Bf-ing after tongue-tie

[mkat83]

To try and make a long story sorta short, ds and I have had various bfing challenges from the start.  We started with a nipple shield, and when we weaned off it at 7 weeks (because he was pulling my nipple all the way to the end of the shield), my nipples quickly became a mess, and bfing was terribly painful for a while.  My research led me to suspect tongue-tie, but several LCs and an oral surgeon all said he was not tied.  So I dropped it.

Things got better... I think my nipples became somewhat conditioned to ds's latch, but I knew something still wasn't right.  I came across an article that got me thinking about tongue-tie again, and I followed my intuition and sought out an expert.  About 3 weeks ago we drove 2.5 hours to see the expert, and guess what?  DS had both a tongue and lip tie, both of which were clipped that day.  But, DS already had nearly 5 months of sucking the "old way" under his belt.  So, now I'm trying to figure out how to help him learn to use his "new" mouth.  Although, I think he is going to need a second clip for his tongue :(

The doc that we saw made a lot of observations that made so much sense.  I wish I had a recording of everything he said.  One of the things was about how DS's tongue was creating a pocket that fills with air, and if he loses his latch at all, that air goes into his stomach.  Ah ha!  That helps explain the excessive gas and spit up!

For a while now, I've been nursing almost exclusively while side-lying.  Most of the time, DS will fall asleep, and that is the only way I've found to prevent him from spitting up tons after he nurses.  I am hoping that once his tongue is clipped again and his latch improves that the spit up will also improve if he takes in less air.  Does that line of thinking make sense?

Also, I've had an over supply on my right side only almost constantly for several months now.  DS latches very differently on the right vs. left side, and I suspect that the way he latches/sucks on the right side must have something to do with my over supply.... maybe that is what is causing the OS?  He sometimes will not latch on the right, but will latch on the left.  He always sounds like he's gulping the milk down on the right, but he's more relaxed on the left side.  But, he pinches the heck out of my left nipple.  Before his tongue was clipped there was some pinching, but since the clip its gotten a lot worse.  My nipple comes out extremely blanched most of the time.  His latch doesn't hurt at all on the right (oversupply) side....  does anyone have any insight into this?

I'm trying to figure out if there is some other underlying cause of the drasticly different latch on each side.  One LC who looked at a photo of DS via e-mail commented on the way DS held his body while lying down, and suggested that maybe there were some restrictions from birth that caused him to latch on each side differently.  Anyone know more about this sort of thing?  To me, it sounds like this is not really related to the tongue-tie, and is an additional issue to be addressed.  

He's seen a CST quite a few times, but I've not seen any real change as a result.  I'm hoping the CST will help once his tongue is completely released.

Sorry for a rambling post, but I'd be interested to hear any feedback that anyone has.

[mt_gooseberry]

I have been dealing with similar issues.  DS had his tongue-tie clipped at 2wks, but with no improvement.  I finally took him to a LC at 4wks, and we determined he also had a posterior tie.  Unfortunately, neither of us could convince any dr. that it needed to be clipped, so we have been trying to deal with the problems through therapy.  After 3 months, I can finally nurse more or less comfortably, but DS still deals with the reflux, gas, choking, and drool (lots and lots of drool).  My nipples no longer look pinched or blanched, and DS doesn't break the seal or come off much, and his suck-swallow-breathe rythym is much improved.  I feel that some aspects of the therapy worked better than others.  Getting DS to use a Soothie pacifier and practicing "baby-led breastfeeding" seemed to do the most good. 

We also had the issue of DS not nursing the same on both sides.  We did have a session with the chiropractor, but I don't know if that helped or if it just got better with time.  He is the same on both sides now, but it just kind of got better gradually.

I guess I just want to tell you to hang in there...it will get better if you keep trying, and it is soooo worth it! 

[CookAMH]

Sounds similar to my baby :). It takes time, give it a few weeks at least, for him to relearn.

With the CST, did she work inside his mouth at all? My babe was tight from the birth and two sessions of manual therapy following TT and lip clipping made a world of difference in releasing her. The therapist had me work in her mouth a couple times, rubbing gums, massaging floor of mouth under tongue, to help release and help her learn how her mouth can now move.  She showed it to me though and guided me in how to do it.  Have you done chiropractic, with an inversion? Baby goes upside down to unkink and sort of rewind it self through the birth canal, of sorts. It was done around 6 weeks for my LO and it helped a good deal. CST followed about a month later.

I'm glad you got them clipped, and improvement IS ahead. We're nursing strong at 9 mo, though she's still small. But we're nursing full time and the sessions are happy now. (and have been for months).

[mkat83]

Well, we went back to the dentist who is a TT expert 2.5 hours from us yesterday and DS has a second clip on his tongue at age 5.5 months (3 weeks after the first).  I was pretty certain that he still needed a second clip because his tongue was still SO tight when I would run my finger under it.  When I wan my finger under his tongue last night, I could finally really feel some difference.  He had a submucousal tie, so the first clip released the membranes, and the second released the remaining frenulum.  So I'm hoping that NOW we will really start to get somewhere with him being fully released!  I hated having to do it a second time, but I am hoping the results will be worth it.  At least he was in a good mood last night once we got home.

We have an appointment later this morning with a new CST (old was one good, but a friend uses this one, so I had been wanting to try her out).  I'm interested to see how that goes.  This CST is also an occupational therapist, I think, so not sure what other observations she might have.

Another TT expert that I had e-mailed (Alison Hazelbaker) said that if I didn't start seeing improvements I might also see a chiropractor or an orofacial myologist (I had to Google that one!).  DS has had chiropractic since he was a few weeks old, but not since his tongue has been released, so I'll have to see how that helps now.  (I saw this chiro all through my pregnancy, and I think it really helped me!)  I did find an orofacial myologist, but the only one around here is an hour away.  However, she was very informative via e-mail and is willing to come to us if necessary.  She is also a speech therapist and takes our insurance.  I'm going to try a few other things first, though, before I pursue things with her.

Another TT expert (Cathy Genna Watson) knew of an LC about an hour from me who really knows her stuff when it comes to TT and a baby's suck.... but that's an hour away, so I'll also keep that one stored away in the "things to try later if needed" file.

What had first made me think DS had a tie when he was very young was this article I found on a British lactation consultant's website.  When I started investigating TT the second time around, I went back to this site.  The LC has an international TT consultation service that she will do with you via e-mail, so I contacted her.  She not only identified the TT quickly via photos, but she also noted a lot of subtle things about DS's body position that indicated what she referred to as "retained moulding/compressions from birth."  (Interestingly, when I google that phrase, almost all the results are from the UK, Australia, or New Zealand.... I'm wondering if it is called something else in the USA, or perhaps its just not recognized as readily here??)

Anyhow, the British LC recommended I see a chiropractor or a pediatric osteopath.  There are no pediatric osteopaths anywhere in my area, and not many who practice osteopathic manipulation, but I did find one who is an internist and also sees children/babies.  So, I also have an appointment with him, but couldn't get in until Jan 5.

So.... I'm tackling this from a lot of fronts now, lol!  Hopefully at least one of these will make a difference.  I think one of the harder parts of this is that my son was relatively old when having his clips done.... (4 months and 5 months) rather than weeks old.  I worry that this means he has more work to do in overcoming the habits he has already learned.  At least with any future babies I will know what to look for right away and it won't take me months of research to figure it out.

Quote:

With the CST, did she work inside his mouth at all? My babe was tight from the birth and two sessions of manual therapy following TT and lip clipping made a world of difference in releasing her. The therapist had me work in her mouth a couple times, rubbing gums, massaging floor of mouth under tongue, to help release and help her learn how her mouth can now move.  She showed it to me though and guided me in how to do it.  Have you done chiropractic, with an inversion? Baby goes upside down to unkink and sort of rewind it self through the birth canal, of sorts. It was done around 6 weeks for my LO and it helped a good deal. CST followed about a month later.

The CST did do some work inside his mouth in the one session he's had since the first clip.  I'm hoping now with the second clip, the CST will start to show some real improvement.

The chiropractor did do an inversion a while back, and I forget how old he was then.  I didn't know what it was called at the time, but I remember being amazed when she held him upside down!  The British LC had mentioned that it might be hard to see any improvements from the body work before having the tongue restrictions cleared up, so more chiro work now might have a lot more benefit.  My Chiro is closed this coming week for the holidays, but I'm looking forward to talking to her after that.

mt_gooseberry, thanks for your words of encouragement!

[CookAMH]

You are doing all the right things. It's hard work and takes so much of your energy (physical and emotional) but you are doing great things for your LO. Keep it up. I'm glad you got the second clipping done - I can see based on your description how that was needed! I too hope the CST that follows will bring things full circle. Update us when you can!

[CookAMH]

How are things going?

[mkat83]

Well, the second CST that we saw a few weeks ago was very different from the first CST.  This second CST is also an occupational therapist, so she had a lot of observations from that point of view as well.  She recommended I get a Nuk brush (I had to google that one) to help him with moving his tongue around.  He seemed really content after the CST that day.

Last week we saw a local osteopath who is basically a very natural, holistic doctor.  I explained everything to him (he did not know what tongue-tie was), and told him what the British LC had noted. He said there was some cranial compression, and he did some work on that.  He felt ds's hips were in good alignment, and did not see anything there as noted by the LC.  Now that I've thought about it more, maybe it has more to do with ds's gut than his pelvic structure, perhaps.  Anyhow, we go back to the osteopath in a few more weeks for another session.  The osteopath said that what he was doing was essentially CST, but also a little more of an osteopathic adjustment (I think that's how he put it).  So, he can bill it to my insurance as an osteopathic adjustment instead of me paying out of pocket for CST, which is great.  However, I think I'm going to make some more appointments with the original CST to see how things continue to go.

As far as changes in DS, he seems to be spitting up a lot less, which I think is a result of him not swallowing so much air.  He still is rough on my left nipple, but I think the osteopath helped that some with his adjustment.  I've seen a lot more movement from his tongue just watching him, and when he goes to latch on or comes off, I can see his tongue in ways that I had never seen before.  Its funny how you don't realize what you weren't seeing until you see it!

Also, my constant oversupply on my right side has FINALLY calmed down.  I definitely think there is a correlation!

There have been some definite changes, but we still have plenty of room for improvement.  When he no longer pinches the *#&$ out of my left nipple, that will be great!