Minor tongue-tie-- What to do? « Back to Group Discussions

[TenzinsMama]

DD is almost 7 weeks old... Her latch was good up until about the past two weeks, when she started 'smacking' while nursing.  We saw a doc who runs a breastfeeding clinic, and it turns out DD has a minor tongue-tie.  She's experiencing 'oral fatigue' because of it, and the latch gets sloppy which is why I'm hearing the smacking.  It's up to me if I want to get it cut-- I was told to see how the next two weeks go, since babies can adapt to it and nurse well.  It's optional because it is minor, and she is gaining weight appropriately thus far-- though it is at the low end of the 'normal', healthy rate.

Sometimes the latch is just perfect, but then when it isn't, it's pretty frustrating for me because I have to take her off and re-latch... and sometimes it doesn't seem to matter how many times I do that, she still smacks.  The problem with the smacking is that she's taking in air and then gets gassy afterwards... As well, I've been told by my midwife that her inefficient sucking could lead to a decrease in my milk supply.  Althought at this point, I have a hard time imagining that because I have an overactive let-down and lots of supply, and it was like this with DS, so I guess I'm thinking optimistically.  It's like DD gets on, gets tired, then realizes she doesn't have to do a lot to get some milk-- she can just be on the end of the nipple and it flows in enough to make her happy. 

I wish the nursing was going easier for us-- I'm finding that I'm really having to concentrate on what we are doing each time, and it's taking away from some of the enjoyment of it like what I experienced with DS.  With him, I could do it without thinking, and just melt into it, you know?  Also, with him, I could nurse him side-lying-- but with DD, it's hard for her to latch and then she slips off pretty quick most times.

Perhaps getting the tongue-tie fixed would help with all of this, I don't know... She wasn't smacking right from the start, so why now?  Is it because she is having to work harder to get the milk, since things have leveled off since the days of engorgement excess milk production?

Anybody with experience with this issue?  Anybody with babies who have had their tongue-tie clipped?  I think I'd fall apart in there, if they were doing it to her...

[livelovelaugh]

I have been staring at DS2 in the past few days or so wondering if he has a mild TT as well.  DD1 had it, and with her she had the heart shaped tongue/snake like tip so it was really obvious.  With her, the pediatricians still were not even worried and said that typically nowadays they just watch and see and it tends to stretch out on its own.  She was gaining fine (probably lower end of normal too) and they were not worried. They said it could lea to speech delays in some cases later on, but stressed that it really tends to work itself out.  We thought about it and decided to get it clipped.  They said if we were going to do it then 3 weeks was an ideal time, and if you wait and the child has problems later on (when older and stronger) then they have to be sedated.  We went to an ENT that we know and trust, and while I hated that I was doing this to my baby, it was so quick and fast, and I put her RIGHT on the boob after, and it was fine...they use something...was it silver nitrate?...to make it heal faster/stop bleeding...it was so fast and she was really fine...she cried, but nursed immediately and was happy from there on out!  I would definitely prefer not to do something like this, but I didn't want to wait and see if there were other problems.

DS2 is very spitty, and now that I think he has a bit of TT himself, I am going to think about it again if the doc sees it as well.  We go Tues. for his one month, so I don't want to wait too much longer...

[tri31]

I am on the fence about this too. Her pediatrician says it's okay to wait, but said for sure her tongue would never change at all. He said some people are tongue tied all their lives and it's fine. But now reading your posts I am concerned she could develop an feeding issue. We are out of town for a week long vacation starting next weekend. She is 3 weeks,and gaining plenty of weight she was 8lbs 4 last week( born at 6lbs 12). I could likely have an apt to have the procedure this next week. I keep hearing babies recover almost immediatly.Even when they are older and sedated I imagine the  mouth is still tender while it heals so either way she may experience some discomfort ???

[livelovelaugh]

It was so hard for us to decide with DD2, but having been through it I will do it again in a heartbeat if doc thinks she has even a minor tongue tie...it was SO quick and my boob was out and at the ready and it really was not as big a deal as I thought it would be.  For me, I just knew that the wondering and waiting would stress me out, and there was no definitive timeline, just waiting, so it made more sense to do it and it was so nice once that little tongue was free! 

Tri31 - maybe you could just make the appointment for when you get back, think about it some more, and either do it if you feel comfortable with it or cancel the appt?  What does her tongue look like?  Is the frenulum way up front?  Heart-shaped tip?  My DS does not have that (DD2 did) but I still think he is tongue tied from pics I have looked at online, and I think it might be causing his spitting up (they take in a lot more air).  Good luck!!!
 

[kjourdan]

That's interesting.  I have started hearing smacking with my guy but it happens early on right after let down...the nurse I spoke to theorized that he was getting overwhelmed by the heavy milk flow but didn't mention tongue-tie.  He has been gaining like crazy, so we aren't due back until a 2-month well-baby check.  Can you share a link of where you were looking at information?

[livelovelaugh]

I keep ending up at this site...they have pics and good info, link to a chart for assessment,etc.  There is tons of info out there, all pretty consistent.  It is so common.  NAK

http://newborns.stanford.edu/PhotoGallery/Ankyloglossia1.html

[freegirl23cat]

I agree w pp that isnt really *too* bad...dd was 32 wk preemie and had hers clipped in nicu for minor tt @ 3 wks. I put her right to breast.. she is 9 wks now and still clicks :(and gassy from air. She is gaining fine though. Whatever decision you make will be right one for you.

[Momo123]

My older DS had it and so did my second one born last month. We had it revised when he was 5 days old because of the difficulties I had nursing my older one. I really think it depends on the situation, some are mild and do fine with no clipping but others struggle right away or down the line. Mine is still having trouble maintaining his latch throughout and I have supply issues but it is much better than last time (older DS could not suck well at all and would just cry or fall asleep at the breast).

I agree with PP that whatever decision you make will be right. The procedure itself is not bad at all, and they nurse right afterwards. They swaddle the babies to keep them from moving and it is very quick. I went to a dentist who uses a laser and there is no bleeding because it cauterizes the tissue as it cuts. My older DS had his clipped at 6 and 8 weeks (couldn't get it all the first time) with scissors and though there was blood, recovery was fairly easy. I had my DH help hold his head still because I was too chicken to look.

Also, it might help to see a cranial sacral therapist after the procedure (or even if you decide not to do it) as they can help release any tension in the jaw/facial muscles/skull that is affecting nursing and integrate the new change to the tongue.

[TenzinsMama]

Thanks, everyone, for all the nuggets of info... Just wanted to give an update, too-- We ended up deciding not to have it clipped.  We went back to the LC and confirmed that it was so very minor, and since I wasn't having any nipple pain and DD was gaining weight well, there wasn't any need to do anything about it.  DD hasn't been 'clicking' as much, and she seems like she's getting better each day with having a great latch and staying on-- we've even been able to nurse side-lying in the night, so much easier.