how important nursing was for babies and their
mothers and was willing to help me as much as he possibly could. So,
I gave it a try.
We took an SNS home and a
portable pump. Getting the SNS attached to my breast, and sticking it
in Lindsay's mouth with her latched on properly was a nightmare. Sarah
made it look so easy using the football hold, but Lindsay and I couldn't
get the hang of it. She would become frustrated and start screaming,
then I would become frustrated and start crying.
But finally, after several
tries, we got it right. After feeding Lindsay, I had to rinse out the
SNS and get the pump together to pump for twenty minutes on each side.
I stored what breast milk I expressed to put in the SNS for the next
feeding so Lindsay would get less formula. I did end up with sore nipples,
as Lindsay was not sucking correctly.
I called Sarah every day
and received support from her. I did everything that she told me to
do, except get Lindsay's frenulum clipped. After ten days, I could no
longer go on. I either had to get Lindsay's frenulum clipped, or give
up breastfeeding. I contacted Sarah, and she referred me to an ear,
nose, and throat doctor who could do the procedure. I made an appointment
for the next day.
First, the doctor anesthetized
Lindsay's tongue, which she didn't like at all. Then he left to see
other patients while the medicine took effect. Lindsay wanted to nurse,
but couldn't because she couldn't feel anything. She had this puzzled
look on her face every time she tried to latch on. The procedure didn't
take very long, and there wasn't much blood. Lindsay went to sleep afterwards
and didn't wake up for three hours.
I called Sarah when we got
home. She was very supportive and understanding of my feelings. Sarah
said that a lot of babies can nurse properly right after surgery and
that many mothers' sore nipples go away soon. Lindsay was able to nurse
better, but it took several days for my soreness to go away. I still
had to feed Lindsay supplements and use the breast pump. When I went
to visit Sarah at the hospital a few days later, I told her about the
anesthetic. She was surprised that the doctor had used it. She said
that most of the time, doctors don't use anesthetic for this procedure.
When she looked into Lindsay's mouth, she said that the doctor had made
a very deep cut.
The following week, I discontinued
using the SNS. Lindsay did fine. I continued to pump my breasts to build
up my milk supply. A week after that, I stopped pumping. I monitored
her wet and dirty diapers closely, and while she didn't have many wet
diapers at night, Lindsay was finally gaining the weight that her pediatrician
wanted her to. Lindsay had only gained two ounces per week for the first
three weeks. After I had her frenulum clipped and it healed, she gained
ten ounces in the fourth week. We were finally a nursing couple.
I started attending La Leche League meetings when Lindsay was two
months old. The support and encouragement that I received from the meetings
helped to keep me nursing throughout Lindsay's baby- and toddlerhood.
Editor's Note:
Incidence of tongue-tie is rare. Sore nipples are more often related
to improper positioning at the breast or incorrect latch-on. For help
with either of these situations, contact your local LLL Leader.
Last updated 11/12/06 by jlm.
Page last edited Sun Oct 14 09:30:47 UTC 2007.
