Tongue-tie causing all these problems? UPDATE OALD/biting/over-feeding?

[penstamon]

I am so frustrated and feeling horrible that I am just realizing this now.  After a rocky start BFing DS1, I thought I would be a pro when DS2 was born.  Things were fine the first month and then the nipple pain began.  He is almost 8w, so I have been dealing with this pain for almost a month and I feel so stupid for letting it go this long.  I thought it was a bad latch- my friend is an LC and noticed he didn't open his mouth wide enough.  So I had been getting him to open wide and making sure his lip wasn't curled under and still I am in pain when he nurses- where his bottom gums are.

I started looking into tongue tie and noticed that his tongue does have a slightly heart shaped appearance.  He never would take my finger to suck and I just realized that his tongue isn't covering the bottom gum when he tries.   He gets so frustrated.  He swallows a lot of air while nursing and is miserable until he spits up (sometimes a lot) or burps.  He is super fussy every evening and I have to just keep nursing for hours.  He generally eats every 1-2 hours all day long.  I have to sleep sitting up with him on my chest every night.  His weight gain is great, almost too great- he was born at 7lbs 13oz and was 13lbs 2oz at 6w.

Have I waited too long?  Is it going to be painful for him to fix tongue tie now?  I feel awful... 

[PatioGardener]

nak

My doc will do them in the office until 3 months old.

please don't blame yourself - postpartum time is hard!

[motherhendoula]

I would invest in seeing an IBCLC - or someone who can diagnose a tongue -tie, they typically cause Mom nipple pain from the very first latch on.  I dont know why the first month would go by smoothly and then suddenly its an issue - so i wonder if it could be something else - sorry im not really skilled enough to give you any further ideas or advice!  

If it is a tongue tie - its certainly not too late to fix it quickly - every area is different, there seems to be places where dentists handle it, sometimes its the pediatrician, where i am there is like 1 IBCLC who still does it - so you may have to look around.  LLL should be a good resource, as well as any doula groups in your area - or just call an IBCLC directly. 

The one thing you talk about him being fussy and swallowing a lot of air - how is the flow of milk?  do you think maybe you have a forceful let-down?  i just think this problem may need a little more research! 

[ewe+lamb]

Well it's sort of understandable that the tt was undiagnosed if the OP had sufficient supply that he didn't have to nurse that hard - I've certinaly come across this sort of thing, mothers with great supply, bb doesn't have to work that hard and when the supply starts to slow down as the breast isn't stimulated enough then bb has to try to start working to get the milk and this is when the pain and cracks happen - certainly tts here in europe often go undiagnosed for quite some considerable time - I know that in the USA folk are getting alot better at diagnosing and treating! 

I would certainly try and find someone who can clip the tt - as the PP mentioned it's certainly not too late, although it may hurt slightly most tts are non-vascular then there is little bleeding and no anaesthetic is required, nurse as soon as the clip is done - contact a local LLL leader or an IBCLC who may know of a good ENT person who can help you.

[motherhendoula]

Keep us updated Penstamom!

[penstamon]

Well, the pedi did not see any indication of a tongue tie- he thinks that LO is biting me while nursing, hence the pain.  This sounds odd to me and not quite likely since I have been bit plenty and it wasn't a constant pain that got worse by the end of a nursing session.  DS has jumped from 55th % at birth for weight to 95th, so the pedi thinks he may be overeating to help with a colicky tummy.  Also, I have a very strong OALD and plenty of milk so this may be causing him problems.  My LC friend (also a LLL leader) has been on vacation but I hope to connect with her soon and get her trusted opinion.

The pedi did mention that I should possibly try and feed DS less since he is so chunky and an over-full tummy may cause the spitting up and related problems.  Apparently I was wrong about the tongue-tie!  DS has been sticking his tongue out at me all day and it looks normal now.  I feel silly for thinking that was the problem.  Perhaps this is a stage we will just grow out of?

[PatioGardener]

Hmmm... If it's a heart shaped tongue (like this http://www.cssd.us/images/hottopicx/tonguetie.jpg on left) then it's a tongue-tie. Does your doc have lots of experience with them?

Otherwise, yes, it could be that your baby is clamping down to stem the flow of lots of milk. Can you try nursing uphill? (with baby upright and you leaning back a bit?) That may help.

As for feeding less - bad bad idea in my opinion. Babies are made to feed on cue. If baby asks to eat, then they need to eat. All the medical organizations (including AAP) say feed on demand. Breastfed babies slim out as they get older.

[Marissamom]

Originally Posted by PatioGardener 

As for feeding less - bad bad idea in my opinion. Babies are made to feed on cue. If baby asks to eat, then they need to eat. All the medical organizations (including AAP) say feed on demand. Breastfed babies slim out as they get older.

 

your Ped is most likely using growth charts based on formula fed babies. breastmilk is more easily digested by younger babies, so breastfed babies gain faster in the first few months and then slow down and gain less weight then the formula fed babies (because formula does contain more calories once their little tummies can digest it better)

[goodygumdrops]

 I would also make sure to see an IBCLC.  Again, I agree with PatioGardener! 

[cyclamen]

Regarding oald and oversupply, i had that and my dd had posterior tongue tie (which many peds are unable to recognize because it looks fleshy and muscular).  she was unable to extend her tongue over the gums but she was also pulling back on my nipples because of the oversupply.  ironically, or luckily, the same oversupply is probably what kept her from losing too much weight in the first 8 weeks because the milk just shot down the back of her throat, no sucking needed.  Block feeding, rathring than limiting my dd's feeds, helped reduce the tugging and spitting up.  I had to do some pretty massive block feeds (like 8-12 hours) but some people do fine on just 1-2 hours of feeding only from one side, then switching.  anyhow, i also totally agree with the suggestion to contact and ibclc.

[motherhendoula]

Originally Posted by cyclamen 

Regarding oald and oversupply, i had that and my dd had posterior tongue tie (which many peds are unable to recognize because it looks fleshy and muscular).  she was unable to extend her tongue over the gums but she was also pulling back on my nipples because of the oversupply.  ironically, or luckily, the same oversupply is probably what kept her from losing too much weight in the first 8 weeks because the milk just shot down the back of her throat, no sucking needed.  Block feeding, rathring than limiting my dd's feeds, helped reduce the tugging and spitting up.  I had to do some pretty massive block feeds (like 8-12 hours) but some people do fine on just 1-2 hours of feeding only from one side, then switching.  anyhow, i also totally agree with the suggestion to contact and ibclc.

This really nails it!!   Also - like another PP mentioned - baby could be biting down to stem the forceful gush of milk.   Feeding him less often isnt really the way to go - but block feeding will help - it can take a few weeks to even out -  hope your LC /LLL friend can help as well!