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Tuesday, January 4, 2011

Tongue-Tie Discussion on Doctors TV

I was glad to have it called to my attention that Tongue-Tie was discussed on Doctors TV by Dr. Jim Sears. I don't watch much TV and it's the first time I heard of the show, but I do know Drs. Sears (the father and 2 sons, all authors of many parenting books), and I knew it would be a great resource for trying to self-recognize if their baby has tongue-tie, making the decision to find a physician who will do the simple procedure, and seeing what all is involved.

Most new parents have no idea what tongue-tie is. It was my mother that was watching the show and told me about it. She said, if it wasn't for me, she wouldn't have known what it was, but because she knew I took care of breastfeeding problems and tight frenulums, it made her pay attention.

It is very intimidating to a new parent to think about "someone" making a little snip under their baby's tongue. All to often, it's the Pediatrician who tells the parent that nothing needs to be done when a parent thinks their baby may be tongue-tie. The mother goes on continuing to not be able to breastfeed. Her baby may not latch. It may be a painful latch, or it may be poor milk transfer with a failure to gain  weight. Without the Pediatrician to concur, I find parents are reluctant to pursue treatment. I find that if a Pediatrician confirms the concerns, the parents will often follow through. Far too many Pediatricians blow off tongue- tie issues, and new vulnerable parents don't know to keep questioning. That's why I am so glad this topic was covered on TV programing. I find the more (main stream) information parents have on tongue-tie and frenotomy empowers them to trust their instincts and follow through finding resources.

Dr. Sears video is here.

I take care of frenulums for breastfeeding problems. The earlier the better, but I have no age limit. I do it right in the office, parents can be present and in constant contact with their baby. After the quick procedure, if the baby is hungry, I like the baby to go to breast or at least have some skin-to-skin time while I answer questions and make some recommendations for success.

If you have sore nipples from the first latch like the baby is biting or gnawing, a tight frenulum should be evaluated for. If there is poor milk transfer with weight loss, jaundice, or decreased urine or stooling, consider checking for tongue-tie. If your IBCLC, midwife, or postpartum nurse nurse tells you they think your baby has tongue-tie, especially if you live in my area, they are usually right-on as I have been working with them for over 12 years and many of our breastfeeding supportive have been around long before me.


TopHat said...

On tongue-tie- do find some moms forgo the frenectomy and try to just work around the tongue tie? Are there resources for that? I always figured if my child ha tongue tie, I'd get it clipped but I recently ran into someone who is trying to avoid that and I was curious about logistics and what is known about coping while opting out of the surgery.

Permission to Mother said...

Great Question!

If the mom has severe pain, damaged nipples or the baby isn't feeding well at the breast, it does not make sense to opt out.

However, if it is a mild case, for example, if the feeds are lengthy, but mom is tolerating breastfeeding well, I may have her give it more time if that is her preference. In the meantime, we make sure she pays attention to position and latch, gives lots of skin-to-skin, protects her milk supply, and manage other particular concerns. All other factors should be optimzed.

PS- the office procedure is frenotomy (the snip). A frenectomy is done usually under anesthesia. It usually cuts the muscle and has stitches.

Tammy S. said...

Oh this post brought back floods of memories for me. I was a first time mother with latch issues in hospital. Only one of several OB nurses who tried to help us mentioned she thought my daughter had this condition. Unfortunately, the IBCLC wasn't due in during my entire hospital stay so we were discharged and spent 2 frustrating and tearful days at home prior to getting that consult that I paid for out of pocket. The IBCLC readily agreed as I mentioned what the one nurse had thought and luckily my pediatrician didn't hesitate with giving me a referral to an ENT. More tears as the ENT's scheduler informed me that he only performed "the procedure" in an OR under anesthesia and that I'd have to wait 3 weeks for an appt.! Thankfully, one of his associates could see us immediately and performed the frenotomy in office same day. My 5 day old infant didn't even shed a tear and there was barely a drop of blood. She latched on immediately after and ate like there was no tomorrow.
I remember my feelings of failure in those first few days at the thought of not being able to naturally nourish my baby. As I reflect back now, I also think this created some attachment / bonding issues early on for she and I.
Denise, you are a GREAT asset to this community! Thank you!

TopHat said...

Thanks! And thanks for being kind about my inability to have decent grammar on the Internet. :)

Christy said...

Like Tammy, this post brought back memories from 3 short years ago.

Since long before I got pregnant, I knew I wanted to breastfeed. While I was pregnant, I went to LaLeche meetings and thankfully, found you!

When I gave birth and saw my son's first cry, I knew he was tongue-tied. I didn't know it would affect his nursing though. I vividly remember him not latching. I cried all the way to the nurses station to get formula for him. It broke my heart.

When we were released from the hospital, we went to your office and I sat in the corner crying while my husband held my son, and you did the frenotomy. It was over in the blink of an eye, and he went straight to nursing afterwards.

I'm so thankful you were able to take care of him, and still do.

Permission to Mother said...

Tammy S. and Christy, Thank you for sharing your experience. Tammy, I especially like how you contribute to this topic the lost bonding time. I hope with that insight more mothers will recognize their feelings which may be similar.

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