A Tongue Tied Story

by sarahmfry, February 06, 2013


Christian just got his frenulum clipped!  His fren-u-WHAT?  You say?

Christian tried to nurse when he was in the hospital, and it seemed he might get the hang of it.  But that was back in those early days of colostrum, when all he needed was a teaspoon to fill his MARBLE-SIZED tummy. (Another lactation story for another day. lol)

I think I talked a tiny bit about the possibility of tongue-tied babies with my nurse at the hospital, but at that time it seemed like he was going to figure things out. 

When we got home and his nutrition needs increased,  it became quickly apparent that he was NOT settling into this nursing thing.    But I am fairly committed to the health benefits of breastmilk, so we pressed on...trying and trying to get him to latch. Because of my babies' traditional feeding issues, I have seen many, many lactation consultants and experts.  I have learned a lot of tricks.  I have learned a lot of information that can help understand the nursing/latching/lactating/pumping process.  But even with my determination and information, we usually both ended up crying during feedings. Actually, he screamed.  I usually only cried. : )

Finally, I realized it was time to start the pumping & bottle routine.  It was sad, but it was the right thing to do.  I hoped that he would "grow out" of his feeding issues and get stronger and learn to latch.  I started him on the Avent bottle, and he ate okay.  But he swallowed tons of air.  The screaming began.  Long, frustrating feedings and longer screamings after the feedings.  I quickly switched to the old but expensive friends, Dr. Brown bottles.

They gave IMMEDIATE relief from the worst of the gas-screaming.  But Christian still didn't seem to be an efficient eater.  I had been trained from all of my lactation consultants to listen and watch for the signs of proper or improper feeding.  Things that most nursing mammas never think about. They just stick their kid where he goes and he goes to town!  Not me.  Nursing is not like that for me.  Anyway...back to the signs and noises....He made clicking noises and such - signs of inefficient latching.  Consequently, he was swallowing tank-fulls of air.   And needed to be burped every HALF ounce.  That's a lot of burping, people.  And feedings were LONG and exhausting. And then - after I changed him and calmed him down and topped him off and he finally fell asleep - I had to pump.  Then wash the pumping gear for the next feeding.

  He also spit a lot.  I learned early on in my colic studies the anatomy of a burp...and his burps were milk-stuck-on-top-of-air-pocket burps.  Sometimes the shoot-out-and-cover-you kind.  Lots of laundry.  Lots of fussiness.

But one day when he was screaming (don't know why he was screaming at the time - he's been quite a fussy baby) I noticed that his tongue looked funny.  That string under his tongue (which is called the frenulum) looked white and tight.  His tongue looked short - kindof stuck.  My mom saw it too, and she agreed.  Between the two of us we have nursed 9 babies.  So...maybe we were on to something?

Tongue Tie – Cup shaped tongue when attempting intra-oral elevation.

I talked to a nurse about it at my next WIC appointment.  She agreed.  Waited until Christian's next checkup...Had my pediatrician take a look.  She agreed.  She had to send me to a lactation consultant....waited for an appointment at the hospital....she agreed.  Waited for the pediatrician's office to call me back...they were sending him to an ENT (ear-nose-throat) specialist to possibly have his short frenulum clipped.  Waited for an appointment.  (During this process I was prepared to "fight" for another opinion if necessary, but all of the opinions agreed his frenulum was short so I didn't have to fight.)

Well...the appointment was Monday.  He was 5 weeks and 2 days old.  It was a breeze.  They sent me out of the room for the procedure (apparently mommas freak out a little when they see the scissors coming towards their baby....)  In less than 5 minutes, the doc came out to the waiting room and retrieved me.  Christian didn't even shed a tear, they said.  I never saw a drop of blood.  He was alert and perfectly fine, sporting a clipped frenulum.  I packed him up and took him home.

I was hopeful that it would at least help with the air-swallowing issues.  And maybe the spitting up would get better.  I tried to keep my hopes low that after 4 weeks on the bottle he would have the patience to latch and nurse.  Each baby has his own feeding personality.  Christian's is the "don't-stick-that-thing-in-my-face-I'm-starving-and-I-refuse-to-latch" kind of personality.  Little or no patience, especially since his tongue would not cooperate. (Sometime when you're bored you should read about all of the technical things a tongue does during feeding.  It's truly amazing.)

But yesterday, he nursed!  He was pretty ticked off at first that the bottle wasn't dumping it down his throat and he actually had to exert some effort, but we kept at it and he nursed.

Only a mama who desperately wants to be able to nurse and carries a $200.00 Medella double pump on her shoulder when she goes out instead of a cute purse can understand how happy-a-day it was.

We're still not out of the woods, but we are working on it.  He still gets frustrated.  And nursing requires a different kind of baby-cue reading than does bottle feeding.  You can't see how much they've eaten, so you have to read the cues more carefully.  Is this a need-to-burp cry?  An I-need-changed cry?  A done-burping-and-want-more cry?  A this jug is empty, time to switch cry?  Done, time to swaddle and snuggle cry?  Or a I'm ticked off and I want the bottle cry?  It might sound complicated and funny to those of you to whom nursing is a breeze.  But it's not funny.  At all.

At this point, I still give him a bottle at night because I can't bear to add any more time and fussing to the nighttime feedings.  I'm letting him get his latching practice first during the daytime, when I'm more awake.

I share this long and painfully detailed story with you for a couple of reasons.

One....saying things with few words is exhaustingly difficult for me and I'm not in the mood to edit, so I just let the story come out as it would.

And two:  Perhaps some mamma somewhere will gain courage from some aspect of our story.

Maybe you just want to know that you're not weird because nursing is really, really hard and not relaxing for you.  Don't let people make you feel like it's because you're "young" or "new at this"  (in other words...things are hard cuz you don't have a clue what you're doing or are doing it wrong.  grrr.)  Five babies and MANY professional appointments later, nursing is still a challenge for me.  So be encouraged and be brave.  And formula never killed anybody.  If you need to use formula to survive, DO IT!  I have proof in my household that your kids can still be smart and healthy.  : )

Maybe you are looking for some feeding solutions and tongue-tied is something to ask your doc to check out.

Maybe you just needed reminded that the medical field is necessary and wonderful, but does not even remotely replace a mother's intuition.  PLEASE trust your mamma-gut when it talks to you.  I am so thankful for a mama who continues to remind me to trust my  mommy gut.  And if there is something frustrating in any aspect of your parenting, look for solutions!  Ask for help!  Do some research!  It helps.

Maybe you are pregnant and need to just be aware that the tongue-tied issue is real, but often completely ignored, in hospitals and pediatrician offices.  There is a history to this oversight.  Midwives used to keep one fingernail sharpened to quickly swipe a short-looking frenulum at birth.  Quick, painless, and done.  But then the medical community decided that too many frenulums were being cut without need, and the pendulum swung....probably around the time bottle feeding became the norm.  Now that nursing is back in vogue, the medical community has all these crazy hoops in place you have to jump through to get that tongue fixed.  But the procedure is actually amazingly simple.  Very little blood.  Almost no risk of infection.  Very little, if any, pain for baby (though they may be ticked at the gloved hand in their mouth.)  Many babies can latch on and nurse successfully, right after the procedure. 

Being tongue-tied can also dramatically affect speech development.  A nurse told me yesterday that they found our her son was tongue tied...when he was 15!!!  I personally have a speech issue (a lisp), for which I've been to speech therapy (unsuccessfully).  After learning that short frenulums can run in the family, my mom and I are very curious if that might have been an issue for which my speech accommodated during my speech development.  (Try saying an "S" with your tongue stuck on the bottom of your mouth.  It doesn't work unless you accommodate by creating the sound incorrectly.) 

Some babies can also be a bit tongue tied without any speech or feeding issues.  Sometimes the frenulum stretches as the child grows and no intervention is needed.  Probably another reason the medical community does not do a standard check in the hospital (which would be so simple!).  They wait to see if there are issues.

I am not going to pretend that the little frenulum-clipping procedure magically solved all of our life problems and washed my dishes for me.  But I am extremely grateful that we caught it when we did.  And I am thankful for the hope that it is helping.

So there you have it.  Our tongue-tied story.


Want to learn more?  Here are some links:
TongueTie.net (a VERY helpful picture guide!)

 note:  A word to the wise.  Be careful if googling about frenulums.  There is more than one kind. : )


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