Help needed following tongue tie clipping (update in post #16) - Mothering Forums

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#1 of 17 Old 07-06-2011, 09:19 PM - Thread Starter
 
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DD (13 weeks) had her tongue tie clipped yesterday. She's had slow gain for the last two months, about 1.5-2oz a week.  She nurses mostly on one side, I barely have anything on the right side.   I'm sweeping my finger under her tongue and getting her to stick her tongue out a few times a day.  Struggled with refusal to nurse many times in the last few weeks, either from dairy reaction, congestion, too tired. She is extremely hard to nurse if she wants to sleep. She does not nurse for comfort. She goes after a pacifier though.

 

Her latch has seemed weak up until this afternoon, following the clipping. Is that normal?

 

I've been offering an ounce or two of pumped milk following many feedings, and she'll only take half an once, maybe 1 oz. She gained 4oz in the last two weeks. I'm offering pumped milk after most feedings now except when she falls asleep (so, late evening, middle of the night, no bottle). Tonight, I went to the store so I pumped and had DH feed her the whole bottle, 4oz. It was a fight to get her to take 2oz. We just got the Dr. Brown's bottles with the preemie nipple.

 

There are many times there is more milk but she's done, but she's only getting about 2-2.5 oz. Say she eats at 5am and nurses well (thankfully!), then if she awakes at 8, she doesn't want any milk! She doesn't fuss that time, but will.not.nurse. She's got to be hungry though. If she was gaining fine, I'd say, well, you just don't need it, but I believe she does need it. Why wouldn't she want to eat? She sleeps a while at night and I usually wake her to feed when I go to bed, then I wake her by 6 or so if she's not up. Last night, I set my alarm for 3:30 to feed her then in hopes that she'll get better practice with the way it feels now and strengthen her latch. That was so-so, but then at 7, it was EXTREMELY hard to get her to nurse. She'd just cry. No reflux that I know of, we resolved that early on. She seems very sensitive.  We have the first of 1-4 visits with a physical therapist to hopefully resolve body tension in her head and spine that chiropractic did not resolve. She had a hematoma at birth.

 

I'm not sure what i"m asking for, but the things I've been wondering today is 1) why doesn't she eat more in one setting when there is more milk, either in my breast or in a bottle? I'm confused because one time, she took 5oz from a bottle (yesterday, after nursing poorly all morning, the day of tongue clipping).  and 2) How long until she might start nursing longer now that her tongue has been clipped? I saw one old post that it took a couple of weeks until the latch got better. The last two feedings, it WAS a little stronger. When she nursed more weakly yesterday and this morning, she nursed LONGER but I know she took less milk than when she used to nurse for 3-4 min, nursing steadily.

 

I'm still off diary. Maybe it's her general upset. She cried a lot in her car seat today while doing an errand.

 

She was 8lbs 4oz at birth, gained very well the first 4 weeks, then slowed and is at 11lbs 9oz today. OVERALL it's fine, but that is because she took on weight so well the first month, but the last month has only been 1/2 lb a month. That is too much of a trend for me to be comfortable with. I gained 1lb a month as a newborn, DH was small but was sickly, and our 2yo gained very well the first 4 months - sometimes 12oz a week (then slowed a lot around 4-5 mo).

 

Any suggestions/encouragement of those who have been there.  I want to eventually get off bottles and have her gain well on nursing alone.

 

Also, I haven't checked what is normal awake time for this age (3mo) but she is ready to go back to sleep after 45-60min and seems to sleep from her evening nap (6ish) on, with little to no awake time until the morning.

 

 


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#2 of 17 Old 07-07-2011, 09:11 AM - Thread Starter
 
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Wow, I just looked and noticed she has lip tie too! It seems thick and coming to the base of her gums. Hoping we can get her in asap for that.


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#3 of 17 Old 07-07-2011, 09:54 AM
 
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I had never heard of being tongue tied until the pediatrician at the hospital told me my son had it at birth. No wonder It was such a struggle to get him to latch on in the hospital. He was born at 7.5 lbs and by the time we left the hospital he was only 6lbs 14oz. I had plenty of colostrum to feed him but he got frustrated when trying to nurse. I ended up feeding pumped colostrum to him in the hospital. :( It was even more of a nightmare when we got home. My son had a strong suck so the doctor downplayed him having to get the skin cut. Finally a week later, we drove him to another town to get the simple procedure done. I still dont know why we payed so much money for a procedure I or anyone else could have performed. The lactation consultant said that it would be a struggle to get my milk supply up but it was well worth the effort. After many days and nights of both me and the baby crying from frustration, he finally figured out how to latch on properly. We have been going strong for eight months now!

 

The doctors said that sucking on a binkie and/or breastfeeding would relieve ay pain the baby was feeling from the little surgery. I did some research and found that if breastfeeding was continued, a chance that the skin would grow back was small. I guess the skin wants to grow back when they are still little babies.

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#4 of 17 Old 07-07-2011, 10:11 AM
 
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My DD had a lip tie until about 3 weeks ago. Our ped wouldnt clip it because nursing was fine and she said it would go away on her own. I was told that she would clip it when DD was 3 or 4 if it hadnt gone away by then. Last week, DD fell and hit her lip on something and it detached. Apparently that is pretty normal, and most kids dont make it to 3 without detaching it.

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#5 of 17 Old 07-07-2011, 10:13 AM
 
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P.S. I was very worrysom about every little thing for the first couple months of my son's life. I exclusively pumped for the first seventeen days of having him. He only drank from bottles and seemed to be doing so-so. The ladies at La Leche League were astonished that my body kept producing milk for about two weeks without a baby latching on! For some reason I thought I would be able to keep producing milk if I kept pumping. Wrong. He often refused the bottle and boob so I felt like he may have been starving. He was very sleepy and groggy because I was on pain killers after my c-section. Along with his tongue being tied, I'm sure the exposure to drugs didn't help. I'm almost wondering if it took his appetite away or if he was too tired to eat. The Pediatrician said that this difficult time I was having breastfeeding was not worth losing sleep over and that I should just formula feed because my nipples were too flat. I was very upset at this. She even fed him a bottle of formula at the office. My poor baby had so many things going against him! Sometimes I just had to take a deep breath and relax. I realized the importance of breastfeeding and that giving up was not an option! Never give up! Some people say "Oh my baby just didn't want the boob". KEEP TRYING in little segments throughout the day. It is so worth it! As long as your baby is not losing too much weight and better yet, gaining weight even if just a little, you two will be fine. I finally excepted the fact that, when he is hungry, he will eat. As long as he is eating, sleeping, alert throughout the day at awake times, and peeing and pooping, and gradually gaining weight, than he is FINE! I am sure your baby will be fine too!

 

And don't worry about what time your baby wakes up and eats. Just make sure you let her feed whenever she wants. I often felt like I had to forcefeed my baby. Just keep an eye on her and I am sure all will be well.

 

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#6 of 17 Old 07-07-2011, 11:08 AM
 
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About the sleeping thing, everyone asks me when my son goes to bed and wakes up. He usually sleeps throught the whole night after I feed him. He periodically wakes up in the middle of the night (2-3 times) and I just roll over and feed him. He goes right back to sleep. He is 8mo now, but he did this when he was little as well. I often felt that I had to wake him up to feed him in the beginning. We have to remember that babies have a tough time, and we just have to be there to suport them and their feelings. Your daughter may come to love breastfeeding. I was tempted to only bottle feed because my son seemed to eat wwwaaaayyyy more from the bottle than the boob. But the nursing consultants told me that if I ever wanted to be successful, than I would have to take the bottles and binkes away! So I did. I only offered the boob. You can imagine how much more fussy my baby became at this time. They even suggested that letting the baby lap breastmilk from a bowl or cup was better than a bottle. Sounds crazy! But if you want to exclusively breastfeed, you must train your daughter to do so and it is critical to take the bottle away. It is going to be like she is starting all over again, but if she is hungry, she will eat TRUST ME. I hope that things are going better for you and your little one.

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#7 of 17 Old 07-07-2011, 08:22 PM - Thread Starter
 
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Thanks for the help. Here's a pic of her lip tie, and only by the grace of God, we got in today to get it snipped.  Doctor considered it a class 3 lip tie and the procedure went smoothly.

lip tie Neri x.jpg

 

She's been nursing poorly during the day but well at night. I'm confused about why she wouldn't want to eat in the morning after it has been a few hours, I really don't get that. Any ideas are welcome.

 

DH has been encouraging me to just give it a few days and not be discouraged, let her mouth heal, help her relearn sucking, etc. If all else fails, we have an excellent feeding clinic with an occupational therapist / LC who wrote a book about sucking skills who I know can help us. Just costs money....


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#8 of 17 Old 07-08-2011, 07:29 AM
 
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It may be discomfort that is keeping her from temporarily nursing. Were you giving any info for pain medications? It took my guy 2-3 days to get over the discomfort of the clipping. Also, be sure to flip the lip 3-4 times a day or the tie can grow back!

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#9 of 17 Old 07-10-2011, 05:32 PM
 
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i don't have any advice but I pretty much could have written your post and would like to hear what others may offer. Major BF issues in the beginning then finally got a posterior tt clipped at 8 weeks. Things did get gradually better after that. But at almost 5 months, my DS STILL has the strange eating pattern you describe: nurses well at night but starting at around 7am often refuses to nurse or takes only a little then cries and refuses when it seems he must be hungry. He does this all day long most of the time, and often does the same with his sitter with the bottle (I PT WOH). My DS is small (10th percentile) but seems to be gaining weight gradually, if a bit slowly. Because of this I am not too concerned, but do have to deal with pressure from family members to supplement and start solids asap since my babe is not as chubby as they'd like.


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#10 of 17 Old 07-10-2011, 11:14 PM - Thread Starter
 
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The last 36 hours have been so stressful. After some progress the first 24 hours following some body work by a physical therapist including CST, we're the worst we've been with her refusing the breast for almost 12 hours today despite some tactics that have worked in the past. Her frustration at the breast cuts deep in my heart - how did it get to be this way? What will change? She is 5 days beyond her tongue clipping and three past her lip clipping...please tell me it'll get better and that it's just residual from tt and lip tie! The PT felt a lot of her issues are related to the birth (fast, had a hematoma, must have dropped into my pelvis quickly).

 

Is it just asking for trouble if I "give her a break" and offer bottles during the day and nurse at night (when she does best)?  I don't want to exasperate her emotionally but I want to keep nursing. We're going out of town this week, it can't be changed.

 

I've been crying a lot the last 24 hours  :(.

 

I was reading about crying-in-arms for emotional release for babies with trauma (birth, for us, I think) and have talked with DH just about trying that. Not silencing DD when she cries by bouncing or holding paci in until she takes it, but letting her cry in my relaxed arms to release the tension that has built up in her (making sure other needs are met first). 


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#11 of 17 Old 07-11-2011, 05:54 PM
 
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sorry - duplicate post, please see below.

 

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#12 of 17 Old 07-12-2011, 04:42 PM
 
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I'm pretty much a "show me the evidence" kind of person. Even so, I'm going to share an anecdote with you and maybe it will be something you and your daughter will want to try.

 

I actually saw this and wouldn't believe it if I hadn't, so you may be skeptical :)

 

The baby was about 6 weeks old, and had never nursed. Traumatic birth - immediately whisked away from mom, deep suctioned etc. Forward to a suggestion from a (doesn't need evidence) LC to let the baby express her dismay at her birth so she could move on. I was quite eyesroll.gif.

 

Baby was naked expect for a diaper, placed on mom's bare chest/tummy. Mom was mostly laying down - sorta propped up on some pillows. Baby lay there for 2 hours, and would snuggle in, head toward the nipple and then just freak out and cry and howl. She was well fed before this started, so it was not hunger. It was as if she needed to complain about her rough start in life. Mom comforted her, apologized, reassured her and told her how unfair it had been. Baby did the same thing again. Finally, after about 2 hours and lots of tears from baby and mom, the baby latched and nursed. It was amazing.

 

Anyway, there it is, for what it's worth. Just one anecdote from one mother-baby pair. It may be useful to you or not, just thought I'd pass it on.

 

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#13 of 17 Old 07-13-2011, 10:15 PM - Thread Starter
 
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Thanks for that.  We did try Monday morning, some Monday evening and a little bit this afternoon of crying in arms. The first was the worst, but I really felt like she needed it, so I was able to be relaxed. I cried with her, talked to her. It must have made a difference because that is the only thing new, and nursing has gone better starting yesterday. I have not offered any bottles for the last 48 hours, and she has been able to get what she needs from nursing. And, last night, she roused to eat at 3:30a and 7:30a instead of me waking her when my alarm was set for 5a, I hope that means a good change. NOW, I have yet to know whether the amount of nursing is enough for her to gain well, or if it is just like before, but a change I did notice is my nipples are a little sore, and were last week. They were not over the weekend when we struggled big time, so I'm wondering if the sore nipples means she's sucking differently with getting clipped, and it's like that early-days-of-nursing soreness.  I still have to bounce a good bit during the day to keep her on, and I did get a nipple shield but am not using it. It ended up being enough for her to pull my nipple out with my fingers just before latching her on.

 

I will be in a tough place if she's not getting enough on nursing alone with no pumped bottles, because I am starting to wonder if offering a bottle after she refused nursing was part of the problem of her refusing. I suppose a happy medium would be for DH to give her a bottle once a day that is a nice big feeding but not offer it as an alternative if she refuses.  If she still isn't gaining well after all of this, I'm not sure what I'll do. The best thing is to probably keep up with frequent feeds like we are, and to do what I can for good milk supply. Since I want to go easy on bottles, I don't really want to pump between feedings since if say only an hour passes from when I pump till she nurses, she'll get less than if I hadn't pumped.  Any tips?

 

So, I think the times of crying in arms was therapeutic for her. She really got mad and kicked and screamed, like one mama described on her blog years ago, where I found and got the idea. We have another session for CST in two days, so I'm looking forward to that. I'll also drop in to get her weighed. I'm hoping for a weight close to 12lb. She was 11lb 9oz about 10 days ago. I *hope* and am praying that this improvement will not be short lived, and that she IS indeed sucking like she should be. I still have to flip her upper lip out. I'm doing the tongue exercises and she doesn't easily suck on my pinky finger, she sort of gags but doesn't get upset. I've been lifting her lip daily and the PT has me gently rubbing her gums.

 

All this while we've been out of town at our church family conference this week. I've had to miss a lot of activities to come back to our cabin to feed her, but everyone understands. And I'm not cooking this week so that is nice, and DS (2yo) is well occupied.


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#14 of 17 Old 07-18-2011, 10:10 PM - Thread Starter
 
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Just an update that things have improved a great deal. I haven't given my DD a bottle in a whole week, and she is nursing longer. I'm thinking three things made a difference (and the grace of God to make these things effective) following her lip and tongue clipping:

 

1. crying in arms to release tension (30 min of screaming, raging kicking one day, 30 min that evening, and very little now)

2. CST, two sessions so far (cranial sacral therapy) to release tension and reset her body from tongue tie and the precipitous birth

3. one morning, she didn't nurse much (but was not upset) and I decided NOT to offer a bottle of pumped milk and just try to work in nursing again. I had figured out that it was easy to rock her to sleep a little later and get her latched on, if a previous feeding went downhill. I relied on that a good bit this past week especially since we were away at a family conference with our church. I missed out on a lot of stuff but my priority was good nursing. So, I had wondered if we didn't start the day with a bottle as an option, would she nurse better the rest of the day? She did, whether or not that was rthe reason, or maybe the timing was coincidental.

 

We have had much less refusal. Either she's improving with the above or I'm figuring out what works best for her. Now, I hope someday she'll nurse after she's been awake b/c right now, she seems to only nurse right after getting up. It works for now, but she'll eventually be awake longer but will need to eat.  She gained 8oz in a week and a half which had been her trend for a whole month lately, so that is great news. I really feel like she's gaining well on nursing alone. joy.gif

 

 


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#15 of 17 Old 07-19-2011, 07:23 AM
 
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Congratulations! You are a superstar!

 

That's amazing, Mama. I can tell it took a lot of work, and missing out on things at your conference, but what a difference that dedication made!

 

Hope it continues to improve.

 

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#16 of 17 Old 11-03-2011, 12:00 AM - Thread Starter
 
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Just a final update that things are going pretty well. I've continued to struggle with supply, and she's small, but she's nursing regularly, never refuses, and can easily take a bottle. Still only nursing on one side (same as DS). Every now and then I pump if she didn't fully nurse, and I'll give it to her later that day.  She's almost 7 mo and probably between 14-15 lbs, and was 12lbs 10oz at 4 mo. So her rate of growth picked up some (compared to half a pound a month) but isn't quite like her brother's was at that age. Looking at my baby book, I gained about 1lb per month in early infancy.

 

She was ready for solids around 6.5 mo, so she is taking to that well (sitting up, etc) and am glad to add it in while still nursing as much as before.  I really had to persist with bouncing, patting, shushing while she nursed. She will nurse anytime now, so I can nurse her before a nap. She occasionally gets frustrated for slow letdown, and occasionally falls asleep nursing. Her brother is a fun distraction. I still need to pat and bounce until letdown occurs, but I don't stress about it now, that's just what we need to do.

 

And, she is soooo happy and content! It's incredible. Relaxed, no sign of the former tension and bother she had. Looking back, I feel that the therapy and the crying in arms were the turning point for us. Here's a pic.

photo.JPG


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#17 of 17 Old 11-12-2011, 07:34 AM
 
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I just read this thread with great interest.  After a lot of searching, I discovered DS is lip and tongue tied, and we are driving 2.5 hours next week to see a doc who is very good at treating it.  I had never heard of the crying-in-arms, but I had heard that sometimes babies just need to let their emotions out.  I hadn't looked into that more, but I am definitely going to look into it more now.  Thank you for sharing your story!


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