Success w/ NOT clipping posterior tongue tie?

[JustSo]

DD (~6 wks old) was diagnosed with posterior tongue tie type 3. The first few weeks were a nightmare - I cried every day from the pain but thankfully, it's gotten worlds better:  My nipple pain is now minimal/non existent and her weight gain has been great.

The last few days though, she's begun making the clicking noise when she nurses (she never did this before), and it's usually during the daytime and especially when the nipple is soft (not firm from fullness). I *think* this clicking (loss of suction) has resulted in her taking in more air and possibly contributed to green poop. :( 

I tend to obsess about these types of things and am starting to think that this may be the beginning of a downward trend in our nursing experience. :( My Worst Fear is her slowly not being able to nurse efficiently, me losing my supply and being left with no choice but to give her formula.

My question is this: does anyone have a success story they can share about NOT clipping their tongue tied baby? Seems everything I read online is either about parents extolling the virtues of clipping or lamenting multiple clippings! What about not clipping at all? and STILL having a positive breastfeeding experience?

gratefully (typing while holding baby...)

Edited by JustSo - 9/20/11 at 4:44pm

[JustSo]

  bumping...  does anyone have anything positive to say about NOT clipping a tongue tie??

[homemademom]

Not me, sorry. Clipping (once at 4 wks, and again at 6 mths) saved our bfing relationship. However, there is one mama that I know of at MDC who didn't clip and still was able to nurse. I'll see if I can track down the user name. . .

eta: it's Marissamom.  You could try to pm her.

[JustSo]

homemademom - Awesome, thanks :)  Just curious... you had your LO clippled at 4 wks and again at 6 mos... how did it go at 6 mos? Was general anesthesia required? That is (one of my) fears - to not clip early but then have breastfeeding issues later on which require a clip. I hear it's more difficult the older the infant is.

[homemademom]

Originally Posted by JustSo 

homemademom - Awesome, thanks :)  Just curious... you had your LO clippled at 4 wks and again at 6 mos... how did it go at 6 mos? Was general anesthesia required? That is (one of my) fears - to not clip early but then have breastfeeding issues later on which require a clip. I hear it's more difficult the older the infant is.

I was definitely not okay with gen anesthesia so we found a pediatric dentist with a specialty in laser procedures and tongue tie (in infants up to adults).  We had to travel 4 or so hours by car to another state, but it was so worth it. At 1 mth, dh swaddled ds and held him on his chest in the dentist's chair. The dentist put numbing cream under his tongue. Then, he gave him a shot of novicaine. Then, the dentist used a laser which automatically cauterized the tissue so there was no bleeding and sutures were unnecessary.  The procedure was the same at 6 mths, except dh just held ds, instead of swaddling him and ds did fantastic! He cried, of course, while people were in his mouth and holding him down, but it took all of 5 or 6 minutes.  Afterward, I picked him up and he started smiling and had no problems at all. He nursed about 30 minutes after that.  

Prior to the first procedure, ds couldn't transfer milk *at all* and he was KILLING my nipples.  I had to exclusively pump and also supp with formula (because my supply had tanked before we could figure out what was going on). After the first procedure, things still were not great. He had a high arched palate (we went to a cranial sacral therapist for 6 wks to help resolve it), and he still seemed to have as shallow latch. At 11ish weeks, he finally was able to get on the breast, but his milk transfer still wasn't perfect and my supply still didn't seem to be up to par, so we had to supplement with bottles still (at first, as many as 15 oz but eventually down to 6 oz, where it stayed for about 2 months). I felt that his tongue still wasn't right, so we went back to the dentist at 6 mths (he told us at the beginning that he tended to be conservative with the new babies, so we might need to come back when he was a little older).  A week later, I didn't need any more supplements. He was able to transfer milk 100%, my supply caught up, and here we are!

HTH!

Edited by homemademom - 9/23/11 at 8:57am

[JustSo]

Oh, I'm so glad it all worked out for you and your son. And it's helpful to hear how the laser frenotomy goes, that seems like a preferable option to snipping, esp for a posterior tongue tie. I hear that the snip for posteriors isn't just one cut, that it winds up looking like a diamond wound?? :(  

Anyway, I guess I'm surprised that there aren't more stories about not clipping... then again, I am posting in the "challenges" forum, so maybe if TT is an issue, it's enough of an issue to warrant a clip and not just grin and bear it. I truly think my DD has a "mild to moderate" TT situation (she also has a high palate -- btw, thanks for the craniosacral tip; I didn't know that CST could help a high palate) and that I'm blessed with anatomy/supply that happens to work with her, despite her physiological challenges. If I was in your situation, with a lot more pain and no milk transfer, absolutely, I would opt for a clipping, no hesitation. 

Thanks for sharing your experience :)  

[homemademom]

Originally Posted by JustSo 

Anyway, I guess I'm surprised that there aren't more stories about not clipping... then again, I am posting in the "challenges" forum, so maybe if TT is an issue, it's enough of an issue to warrant a clip and not just grin and bear it. I truly think my DD has a "mild to moderate" TT situation (she also has a high palate -- btw, thanks for the craniosacral tip; I didn't know that CST could help a high palate) and that I'm blessed with anatomy/supply that happens to work with her, despite her physiological challenges. If I was in your situation, with a lot more pain and no milk transfer, absolutely, I would opt for a clipping, no hesitation. 

Yes, I think you're right--a mismatch of supply and the mom's or baby's anatomy is going to determine how well nursing goes, and those with the extreme cases are going to end up here!  I've definitely read stories of woman whose babies clicked the entire time they nursed or always had a shallow latch or mom's nipples always came out with that flattened lipstick look, and yet, the mom never had pain and the baby gained weight so she never sought help.  Most likely they were dealing with some degree of tongue tie but it didn't get in the way, so no need to intervene.

How old is your baby, btw? The CST and one website in particular both mentioned that the bubble palate can resolve spontaneously between 10 and 12 weeks. I don't think it was a coincidence that things greatly improved for us around that time.

[JustSo]

Originally Posted by homemademom 

How old is your baby, btw? The CST and one website in particular both mentioned that the bubble palate can resolve spontaneously between 10 and 12 weeks. I don't think it was a coincidence that things greatly improved for us around that time.

DD just turned 6 weeks old... what are your thoughts on CST? do you think it helped? I'm new to it and am still a tad skeptical ... 

[homemademom]

I do think it helped. The CST we saw is also a pediatric physical therapist so she wasn't coming from a "natural" (and sometimes unscientific) perspective.  She showed me how three bones make up the palate and by gently massaging and rocking the bones, they are able to move more freely beside each other allowing them to shift into place, the way the palate should be.  That's why I think many cases get better around 12 weeks because the head and mouth have grown enough to let those bones fall down and spread out.  She did some gentle massage and pressure on his spine, neck and jaw to release tension, too. Very soft, no manipulation or jarring movements. I can't prove that it wasn't time alone that healed his problem, but I do feel that she helped him get everything worked out in his body. He really did have a lot of weird tension in his neck and jaw, probably from trying to nurse while compensating for the TT (he tended to stiffen his neck, so much so that I thought we needed to see a neurologist), but after CST, he was great. We went for 6 or 8 sessions over 6 weeks. 

ETA: The dropping down of his palate really was quite dramatic.  At 6 wks old, it looked like someone had taken their thumb and pressed a perfect thumbprint high up into his palate. 5 weeks later, a week before the end of our CST, he had a noticeably different palate, much flatter, lower and more normal looking. The following week, she said his palate was within the range of normal, still a little high, but a normal high (which both dh and I have).

[JustSo]

Originally Posted by homemademom 

I do think it helped. The CST we saw is also a pediatric physical therapist so she wasn't coming from a "natural" (and sometimes unscientific) perspective.  She showed me how three bones make up the palate and by gently massaging and rocking the bones, they are able to move more freely beside each other allowing them to shift into place, the way the palate should be.  That's why I think many cases get better around 12 weeks because the head and mouth have grown enough to let those bones fall down and spread out.  She did some gentle massage and pressure on his spine, neck and jaw to release tension, too. Very soft, no manipulation or jarring movements. I can't prove that it wasn't time alone that healed his problem, but I do feel that she helped him get everything worked out in his body. He really did have a lot of weird tension in his neck and jaw, probably from trying to nurse while compensating for the TT (he tended to stiffen his neck, so much so that I thought we needed to see a neurologist), but after CST, he was great. We went for 6 or 8 sessions over 6 weeks. 

ETA: The dropping down of his palate really was quite dramatic.  At 6 wks old, it looked like someone had taken their thumb and pressed a perfect thumbprint high up into his palate. 5 weeks later, a week before the end of our CST, he had a noticeably different palate, much flatter, lower and more normal looking. The following week, she said his palate was within the range of normal, still a little high, but a normal high (which both dh and I have).

Wow, that's a great and inspiring description of how CST helped your son. And I find it interesting that there are different approaches to CST. I would probably feel more comfortable/assured with someone like you describe. Thanks so much. You've really given me another solution besides clipping: Find a CST who can help with the palate. Thanks again. :)

[bignerpie]

My son has a tongue tie, and we did not have it clipped. I breastfed him for 18 months.

I don't know how severe his tongue tie is, so maybe it's not that bad. The LC I saw in the hospital said it needed to be clipped, but the pediatrician said it was fine. I was supposed to take him to an ENT for a consultation but never did. My son's latch wasn't perfect in the beginning, but we were able to correct it without getting him clipped, so I didn't think it was an issue.

[JustSo]

Originally Posted by bignerpie 

My son has a tongue tie, and we did not have it clipped. I breastfed him for 18 months.

I don't know how severe his tongue tie is, so maybe it's not that bad. The LC I saw in the hospital said it needed to be clipped, but the pediatrician said it was fine. I was supposed to take him to an ENT for a consultation but never did. My son's latch wasn't perfect in the beginning, but we were able to correct it without getting him clipped, so I didn't think it was an issue.

Your experience sounds like mine so far... DD and I had problems really early on (like the first month) but now things are much better. Same thing happened with my son, only I had no clue what a tongue tie was and no one diagnosed him as having it at the time, so I just grinned and bore the pain for about 6 weeks and then it got better. 

[homemademom]

Originally Posted by bignerpie 

My son has a tongue tie, and we did not have it clipped. I breastfed him for 18 months.

I don't know how severe his tongue tie is, so maybe it's not that bad. The LC I saw in the hospital said it needed to be clipped, but the pediatrician said it was fine. I was supposed to take him to an ENT for a consultation but never did. My son's latch wasn't perfect in the beginning, but we were able to correct it without getting him clipped, so I didn't think it was an issue.

Originally Posted by JustSo 

Your experience sounds like mine so far... DD and I had problems really early on (like the first month) but now things are much better. Same thing happened with my son, only I had no clue what a tongue tie was and no one diagnosed him as having it at the time, so I just grinned and bore the pain for about 6 weeks and then it got better. 

Would you say that your babies had posterior tongue ties or anterior, the kind where the frenulum is attached pretty close to the tip of the tongue (sometimes causing a little indention in the tip of the tongue)?

[Mosaic]

I hate coming in here and posting exactly what you don't want to hear, but if it saves you some of what we have been through, it's worth it. My DD had a posterior tie (and lots of other issues) but was gaining weight, too. I still knew something was off, and our SLP explained that she was basically "freeloading" in those early times when my milk supply was high. Once the supply regulates and the baby has to work harder to maintain that supply/demand relationship, this clicking and green poos (lacking hindmilk, perhaps?) which signal inefficient feeding could result in plummeting weight.

I DO know that I've read of others who haven't clipped and had an ok nursing relationship, so I don't post this just to be a negative nancy. But I do want to mention it because before we dealt with all this stuff, I had no idea that poor nursing skills could still be masked by weight gain, and for months, too. Long-term, though, I would think that the clicking is a sure-fire sign that her nursing habits are not what they should be. I would really encourage you to consider your options sooner rather than later, especially given the complications of later clipping, feeding therapy, etc. that a delay may present.

[JustSo]

Originally Posted by homemademom 

Would you say that your babies had posterior tongue ties or anterior, the kind where the frenulum is attached pretty close to the tip of the tongue (sometimes causing a little indention in the tip of the tongue)?

 Mine has a type 3 posterior tongue tie (farther back from the tip of the tongue) 

[JustSo]

Originally Posted by Mosaic 

I hate coming in here and posting exactly what you don't want to hear, but if it saves you some of what we have been through, it's worth it. My DD had a posterior tie (and lots of other issues) but was gaining weight, too. I still knew something was off, and our SLP explained that she was basically "freeloading" in those early times when my milk supply was high. Once the supply regulates and the baby has to work harder to maintain that supply/demand relationship, this clicking and green poos (lacking hindmilk, perhaps?) which signal inefficient feeding could result in plummeting weight.

I DO know that I've read of others who haven't clipped and had an ok nursing relationship, so I don't post this just to be a negative nancy. But I do want to mention it because before we dealt with all this stuff, I had no idea that poor nursing skills could still be masked by weight gain, and for months, too. Long-term, though, I would think that the clicking is a sure-fire sign that her nursing habits are not what they should be. I would really encourage you to consider your options sooner rather than later, especially given the complications of later clipping, feeding therapy, etc. that a delay may present.

  thanks...you're not being neg. nancy! totally valid point and one i think about ALL the time. hence my OP (seeking reassurance )

ok to assume you had your dd clipped? if so, how old was she at the time?

for us, the other consideration is that my DS (now 5 yo) was also posterior TT type with a high palate...exactly like DD, only i had no idea at the time. we had tons of problems for the first 3 months (gagging, projectile vomit, fighting/frustrated at the breast, xtreme pain 4 me and cracked nipples, etc)  and then it got better... nursed til he was 3 1/2 yo!!

so.... i guess i'm hoping she willl be the same and overcome any problems just like her big brother     so far so good. she is 6 wks old and has gained nearly 5 lbs since birth! whatta chunk! 

[bignerpie]

Originally Posted by homemademom 

 the kind where the frenulum is attached pretty close to the tip of the tongue (sometimes causing a little indention in the tip of the tongue)?

This one. The tip of my son's tongue is heart-shaped.

[Mosaic]

Originally Posted by JustSo 

  thanks...you're not being neg. nancy! totally valid point and one i think about ALL the time. hence my OP (seeking reassurance )

ok to assume you had your dd clipped? if so, how old was she at the time?

for us, the other consideration is that my DS (now 5 yo) was also posterior TT type with a high palate...exactly like DD, only i had no idea at the time. we had tons of problems for the first 3 months (gagging, projectile vomit, fighting/frustrated at the breast, xtreme pain 4 me and cracked nipples, etc)  and then it got better... nursed til he was 3 1/2 yo!!

so.... i guess i'm hoping she willl be the same and overcome any problems just like her big brother     so far so good. she is 6 wks old and has gained nearly 5 lbs since birth! whatta chunk! 

Woo-hoo!! Glad to hear that you faced similar issues with your DS and lived to tell about them! We had DD clipped at 3 weeks, and she's almost 18mo now and we're still knee-deep in feeding issues. So I guess from at least our stories, it's pretty clear that clipping a tie doesn't fix feeding difficulties, and leaving a tie alone doesn't doom a nursing relationship, either.

You know, it wouldn't hurt to get a feeding evaluation done just to cover your bases. Maybe the clicking is just noisy, or maybe it's a sign or something else. FWIW, my daughter is still nursing, but my supply is tanking and she's struggling with solid foods and is speech-delayed. But an evaluation could also tell you that there's no need for a clip at all!