Wednesday, August 27, 2014

Lip-Tie and Tongue-Tie {Guest Post}

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Today I asked Lacey to write a post explaining what a tongue-tie is in a baby and how it can affect nursing. When fellow Babywise mom Lacey had her second son and discovered the tie issues, I knew that was an issue Brayden and I faced when he was a baby. Nursing started off horrendous for us. The first three months were pretty miserable for me. I wished multiple times a day that he would give up. He didn't, so I didn't. We pushed through and made it a year. In the early weeks, I went to several lactation consultants ad not one of them thought "tongue-tie." It was more..."I can't see anything wrong. Sorry!" So it was very important for me to provide you with the knowledge about this. Maybe it can help you or maybe you can help a friend in the future if she is having issues and you get this bell ringing in your head. Also, please note that a tie can have a negative impact on bottle-fed babies as well as breastfed babies.

Ties can be a defect but they can also be hereditary. I have a tongue-tie and a lip tie (by the way, my mom wasn't able to breastfeed me). These things haven't had any negative impact I am aware of on my life other than the breastfeeding thing. So if you have one, there is a chance your kids can have one. McKenna had a lip tie, but it never impacted breastfeeding and she has no issues because of it. 

Here is Lacey's info:


by Lacey Olsen

I always heard nursing shouldn't hurt. With my first son, it was extremely painful. Every professional we saw said our latch was great, it seemed there was nothing else we could do to improve it. It took us about 5 months for nursing to feel somewhat painless, however I believe I just accepted that that was the way it felt for me (or that everyone else was lying!). We pushed on and made it to 13 months nursing.  He was my chunky monkey and I have a feeling nothing was going to stop him from getting enough food. He ate great and was sleeping through the night at 12 weeks.

I recently had my second son, and nursing felt familiar. It was painful, but not as intense as with my first. Pushing through painful nursing was something I was used to but my baby was having other issues I was noticing.

A few issues he was having:
- He was still waking twice a night
- He would wake up before his dream feed, about 2 hours after bedtime
- Still wasn't taking full naps
- Only nursed about 2-2.5 ounces per feed
- Could only go about 2 hours between feeds
- His upper lip would always tuck under, even if I flanged it outward myself

First I thought it was a supply issue, then I was worried about snacking. We tried a 3.5 hour routine and then a 2.5 hour routine. The amount of milk he was getting was the big issue that I couldn’t figure out. Nothing we were doing was helping.

Signs of a Tie 
Finally a few friends suggested checking into a lip-tie or tongue-tie. I immediately started researching ties and was overwhelmed at the stories I found. They were all so much like my experience with both my boys.

Some of the symptoms in a baby could be:
-Baby not able to full drain breast
-Baby taking small frequent feeds
-Clicking at the breast
-Difficulty latching on or falls off the breast easily, milk coming out at the sides of the mouth
-Poor weight gain
-Baby pulling away from the breast
-Abnormal Sleep Patterns (due to hunger)
-Unable to keep the upper lip flanged outward
-Has a hard time eating solids once you begin
-Fussing at the breast
-Seeming tired after only a short time nursing

Some of mom’s possible symptoms:
-Sore or cracked nipples
-Pain or discomfort while nursing
-Plugged ducts/thrush/mastitis
-Low supply

With my older son, I had all of the symptoms above. My son had a few of the symptoms, but since he ate and slept great, I never thought to look into it further. His pediatrician did diagnose him with reflux because of him spitting up, coughing, and fussing at the breast; however I’ve never been convinced he had reflux. I had the pediatrician check for a tongue-tie, but he said it looked fine.

With my younger boy I only had a little discomfort and low supply. My baby showed most of the symptoms.

Our Action 
After I researched, it was like a weight was lifted off of my shoulders. I immediately knew that both of my boys had a lip tie and most likely a tongue-tie. I was also really frustrated! The pediatrician never caught the ties on either boys. Five months of nursing pain, useless worry about my supply, all of that could have been prevented if someone properly diagnosed the ties.

I spoke with my local Le Leache League and they gave me a recommendation for a pediatric dentist that was familiar with ties. The consultation was wonderful. The exam was really in depth and took things into account like the strength of the baby’s suck and much more. Tongue-ties can be tricky, because a lot of the time you can’t see it. The restriction can be under the bottom of the mouth, hidden from view. Having a professional who specializes in ties is the best way to get it properly diagnosed. I can’t stress that importance enough!

My baby had a class IV lip tie and a tongue-tie. We decided to revise both. Not only for our nursing relationship (or even our sleep!). There can be issues with a tie as your baby gets older. The procedure was done with a laser and was really fast. My baby cried, but I’m almost convinced it was just from being held down with his mouth open. As soon as they handed him to me (less than 5 minutes later) he gave the dentist a big grin. There was no bleeding and we nursed right after.

Ties in Older Children 
My ODS will have his lip tie revised later this year. Even though he isn’t nursing, he screams when we brush his top front teeth where the tie is.  There are other effects of a lip tie on an older child.

-Pain while brushing
-Hesitation or issues eating solid food
-It’s easier to get cavities because the food doesn’t escape the ‘pockets’ as easy
-Speech Issues
-Gap in the front teeth
-Gagging, choking, or vomiting foods
-Other dental problems
-Pain at the tie site

If you do choose to get a revision done, make sure to do the aftercare. The dentist will teach you stretches that should be done for 4 weeks after the revision. Be consistent with these! 

I also suggest arranging 2 appointments with a bodywork specialist. They help release the muscles that are tight. It’s almost like a mix between a massage therapist and a chiropractor. They lightly encourage your baby to relax those muscles. Our appointment took about an hour and my baby loved every minute of it. 

I also suggest setting up 2 appointments with a lactation specialist for suck training. They’ll teach your baby how to use his newly released muscles to nurse the correct and more effective way. Stretching, bodywork, and suck training will really help get the nursing relationship back on track. Be consistent with it too!

If you think your baby could have a tongue or lip tie, please arrange a consultation with a pediatric dentist or ENT that is known for being able to properly diagnose ties. Your local LLL  or a lactation specialist can help with referrals! If you’re unsure about how much your baby needs it, please meet with a specialist and at least talk it over. It’s much less traumatic for an infant than a 5 year old!

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