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Saturday, March 5, 2011

Posterior Tongue-tie

It's often very satisfying to help a mom with a tongue-tied baby because there is almost INSTANT relief.
If I suspect tongue-tie, I recommend taking care of it as soon as possible, if the mom wants to continue breastfeeding.

This past week a mom came in with her two month old. She had constant nipple pain almost from the first latch. She described her baby as clenching and intense. She has been treated for several rounds with anti-fungals. The baby never showed any symptoms of thrush. Out of desperation, baby was treated, too with anti-fungals. The only thing that consistently relieved nipple pain was to pump and give the nipples a rest from the baby's latch. The focus of treatment was on thrush and keep giving mom more anti fungals. Mom was also doing elimination diets wondering if something in her diet was upsetting the baby making him intense.

What made me suspect tongue-tie?
1. Nothing else helped.
2. I always think of tongue-tie because it's what I do.
3. Yeast doesn't occur at the first or second latch. (However with nipple damage, she could have at some point had an infection.) Also, yeast is hard to treat, but not impossible to treat.
3. The only time she got a break was when the baby wasn't latching.

Okay, so I looked at the baby's mouth. I wasn't that impressed, but there was a posterior frenulum. It wasn't long. It wasn't particularly noticeable. I could see how other professionals not so focused on tongue-tie could easily overlook this. I recommended clipping it because the mom's history was right-on: nipple pain from birth, baby was intense and clenching.

Mom nursed baby right away after frenotomy. As suspected she noticed a decrease in pain, good milk transfer, a satisfied baby, a relaxed snugly baby. And he wasn't very intense anymore.

What  do I learn from this. Tongue-tie may be suspected by just listening to what the mother is saying. A baby who is not getting adequate milk transfer, seems to be biting, clenching, and intense is probably a baby that would benefit from a frenotomy. (especially when "everything" else isn't helping.) Obviously, confirm suspicions of tongue-tie by checking the baby.

My approach to tongue-tie may not be very scientific based, but it's one that works for the families that come to me.

I found this relatively new professional group uniting tongue-tie professionals, International Affiliation Tongue Tie Professionals. 

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