The Long Story of a Short Tongue: Part One

Written by Laura on December 20th, 2010

Breastfeeding, Breastfeeding Alternatives, Feeding With Love
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A freshly baked Bear sleeps.

When people ask how I decided to breastfeed, I often give them a blank stare. For my husband and me, there really was no other choice. We were both breastfed; my mother nursed me until I was two and a half. Our first child nursed easily and fairly effortlessly; our second even more so. Breastfeeding for me was easy, natural and joyful.

When my third son, Puddin’Pie, was born early at 35 weeks, I had to pump for him until he could nurse. I sat in his room in the NICU, watched the machines breathe for him as a machine expressed my milk into plastic bottles. When he came home, I spent another month pumping, breastfeeding, feeding supplements of expressed milk, fiddling with a nipple shield and dragging him to multiple weight checks. It was very hard and very stressful; I felt that it was the hardest I had ever and would ever work to get a child to nurse.

I was so, so wrong.

When our fourth child, Bear, was born at a healthy 38 weeks, I thought breastfeeding would be a snap. He was healthy, term, and I was a seasoned, experienced nursing mother. To top it off, I was able to birth without drugs and he was placed on my belly within seconds of his birth. The breastfeeding cards were definitely in our favor.

But when he tried to latch on for the first time, he unlatched and cried. My doula and I tried again, he seemed unable to latch on. A lactation consultant came in and tried to help, but he never got any suction. I remember my doula saying, “Laura, you might need to get him evaluated for a tongue tie.

“Well, he’s only forty-five minutes old,” I said. “Let’s give him some time.”

That evening, it seemed that I was right. He eventually latched on and nursed . . . but only for a few minutes before falling asleep. I chalked it up to normal newborn sleepiness and kept working at it.

Meanwhile, my doctor came to visit me. He expressed some concern about the baby’s weight loss but I said that he had been having plenty of wet and poopy diapers. The doctor seemed pleased but said he didn’t want the baby’s weight to drop much lower. He wanted me to supplement with expressed milk or formula until my milk came in.

I love my doctor very much and trust him completely, yet I also knew that it is quite normal for babies to lose ten per cent of their birth weight. I also knew all about the benefits of a “virgin gut” and the possibility of “nipple” or “flow” confusion and I didn’t want to risk creating any problems. I agreed but expressed my opinion that everything was fine because, by day two, my milk was already coming in. He still encouraged me to see the hospital lactation consultant again before we left, and I agreed to.

The LC came in and also thought Bear’s weight loss was within the normal limits. She said my doctor is very careful about weight loss but also very pro-breastfeeding, which I knew. I requested formula, but she encouraged me to pump and supplement with my milk. She gave me an intensive one-on-one session with the Bear. Although he latched on and sucked, he never seemed to draw my nipple back into his mouth; it always looked like a “raspberry” instead of a “bottle nipple.” We laughed at his antics and then I pumped some milk, proving my theory that I was making “transitional milk” already. The LC gave me the supplies to tube feed him, which we did, and some formula “just in case.”

That formula turned out to be my saving grace.

The Bear and I were discharged 2 days after his birth. In addition to all the “new baby” paperwork, I had orders for a home health nurse to monitor the baby’s weight loss and two bottles of formula.

The home health nurse came the next day. She turned out to be a sweet lady, the mother of seven and grandmother to four. She loved on Bear and weighed him. He was born at seven pounds, one ounce and discharged at six pounds, six and a half ounces. She helped me wake him up to eat and he ate; we could hear him gulping across the room. He was a still a sleepy baby and a spotty eater but we all thought he just needed some time to wake up and get the hang of it. Meanwhile, I was pumping after every feeding to keep my supply up and to provide milk to supplement with.

Within a few days of coming home, nights became hell. Around 5:00p.m., Bear would cry, scream and generally pitch a fit. I could not get him to nurse. He would cry and suck his fingers but NOT latch on. I tried everything- a nipple shield, a pacifier, the sling, a warm bath and he still cried. If he latched on, I couldn’t move or talk lest he unlatch . . . and then there was no hope of getting him back to the breast. I thought we just had a fussy, high needs baby on our hands.

One night, I was sitting in the rocker trying to get him to latch on. He would try and then let the nipple ooze from his mouth. Out of desperation, I grabbed one of the pre-made bottles of formula and fed it to him. I knew all the risks but something inside me told me that he needed the bottle. He sucked it down and then had a dirty diaper.For a moment, I felt embarrassed. What forth-time mother doesn’t recognize the signs of gas? But I quickly dismissed the feeling as my baby fell into a contented sleep.

The middle of the night feedings were just as bad as the day. Although he woke on a regular basis, he would often fall right back to sleep when we tried to nurse. I was exhausted and would nod off with him. I knew that, at night, he wasn’t getting a full feed from me. I would try to start and finish each feed with formula or expressed breast milk; he would vomit up the formula and suck down the breast milk as if he was starving.

Even after the home health nurse was discharged, he still had frequent weight checks with our doctor. Often, he would gain an ounce, only to lose it (or more) by the next weight check. He had also developed a side preference and would NOT nurse on my left. He was still latching poorly and, when he did latch, I could hear a “clicking” noise as he sucked. I still had a tube and was trying to tube feed him at the breast. It was complicated and often I would latch him on and snake the tube into his mouth, only to have him latch off and suck on the tube! Feedings took over 30 minutes both day and night, and they sometimes ended with the Bear taking a bottle of expressed milk because we were both so frustrated and upset.

To top it off, I thought he was having enough wet and poopy diapers. However, they weren’t very wet, and when he sucked on my pinky, his mouth didn’t seem terribly moist. I thought that I was just used to sopping wet toddler diapers and, of course, a newborn wasn’t going to have diapers as wet as a 25 pound toddler. Sadly, I wasn’t keeping a written record of his diapers, so all I had was my poor, sleep-deprived memory of how many diapers I had changed. Not recording the wet/dirty dirty diaper count was the stupidest thing I have ever done as a parent.

I remember saying to my doctor, “I feel like something is wrong. His latch just doesn’t feel right.” When he questioned me about my supply, my fluid intake and diet, I responded that I was pumping plenty; more than enough to feed him the recommended ounce after each feeding. “I know there’s nothing wrong with me,” I joked. “If something is wrong, it’s with him – not me. We know my boobs work!”

After more consultation, the doctor said, “Keep bringing him in for weight checks and supplement with breastmilk or formula after each feeding. But he’s still little and new; once he wakes up more and gets some weight on him, he’ll get it.”

He was wrong.

Did you have a baby with tongue tie? Share your story in the comments. Stay tuned for part two of Laura’s story later this week – it gets better!

About The Author: Laura

Walden Mommy: Life Behind the Red Front Door My NPN Posts

Laura is the mother to a herd of four small children, wife to her Engineer Husband, and owner of a pesky dog. She blogs about her life in the Midwest at Walden Mommy: Life Behind the Red Front Door.

9 Responses to The Long Story of a Short Tongue: Part One

  1. Maman A Droit  

    Our little guy is tongue-tied but was a champ nurser anyway, much to my relief. I did have quite a bit of nipple pain at first though & I think it was due to the tongue-tie! Even so, we were very lucky I think!

    • Laura

      Oh, wow! I’ve heard that some people can nurse, and have their baby gain weight, even with a tongue tie. I know a couple who had it clipped but would still nurse, abiet with alot of pain. Good for your little dude- and you!

  2. Pearl

    Can’t wait for Part Two!

    The “tube feeding” took me a minute, though. I finally realized you meant a supplemental nurser, but as the mommy of a tummy-tube kid, it confused me at first! :)

    • Laura

      Lol, I can see how that would be confusing!

      I actually used an nG tube. It is a thin tube that snakes through the nose into the stomach. There is a little area at the top where you can “Screw” a syringe in and let the milk flow through the tube into the baby’s stomach. I would either use the tube to finger feed him or slip the end into his mouth after he was latched on. I, or another helper, would sloooowly dispense the milk through the syringe attached to the tube. It was time consuming and messy, but really helped boost my supply in those first few days!

      Thanks for your comment so i could clarify!

  3. Lindsey

    My son did breastfed, and gain, successfully with a tongue-tie (we weren’t even sure right away that he had it, and then when it was confirmed, we weren’t sure it would be detrimental to him). I had the worst nipple pain for weeks while nursing him. It felt like shards of glass at times. Deep fissures formed in my nipples before I had an IBCLC come out around day 7. She ordered a very strict change of regimen which helped me heal, but we didn’t ever go get his tongue tie checked out or clipped. He went on to nurse for 18 months successfully. At age 4, we decided to pursue the surgery, b/c a pedi we saw wondered if it might be affecting his speech. Boy, can you believe such a surgery (outpatient) costs over $10,000?? This is a long way to say, if you’re going to do the surgery, earlier is better. Thankfully, he came out of it well and healed perfectly, but I might do it differently if I had the chance again.

    • Laura

      YIKES! What did the LC do differently, if I may ask? I didn’t have horrible nipple pain (although I had some) but I figure since it was my fourth baby, you could do alot to my nipples before I felt pain. Lol.
      We were told the earlier the better also. My PuddinPie is in speech and his therapist recommends the earlier the better also.

  4. Danielle S.

    I know the “shards of glass” feels like. My first son was tongue-tied and he would gum my breast to express the milk because of his poor latch. The first week he was home I remember holding him while he screamed and trying to get up the courage to try again, and then having his dad come and take him away from me and give him a bottle – I was both relieved and ashamed. I had a LC come by and she diagnosed him with tt immediately, and told me her son had a tt as well and that she “lost a nipple” from it. She went on to tell me her son’s dentist clipped his tongue tie when he was 6 because his tongue was pushing on his bottom teeth. We saw a ped and an ENT specialist about it but no one would clip my son’s tt, and I was too timid to push the issue. I had constant blood blisters on my breasts from the gumming and it felt like shards of glass cutting me inside when he nursed, then around 3 months it started to get better, I guess his tongue grew, and I was able to nurse him until he was almost 3. I’ve since had two other kids and was able to nurse them without any latch problems.

  5. Kay McKee, IBCLC

    I feel like the tongue-tie queen. I’ve been an IBCLC for a long time, and only in the last 5 years are we getting increasing recognition from docs and others that this is a serious feeding issue, that the benefits of human milk and of actually feeding at breast make fixing this problem important (rather than just pumping or switching to formula), and that clipping even before leaving the hospital is by far best. There are different types of TT, and though they can often extend well, many TT babies cannot elevate well, which the AAP newsletter in 2004 indicates is the most important part.

    Sometimes these babies should also be seen by an OT after their tongue is revised, as they often have formed oral behaviors in utero that can be improved.

    Red flags: high domed palate. tongue stays in floor of mouth when fussing. jaw motion is chompy, jerky, or has frequent tremors. Baby does not open well. Top lip rolls in frequently. Suck feels very strong or soft. Clicking or smacky/slurpy noises. Cheeks suck in when sucking. Leaks milk. Frequent congestion. sore nipples. Bites and gnaws on mom. Low milk supply. Baby feeds in short bursts (3-5 sucks then pauses, not 8-12), comes on and off frequently, feeds around the clock when should be spacing out, colicky, gerd, slow wt gain. Early engorgement despite frequent “feeds”.

    Long term: reduced human milk intake, early weaning, sub-optimal growth and health. Dental decay. Narrow dental arch leading to braces. Speech. Can’t lick an ice cream cone or french kiss.

    this is usually a 10-30 second procedure in the first month with only drips of blood and brief if any pain. The babies HATE being held still and scream, but that makes it easier to do and over sooner. the longer you wait, the more developed the tissues (and poor feeding patterns)become, and the more involved, expensive the treatment. Most TT babies BF far more comfortably and effectively right afterward; some will need some LC or OT work.

    What I can’t figure out is why docs are so resistant to clipping or referring for clip, refuse to read or believe their own research, and often put mothers and babies through weeks or months of hell that should be blissful baby time. BUT THEY DON’T BAT AN EYE AT THE ROUTINE REMOVAL OF THE FUNCTIONAL FORESKIN TISSUE OF MOST BABY BOYS, WITH NO LITERATURE TO SUPPORT IT, AND THE CURRENT POSITION BEING THAT BENEFIT DOES NOT OUTWEIGH RISK. What happened to first, do no harm?

    If you think your baby may be tongue tied, please see the info at http://www.kiddsteeth.com and at http://www.brianpalmerdds.com. See an IBCLC, and insist on your baby being evaluated by someone who believes in BF.

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