I'm a FTM with 1 month old son. We EBF on demand and he's gaining weight nicely since his birth. It's no surprise, really, since he feeds so frequently these days. And that's my problem. I'm not sure we're doing it right.
He has a mild case of tongue-tie. So mild, in fact, that the pediatrician he saw at the hospital after birth did not consider him to be tongue-tied at all. The NP at our regular pediatrician's office pointed it out. I myself also have a case of tongue-tie, and self-weaned from breastfeeding at 6 months old. I don't want that to happen to my babe!
Most days, he wants to feed every 1 to 1.5 hours. At night, usually around 2 to 2.5 hours, 3 on occasion. I have no problem with supply - if anything, I have oversupply issues, but I suspect it's because he's not really feeding efficiently enough. He seems to latch on fine at first but he never feeds very long. He either releases and doesn't want to latch on again, or he falls asleep. In an effort to make sure he's getting foremilk and hindmilk, I'm using the block feeding method right now. (We started this because his poop was always green and now it's usually yellow-orangey so I think that's helping.)
I'm not experiencing pain during nursing, squashed nipples, or anything like that. We usually nurse in side-lying position. I am petite with a very big bust (J cup) so it's the only position I've found that is even remotely comfortable.
Given all of the above... how concerned should I be about whether we're getting a deep enough latch? What about the tongue-tie? I'm planning to go to a La Leche meeting but the next one in my area is over a week away, so I was hoping for some quick advice here. DS and I are both frustrated and looking for a solution.
I guess im wondering exactly what you are frustrated with? Everything sounds pretty good - new babies eat ALL the TIME - so that sounds normal - the block feeding seem to help....cant argue with full diapers. A mild tongue tie can sometimes interfere with milk transfer - if that were the case you would NOT see weight gain - this is sometimes categorized as a 'failure to thrive' situation. But you say hes gaining - so your answer is - do not be worried about the latch - it appears to be just fine. Breastfeeding is a two way street - some babies tongue tie isnt very bad - it isnt always necessary to correct it
There may have been many other factors leading to your own weaning -
Happy at Home Mama to DD 4/95 DS 4/98 and DS#2 8/10
The LLL meeting is a good idea.
I see a LOT of tongue tie and in my opinion, surgical treatment, even for "mild" tongue tie, is nearly always recommended. I much prefer the laser treatment to the old fashioned "scissor method" as it gets more tissue and there are less problems with everything from bleeding (although frenectomies don't tend to bleed much at all) to needing to go in and snip more tissue. The laser procedure tends to get it all the first time. If you live in a sparsely populated area, you may not be able to find a Doc who does the laser procedure so you'll have to go with the scissor method, it works and is certainly better than not doing it, but if there IS one around, your Private Practice Lactation Consultant should know about him.
You should probably see a Board Certificated Lactation Consultant to make sure it isn't a Submucosal or Posterior tongue tie. These can look like "mild" tongue ties (the baby doesn't have a "heart shaped tip to the tongue" etc) but can actually cause more problems. I've found a good IBCLC along with seeing a Pediatric Oral Surgeon or Pediatric Dentist who has laser equipment and does TT snips is the best course. You may need a visit or two with the LC after the snip, because a lot of babies tend to continue to nurse as if the tongue is still tied and need some exercises to get the tongue elevated.
Also, sometimes if it IS a submucosal or Posterior TT and it isn't snipped, many moms see a drop in supply around 4-8 weeks, because the baby continues to NOT nurse adequately, or is just sponging off of the Let Down and if a Frenectomy isn't performed, the problems just multiply as the baby continues to nurse "lazy" and as the Let Down gets less intense as time goes on and the baby doesn't increase proactive nursing, the supply can dwindle. Don't believe people who say, "The frenulum will stretch." Research proves this just isn't true. If anything the frenulum gets thicker as the baby gets older. It's better to have the procedure done immediately.
You're concerned because you are an intuitive mom, I'm glad you said something. See a good IBCLC, Private Practice, the hospital ones are just too overbooked, their appointments tend to be really short and many women find they don't know as much about "home from the hospital stuff" like Community Based Private Practice LCs do.
My son had a posterior tt which was super painful and also caused supply issues. Luckily, his clipping fixed everything. He still nurses now at 24 months. Is it likely my future babies will have the same issue? Thanks
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Tongue tie (as well as the closely related lip tie) are usually genetic. Your babies will have a higher risk of midline oral anomolies than others. As I said most Peds are terrible at dxing these issues.
My advice is to see a Private Practice Lactation consultant in the first week or so of all your babies lives. They may not all have midline oral anomalies but as your risk is higher and getting help ASAP and getting TT or lip tie snipped and have the LC see you and the baby through the adaptations after the snip, I'd get IBCLC help in the first week with every baby.
Good luck and Blessings.
My first had a slight tongue-tie and my third had a more average (?) tongue-tie. For this current little one I decided not to snip (hadn't heard of the laser treatment, wow!) and it was a good decision for us and we had a OT work with him. From what I've heard, many tongue-tied babies develop normal tongues later on. My oldest certainly did and DS2 is on his way there. Nursing is no longer super painful and he's gaining weight regularly. I don't think you should be too concerned unless something changes or you notice he's not gaining.
ETA: It is genetic... my husband still has his heart-shaped tongue. And he nursed til 2 :)
Jean, feminist mama raising three boys: W (7), E (5) and L (2.15.13)