Balian's new favorite obsession:
Tuesday, May 31, 2011
Saturday, May 21, 2011
More on Tongue Ties and Breastfeeding
I'm starting to feel like I'm back in college. I consider myself to be a pretty research-driven person, especially when it comes to my kids. From childbirth options to circumcision, diapering, baby routines, cereal in the bottle, environmental toxins, organic milk, vaccines, different styles and methods of parenting, and the like - I've researched it all. I feel like I should never be surprised anymore when it comes to astounding correlations between symptoms and their root causes. Oh, but I am!
The more I learn about tongue-ties and how much they affect not only breastfeeding, but so many other things, I am amazed. The more we go through all of this with Isaiah, the more I realize just how much tied tongues have impacted my life over the past 4 years. So many pieces of the puzzle are coming together. I consider myself to be one of the fortunate few that have been able to get so many questions answered.
This past weekend there was a seminar led by a pediatric dentist, Lawrence Kotlow DDS from Albany, NY. He specializes in laser dental surgery - a lot of which are tied tongues and tied lips. Although I was not able to attend, I was able to get the notes from the ladies at Edenway Birthing Center that were able to be there. It is seriously amazing.
Let's get down to basics.
The technical term for the condition of being tongue-tied is Ankyloglossia.
The tied upper lip is referred to as an abnormal maxillary lip attachment.
Here is an example of Ankyloglossia:
This is a pretty severe one. Either a class III or class IV - probably class IV, since it's all the way to the tip of the tongue - and this is what Isaiah's looked like. He now has a line under his tongue (scar tissue) from the very tip of his tongue, all the way back.
This is Isaiah's abnormal maxillary lip attachment Notice how the tie extends down the gum line to the point that it is actually indenting the gum line upward. This is the most severe classification (class IV) lip tie.
Both tongue and lip ties can be much less severe than these and still cause LOTs of problems.
Apparently the vast majority of OBs, pediatricians, and even lactation consultants don't think that a tongue-tie is that big of a deal. The medical community got out of practice of dealing with them routinely when the percentage of breastfeeding moms dropped dramatically throughout our century due to the cultural norm shifting to bottle-feeding. So for a long time, nobody diagnosed tongue-ties because people simply weren't breastfeeding...and no breastfeeding meant no issues with breastfeeding...so there wasn't an imminent need to diagnose them. Now, a lot of practitioners think that the tied-tongues will simply "stretch out" over time, and that lip ties just need to be taken care of by the time they are 3, so it doesn't interfere with oral development. However, this is not reality, and there really is so much more to it than what they think.
Problems that can occur if a tie is not treated:
Nutritional problems
colic or excessive gas
GI problems like reflux
drooling
gagging
sleep apnea
changes in sleep patterns
speech problems
tooth decay
jaw growth and development
psychological problems
Ssymptoms an infant may exhibit if they have a tie:
gagging
colic and/or gas
GI problems
tongue can not protrude past the gum line out of the mouth
tongue cannot touch the hard palate of the mouth
"poor sleeper"
So it isn't just breastfeeding that is affected by a tongue or lip tie, it's just one of the most significant means by which it is detected. Many of these symptoms - all of the infant symptoms - aren't any better when breastfeeding ceases. Bottle feeding could actually make a lot of these symptoms worse.
I remember what life was like with Bella and Balian as infants. Balian had really bad reflux. He also had gas, and was almost impossible to burp. He would be fine, but then as soon as I would lie him down for a nap he would get fussy. I knew his tummy hurt, but the question was always Why? was he hungry? was it gas? was it the reflux? He pretty much didn't nap during the day, then was so exhausted that he would poop out at night. This, combined with insufficient weight gain and latch problems (see below) made me think he would be better off on a bottle. Nope. It made it tons worse - and added a whole new spin on the already existing problems. He stopped sleeping through the night and always, always, always had gas. It was horrible. Once on the bottle for good, the pediatrician said that he didn't have reflux - he was just eating too much at each feeding - and that's why he was spitting up so much. Just FYI - Balian still can't really extend his tongue over his lip. It goes just about even with the front of his gum line (maybe a bit further) and can touch the inside of his lip, but that's as far as it goes.
And there was Bella, who shared all of the below symptoms with Balian...
Symptoms of a baby with a tie if breastfeeding:
cannot latch on
unsustained latch
slides off of nipple
prolonged feedings
unsatisfied after prolonged feedings
falls asleep at the breast
gumming or chewing on the nipple
poor weight gain or failure to thrive
unable to hold pacifier in mouth
She had every single one of these symptoms. And she doesn't even have a tied tongue - just a tied lip. She didn't seem to have the colic or sleeping issues that Balian did, but breastfeeding was not good. She did have some gas and reflux, but not to the same severity as Balian.
This time around, with Isaiah, we were looking for the tied tongue, and Isaiah's was bad - pretty much all the way to the front (tip of the tongue), causing his tongue to be heart-shaped. Even after Melody (midwife) clipped the front part of the tie, he still could not extend his tongue past his gum-line. He had all of the symptoms above, and I had all of the symptoms below, minus (praise the Lord) the infections or mastitis. I definitely had some bulging ducts, but used wet heat and massage to get them drained. After going to the ENT to get his tongue clipped, things definitely got a LOT better. He started gaining weight, my blisters went away, he was draining me more... I was still a little sore - nothing that I couldn't handle, but still wondering why I was still having some of the same symptoms associated with a tongue-tie, if the tongue-tie had been resolved...
Symptoms of the breastfeeding mom:
creased or blanched nipples after feeding: flattened
cracked, bruised, or blistered nipples: gives it up
bleeding nipples
severe pain with latch
incomplete breast drainage
infected nipples
plugged ducts
Mastitis and nipple thrush
Then we started having some big-time gas/colic issues with Isaiah...just like Balian. It started out not too bad...just some toots that he had no problem getting out - some spitting up - nothing horrible...and he was sleeping well, so it didn't bother me. Then, as he started eating more and growing, things began to change. It's like the more he eats, the more gas he has. He has gone up to 8 hrs. between feedings at night - but very few times. Even when he has gone that long, I've been up with him for as much as an hour or two at a time trying to get gas out - both burps and otherwise. Diet changes (mainly dairy) on my part haven't helped. The kid is almost impossible to burp because he has SO many in there - I could burp him forever and never get them all out. We've tried Mylicon at various times - before, during, and after feeds - and we've had no difference in outcome. Isaiah's sleeping has gotten worse over time. His naps aren't great, because he wakes up frequently needing to burp.
And the whole time I'm thinking "This is just like what happened with Balian..."
I called my Lactation Consultant, and asked her if the gas could be related to the lip tie. It was the only thing that seemed logical. She agreed completely.
The hard thing was what to do about it. It's a pretty difficult thing to find a practitioner who does tie corrections with a laser, but that's what is needed, especially with babies. Up to this point, the only person they (lactation consultants/midwives) knew that did the laser corrections was the pediatric dentist they found in NY(that led the seminar mentioned above)... yeah. That wasn't an option. Looking for a pediatric dentist or ENT that would correct the lip tie on a 2-month-old was a waste of time - most just simply won't do it. (they don't see it as necessary until they are older...like at least 3). And even if they were willing, the procedure would use anesthesia stitches, and would be pretty painful.
However, now they have just recently found another Dr. - Dr. Stacy Cole - a dentist in Ft. Worth that does lip and tongue ties with a laser. No anesthesia, no stitches, quick recovery...and pain dull enough to be handled with a normal dose of Tylenol. Not just for Isaiah, but at any age...meaning all 3 kids.
I've called and gotten more information about it. It isn't cheap - about the same cost as the ENT, but he charges the same amount, regardless of if he does just one or both of the procedures (tongue and lip tie together cost the same as just a lip or just a tongue.) Too bad we didn't know about this dentist before...but at least we know now! But really, getting the lip tie taken care of could save us a ton of time, money, and headache in the long-run. Less cavities/tooth decay - so less fillings and dental visits AND less gas/colic - meaning more sleep and a happier mommy!
So hopefully, we will be getting the issue resolved for Isaiah very soon. The other kids will have to wait a bit. I'll post more once we're on the other side...
***If you want a wealth of information about all of this, go to Dr. Kotlow's website - click on Articles - and you pretty much have all you've ever wanted to know about tongue and lip ties. He has done TONS of research on all of this - most of which has been through experience in his own practice. Seriously, check it out! Great information that you really can't get anywhere else.
The more I learn about tongue-ties and how much they affect not only breastfeeding, but so many other things, I am amazed. The more we go through all of this with Isaiah, the more I realize just how much tied tongues have impacted my life over the past 4 years. So many pieces of the puzzle are coming together. I consider myself to be one of the fortunate few that have been able to get so many questions answered.
This past weekend there was a seminar led by a pediatric dentist, Lawrence Kotlow DDS from Albany, NY. He specializes in laser dental surgery - a lot of which are tied tongues and tied lips. Although I was not able to attend, I was able to get the notes from the ladies at Edenway Birthing Center that were able to be there. It is seriously amazing.
Let's get down to basics.
The technical term for the condition of being tongue-tied is Ankyloglossia.
The tied upper lip is referred to as an abnormal maxillary lip attachment.
 |
| Ankyloglossia |
Here is an example of Ankyloglossia:
This is a pretty severe one. Either a class III or class IV - probably class IV, since it's all the way to the tip of the tongue - and this is what Isaiah's looked like. He now has a line under his tongue (scar tissue) from the very tip of his tongue, all the way back.
 |
| Abnormal maxillary lip attachment |
This is Isaiah's abnormal maxillary lip attachment Notice how the tie extends down the gum line to the point that it is actually indenting the gum line upward. This is the most severe classification (class IV) lip tie.
Both tongue and lip ties can be much less severe than these and still cause LOTs of problems.
Apparently the vast majority of OBs, pediatricians, and even lactation consultants don't think that a tongue-tie is that big of a deal. The medical community got out of practice of dealing with them routinely when the percentage of breastfeeding moms dropped dramatically throughout our century due to the cultural norm shifting to bottle-feeding. So for a long time, nobody diagnosed tongue-ties because people simply weren't breastfeeding...and no breastfeeding meant no issues with breastfeeding...so there wasn't an imminent need to diagnose them. Now, a lot of practitioners think that the tied-tongues will simply "stretch out" over time, and that lip ties just need to be taken care of by the time they are 3, so it doesn't interfere with oral development. However, this is not reality, and there really is so much more to it than what they think.
Problems that can occur if a tie is not treated:
Nutritional problems
colic or excessive gas
GI problems like reflux
drooling
gagging
sleep apnea
changes in sleep patterns
speech problems
tooth decay
jaw growth and development
psychological problems
Ssymptoms an infant may exhibit if they have a tie:
gagging
colic and/or gas
GI problems
tongue can not protrude past the gum line out of the mouth
tongue cannot touch the hard palate of the mouth
"poor sleeper"
So it isn't just breastfeeding that is affected by a tongue or lip tie, it's just one of the most significant means by which it is detected. Many of these symptoms - all of the infant symptoms - aren't any better when breastfeeding ceases. Bottle feeding could actually make a lot of these symptoms worse.
I remember what life was like with Bella and Balian as infants. Balian had really bad reflux. He also had gas, and was almost impossible to burp. He would be fine, but then as soon as I would lie him down for a nap he would get fussy. I knew his tummy hurt, but the question was always Why? was he hungry? was it gas? was it the reflux? He pretty much didn't nap during the day, then was so exhausted that he would poop out at night. This, combined with insufficient weight gain and latch problems (see below) made me think he would be better off on a bottle. Nope. It made it tons worse - and added a whole new spin on the already existing problems. He stopped sleeping through the night and always, always, always had gas. It was horrible. Once on the bottle for good, the pediatrician said that he didn't have reflux - he was just eating too much at each feeding - and that's why he was spitting up so much. Just FYI - Balian still can't really extend his tongue over his lip. It goes just about even with the front of his gum line (maybe a bit further) and can touch the inside of his lip, but that's as far as it goes.
And there was Bella, who shared all of the below symptoms with Balian...
Symptoms of a baby with a tie if breastfeeding:
cannot latch on
unsustained latch
slides off of nipple
prolonged feedings
unsatisfied after prolonged feedings
falls asleep at the breast
gumming or chewing on the nipple
poor weight gain or failure to thrive
unable to hold pacifier in mouth
She had every single one of these symptoms. And she doesn't even have a tied tongue - just a tied lip. She didn't seem to have the colic or sleeping issues that Balian did, but breastfeeding was not good. She did have some gas and reflux, but not to the same severity as Balian.
This time around, with Isaiah, we were looking for the tied tongue, and Isaiah's was bad - pretty much all the way to the front (tip of the tongue), causing his tongue to be heart-shaped. Even after Melody (midwife) clipped the front part of the tie, he still could not extend his tongue past his gum-line. He had all of the symptoms above, and I had all of the symptoms below, minus (praise the Lord) the infections or mastitis. I definitely had some bulging ducts, but used wet heat and massage to get them drained. After going to the ENT to get his tongue clipped, things definitely got a LOT better. He started gaining weight, my blisters went away, he was draining me more... I was still a little sore - nothing that I couldn't handle, but still wondering why I was still having some of the same symptoms associated with a tongue-tie, if the tongue-tie had been resolved...
Symptoms of the breastfeeding mom:
creased or blanched nipples after feeding: flattened
cracked, bruised, or blistered nipples: gives it up
bleeding nipples
severe pain with latch
incomplete breast drainage
infected nipples
plugged ducts
Mastitis and nipple thrush
Then we started having some big-time gas/colic issues with Isaiah...just like Balian. It started out not too bad...just some toots that he had no problem getting out - some spitting up - nothing horrible...and he was sleeping well, so it didn't bother me. Then, as he started eating more and growing, things began to change. It's like the more he eats, the more gas he has. He has gone up to 8 hrs. between feedings at night - but very few times. Even when he has gone that long, I've been up with him for as much as an hour or two at a time trying to get gas out - both burps and otherwise. Diet changes (mainly dairy) on my part haven't helped. The kid is almost impossible to burp because he has SO many in there - I could burp him forever and never get them all out. We've tried Mylicon at various times - before, during, and after feeds - and we've had no difference in outcome. Isaiah's sleeping has gotten worse over time. His naps aren't great, because he wakes up frequently needing to burp.
And the whole time I'm thinking "This is just like what happened with Balian..."
I called my Lactation Consultant, and asked her if the gas could be related to the lip tie. It was the only thing that seemed logical. She agreed completely.
The hard thing was what to do about it. It's a pretty difficult thing to find a practitioner who does tie corrections with a laser, but that's what is needed, especially with babies. Up to this point, the only person they (lactation consultants/midwives) knew that did the laser corrections was the pediatric dentist they found in NY(that led the seminar mentioned above)... yeah. That wasn't an option. Looking for a pediatric dentist or ENT that would correct the lip tie on a 2-month-old was a waste of time - most just simply won't do it. (they don't see it as necessary until they are older...like at least 3). And even if they were willing, the procedure would use anesthesia stitches, and would be pretty painful.
However, now they have just recently found another Dr. - Dr. Stacy Cole - a dentist in Ft. Worth that does lip and tongue ties with a laser. No anesthesia, no stitches, quick recovery...and pain dull enough to be handled with a normal dose of Tylenol. Not just for Isaiah, but at any age...meaning all 3 kids.
I've called and gotten more information about it. It isn't cheap - about the same cost as the ENT, but he charges the same amount, regardless of if he does just one or both of the procedures (tongue and lip tie together cost the same as just a lip or just a tongue.) Too bad we didn't know about this dentist before...but at least we know now! But really, getting the lip tie taken care of could save us a ton of time, money, and headache in the long-run. Less cavities/tooth decay - so less fillings and dental visits AND less gas/colic - meaning more sleep and a happier mommy!
So hopefully, we will be getting the issue resolved for Isaiah very soon. The other kids will have to wait a bit. I'll post more once we're on the other side...
***If you want a wealth of information about all of this, go to Dr. Kotlow's website - click on Articles - and you pretty much have all you've ever wanted to know about tongue and lip ties. He has done TONS of research on all of this - most of which has been through experience in his own practice. Seriously, check it out! Great information that you really can't get anywhere else.
Wednesday, May 18, 2011
2 months!
Isaiah's 2-month stats:
Height: 22 inches
Weight: 9 lbs. 11 oz.
I can't believe Isaiah is 2 months old already. It's amazing how quickly time passes when you're trying to keep up with 3 kids! At home, we're pretty good - we've got a pretty good rhythm going. Outings are getting better, but I still feel pretty overwhelmed with all 3 by myself out and about at this point. I also need to work on divvying up my time with the other two kids a little better than I have been. They are just crying out for attention, and I feel like I'm either feeding or putting Isaiah down for a nap...or trying to catch-up on the motherload of housework that needs to be done that has been neglected for so long. 24 hours in a day just doesn't seem to be enough at this point. But I am celebrating the small accomplishments - last week I did all the laundry and cooked 2 times!! yeah!
Isaiah is doing pretty good. He's smiling a lot - at everybody, keeping eye contact following objects from one side to the other, holding his head up and looking strait ahead when he's on his tummy. And yes, he's still rolling over from tummy to back - both directions.
He's gaining weight well, averaging a little over an ounce per day. He's still nursing exclusively, and he's only had 1 bottle of breast milk. He took the bottle well, we just weren't prepared to give him as much as he needed, which made it very interesting. After that, I did a weigh/feed/weigh to figure out how much he's getting from me, and he's getting close to 6 oz.! We are still having some problems with physical abnormalities of the mouth....which I'll post more on later.
Height: 22 inches
Weight: 9 lbs. 11 oz.
I can't believe Isaiah is 2 months old already. It's amazing how quickly time passes when you're trying to keep up with 3 kids! At home, we're pretty good - we've got a pretty good rhythm going. Outings are getting better, but I still feel pretty overwhelmed with all 3 by myself out and about at this point. I also need to work on divvying up my time with the other two kids a little better than I have been. They are just crying out for attention, and I feel like I'm either feeding or putting Isaiah down for a nap...or trying to catch-up on the motherload of housework that needs to be done that has been neglected for so long. 24 hours in a day just doesn't seem to be enough at this point. But I am celebrating the small accomplishments - last week I did all the laundry and cooked 2 times!! yeah!Isaiah is doing pretty good. He's smiling a lot - at everybody, keeping eye contact following objects from one side to the other, holding his head up and looking strait ahead when he's on his tummy. And yes, he's still rolling over from tummy to back - both directions.
 |
| Isaiah sportin' his BabyLegs and newly made wool cover. |
Wednesday, April 20, 2011
Isaiah Update
We had our last appointment with Melody and crew yesterday at the Birthing Center. So sad... We did a weight check for Isaiah and with his clothes on he weighed 8 lbs. 10 oz. At home I weighed him naked and he was 8 lbs. 5 oz.
Last week at the doctor he weighed 7 lbs. 7 oz., which means that he gained a total of 14 oz. in a week! That's 2 oz. per day!! Yes, we have a growing boy!!
And speaking of growing, Isaiah is rolling over already. It actually started when he was 3 weeks old, and he's done it many times since. He is so strong at such a young age! Now, he's actually starting to kinda scoot himself backward a bit when he's on his tummy somehow...just crazy.
Anyway, to prove it, here's a video of Isaiah rolling - sorry for the odd angle; I couldn't get it to rotate.
Last week at the doctor he weighed 7 lbs. 7 oz., which means that he gained a total of 14 oz. in a week! That's 2 oz. per day!! Yes, we have a growing boy!!
And speaking of growing, Isaiah is rolling over already. It actually started when he was 3 weeks old, and he's done it many times since. He is so strong at such a young age! Now, he's actually starting to kinda scoot himself backward a bit when he's on his tummy somehow...just crazy.
Anyway, to prove it, here's a video of Isaiah rolling - sorry for the odd angle; I couldn't get it to rotate.
Monday, April 18, 2011
Friday, April 15, 2011
Tongue Ties and Breastfeeding
Breastfeeding has never been easy for me.
I had a rough time with both Bella and Balian. Different experiences, but equally as difficult. With Bella, I only lasted 2 months. With Balian, about 2.5. I wanted desperately to breastfeed, so I tried with everything I had for those 2 and 2.5 months. In the end, we ultimately decided that a happy formula-feeding mommy is better than a stressed-out breastfeeding mommy with low birth-weight babies. That decision still stung whenever people asked me about if I had breastfed my kids, and for how long...It just made me re-live the stress, the pain, the exhaustion, and the feelings of inadequacy every time.
So, this time around, I did all the research I possibly could. I learned more about technique - single side vs. double-side feeding, talked to the breastfeeding moms around me about their experiences, read articles on LaLecheLeague's website, rigged up a way to do a very accurate weigh/feed/weigh at home if needed, talked to the midwife a lot about how to deal with issues, and just hoped for the best, but prepared myself for the worst, I suppose.
When I first started midwifery care, we talked about the breastfeeding drama. The first thing Melody asked was "were they tongue tied?"
Tongue tied? I'd never heard of it, other than a figure of speech. I didn't know it actually existed as a condition - and how in the world did that relate to breastfeeding?
Melody had been trained to check for a tied tongue immediately after birth, and considering my breastfeeding history, she was definitely going to be checking. Sure enough, Isaiah had a VERY tied tongue. Heart-shaped in the front, and connected very near the front of the tongue. She didn't do anything at first, but after Isaiah's first feeding, I already had a blister on my nipple.
So, Melody cut his frenulum a bit - as much as she could with the scissors that she had with her, and said we would go from there.
This is not Isaiah. I got this picture from another blog that posted about a tongue-tied baby. But Isaiah's tongue tie was probably just as severe as this one. Notice the connection from the bottom (and tip) of the tongue to the bottom of the mouth. This is the frenulum.
The next day (Friday) we had a check-up with Melody. Isaiah's birth weight was 6 lbs. 8 oz., and now he was at 6lb. 2 oz. She wasn't super-happy with his latch, so she got better scissors and cut as much of Isaiah's frenulum as she felt comfortable cutting. She said that it looked like there was a lot more that was a lot thicker that needed to be cut, but she couldn't be the one to do it. She said to see how it went with what was cut and to go from there.
That night my milk came in and everything got 10x worse. Not only was I dealing with engorgement, but my nipples were in some serious pain. Each day got progressively worse. I got really stressed out about him not latching on right. It got to the point that I dreaded feeding Isaiah, and I was hurting so bad that I didn't want the kids to come within arm's reach when I was feeding...and there were many tears. I hated feedings. Bonding? What bonding? It was too stressful.
By Tuesday I would burst into tears at the thought of feeding him - and I cried the entire 30 minute drive to the Birth Center for my appointment with Melody. Of course, as soon as she saw me, she asked if I was ok, and I immediately shook my head no. She asked what was wrong and I responded "Just thinking about feeding him kills me." She immediately took me into a separate room to talk to me. We weighed Isaiah - 6 lbs. 2 oz. again. In the meantime, Kristin, the chiropractor, came in and started checking out Isaiah. She worked on his hard palette, because it was pretty high, and adjusted his jaw that was out of line. This definitely helped a lot. If nothing else, it helped Isaiah be able to open his mouth up wider. Melody looked at the condition of my nipples. She saw how blistered and cracked they were, gave me some nipple balm that a client's mom makes out of tons of herbs, and immediately called the lactation consultant. Dierdre agreed to meet us at the Birth Center for a consultation ASAP, which was about 2 hrs. later, since she was driving from Arlington.
The first thing Dierdre did was look at Isaiah. She didn't ask me any questions until she was finished. She concluded that Isaiah did indeed have more frenulum under his tongue that needed to get checked out by someone who could cut it. She also said that his upper lip was tied and his lower lip tight - keeping him from latching on with his lips flanged. Also, because of his tied tongue, his tongue movement wasn't great because he was moving the front of his tongue rather than the back of his tongue.
Next, Dierdre showed me how to get into the laid-back position to feed Isaiah. This, she said, would help him to get as good of a latch as he could, and because it keeps his chin steady, it would force him to use the back of his tongue more to suck, rather than using the front of his tongue and his cheeks. It definitely hurt significantly less to nurse, which told me that I could handle the pain that was there until we got the tongue issue handled.
She referred me to a Pediatric ENT in Dallas, Dr. Biovati, to get Isaiah's possible "posterior tongue tie" evaluated and potentially fixed.
She also told me that if I decided to pump that I would need a larger flange than the one that comes with the Medela pump. Apparently pumping is just like nursing - you have to stimulate a good amount of the areola to be able to get the most milk out - and to keep your nipples from being sore. The standard size would probably only get the nipple in my case. No wonder it hurt so bad to pump before!
I definitely left that consultation with hope and encouragement. Encouragement, because I didn't feel like I was doing everything wrong anymore. In the past I always thought it was me that was the problem. But (this time anyway) I was doing everything right, and the problem was something out of my control. I felt hope, because I left feeling like there was at least a glimmer of hope that I could continue to nurse Isaiah - and actually be successful at it in the end, rather than giving up like I did with the other two kiddos.
Monday, March 21 - We made it through another week - one day at a time - until we could go see Dr. Biovati. He took one look at Isaiah, and said that he definitely had a tongue-tie and that only about half of the frenulum had been cut. I held Isaiah, while Dr. Biovati used this contraption that looked like a metal tongue depressor with a slit in it to hold Isaiah's tongue in place. With one snip, Isaiah was no longer tongue-tied. He had me nurse him a bit to wash out whatever blood was present, and immediately his latch felt different.
The next day, Tuesday, we had a weight check. 6 lbs. 6 oz. He had gained about 1/2 an ounce per day. Considering the issues, not too bad!
Over the next couple of days, it seemed like things got worse. Dierdre had warned me that it may be like that for a couple of days. Isaiah had to get used to the ability to move his tongue more - and regain control of that movement. She said that it would take 36-48 hrs. typically to adjust.
It took us about a week, but at that one-week point, Isaiah started latching on a lot better, my nipples began to heal, and I was definitely in a lot less pain. Weight at this point: 6 lbs. 10 oz., so still about 1/2 an ounce per day.
The next week, he was 7 lbs. 1 oz. We're up to about an ounce per day of weight gain!!
This week, he weighed 7 lbs. 7 oz. at the doctor...again about an ounce per day!!
Things are definitely not perfect, but they're better, especially in comparison to where we were. We are not at the point of pain-free nursing yet, but like I said, it's better. There are still times that Isaiah gets lazy or is tired, and reverts back to lazy tongue-action (using the front instead of the back) which causes some soreness, but I know that over time his tongue will get stronger and using the back of his tongue won't be work anymore. We also still have the upper lip tie issue, which is causing us to still show a lot of the symptoms of a tongue tie. I've just in the past couple of days realized this, so I'm just learning about it. I read this blog, which was very helpful. It has a lot of good information from a chiropractor who has dealt with all the things we are dealing with in breastfeeding her kids.
I'm actually beginning to somewhat enjoy this whole breastfeeding thing. Definitely not loving it, but I'm not hating it either. The little accomplishments are what keep me going. I've never been excited about acne - ever - but when Isaiah broke out with baby acne, I did a happy dance, because I knew that acne meant a good dose of hormones, which meant he was getting a good amount of milk. Seeing the wrinkles in his thighs disappear a little bit at a time, watching him fill out more and more, and finding proof on the scale with consistent weight gain couldn't make me happier.
Maybe this time around I'll eventually get to experience the bonding associated with breastfeeding that I've only heard about. Perhaps we'll keep going strong and I'll be able to meet my goal of nursing for an entire year. We'll see. Right now, it's one step at a time, but I'm loving every step of the way.
Back to the question about the other two kids being tongue-tied:
Balian has a tied tongue and a tied upper lip.
Bella's upper lip is tied, but her tongue is not.
So welcome to my world of breastfeeding challenges. Praise the Lord that this time around we have had people around us to teach us about this thing called a tongue-tie. It has given me hope and demolishes the feelings of disappointment and inadequacy from not being successful with breastfeeding in the past. Knowledge is a wonderful thing!
For more general information about tied tongues go here.
For more detail, check out the blog I mentioned above.
I had a rough time with both Bella and Balian. Different experiences, but equally as difficult. With Bella, I only lasted 2 months. With Balian, about 2.5. I wanted desperately to breastfeed, so I tried with everything I had for those 2 and 2.5 months. In the end, we ultimately decided that a happy formula-feeding mommy is better than a stressed-out breastfeeding mommy with low birth-weight babies. That decision still stung whenever people asked me about if I had breastfed my kids, and for how long...It just made me re-live the stress, the pain, the exhaustion, and the feelings of inadequacy every time.
So, this time around, I did all the research I possibly could. I learned more about technique - single side vs. double-side feeding, talked to the breastfeeding moms around me about their experiences, read articles on LaLecheLeague's website, rigged up a way to do a very accurate weigh/feed/weigh at home if needed, talked to the midwife a lot about how to deal with issues, and just hoped for the best, but prepared myself for the worst, I suppose.
When I first started midwifery care, we talked about the breastfeeding drama. The first thing Melody asked was "were they tongue tied?"
Tongue tied? I'd never heard of it, other than a figure of speech. I didn't know it actually existed as a condition - and how in the world did that relate to breastfeeding?
Melody had been trained to check for a tied tongue immediately after birth, and considering my breastfeeding history, she was definitely going to be checking. Sure enough, Isaiah had a VERY tied tongue. Heart-shaped in the front, and connected very near the front of the tongue. She didn't do anything at first, but after Isaiah's first feeding, I already had a blister on my nipple.
So, Melody cut his frenulum a bit - as much as she could with the scissors that she had with her, and said we would go from there.
This is not Isaiah. I got this picture from another blog that posted about a tongue-tied baby. But Isaiah's tongue tie was probably just as severe as this one. Notice the connection from the bottom (and tip) of the tongue to the bottom of the mouth. This is the frenulum.
The next day (Friday) we had a check-up with Melody. Isaiah's birth weight was 6 lbs. 8 oz., and now he was at 6lb. 2 oz. She wasn't super-happy with his latch, so she got better scissors and cut as much of Isaiah's frenulum as she felt comfortable cutting. She said that it looked like there was a lot more that was a lot thicker that needed to be cut, but she couldn't be the one to do it. She said to see how it went with what was cut and to go from there.
That night my milk came in and everything got 10x worse. Not only was I dealing with engorgement, but my nipples were in some serious pain. Each day got progressively worse. I got really stressed out about him not latching on right. It got to the point that I dreaded feeding Isaiah, and I was hurting so bad that I didn't want the kids to come within arm's reach when I was feeding...and there were many tears. I hated feedings. Bonding? What bonding? It was too stressful.
By Tuesday I would burst into tears at the thought of feeding him - and I cried the entire 30 minute drive to the Birth Center for my appointment with Melody. Of course, as soon as she saw me, she asked if I was ok, and I immediately shook my head no. She asked what was wrong and I responded "Just thinking about feeding him kills me." She immediately took me into a separate room to talk to me. We weighed Isaiah - 6 lbs. 2 oz. again. In the meantime, Kristin, the chiropractor, came in and started checking out Isaiah. She worked on his hard palette, because it was pretty high, and adjusted his jaw that was out of line. This definitely helped a lot. If nothing else, it helped Isaiah be able to open his mouth up wider. Melody looked at the condition of my nipples. She saw how blistered and cracked they were, gave me some nipple balm that a client's mom makes out of tons of herbs, and immediately called the lactation consultant. Dierdre agreed to meet us at the Birth Center for a consultation ASAP, which was about 2 hrs. later, since she was driving from Arlington.
The first thing Dierdre did was look at Isaiah. She didn't ask me any questions until she was finished. She concluded that Isaiah did indeed have more frenulum under his tongue that needed to get checked out by someone who could cut it. She also said that his upper lip was tied and his lower lip tight - keeping him from latching on with his lips flanged. Also, because of his tied tongue, his tongue movement wasn't great because he was moving the front of his tongue rather than the back of his tongue.
Next, Dierdre showed me how to get into the laid-back position to feed Isaiah. This, she said, would help him to get as good of a latch as he could, and because it keeps his chin steady, it would force him to use the back of his tongue more to suck, rather than using the front of his tongue and his cheeks. It definitely hurt significantly less to nurse, which told me that I could handle the pain that was there until we got the tongue issue handled.
She referred me to a Pediatric ENT in Dallas, Dr. Biovati, to get Isaiah's possible "posterior tongue tie" evaluated and potentially fixed.
She also told me that if I decided to pump that I would need a larger flange than the one that comes with the Medela pump. Apparently pumping is just like nursing - you have to stimulate a good amount of the areola to be able to get the most milk out - and to keep your nipples from being sore. The standard size would probably only get the nipple in my case. No wonder it hurt so bad to pump before!
I definitely left that consultation with hope and encouragement. Encouragement, because I didn't feel like I was doing everything wrong anymore. In the past I always thought it was me that was the problem. But (this time anyway) I was doing everything right, and the problem was something out of my control. I felt hope, because I left feeling like there was at least a glimmer of hope that I could continue to nurse Isaiah - and actually be successful at it in the end, rather than giving up like I did with the other two kiddos.
Monday, March 21 - We made it through another week - one day at a time - until we could go see Dr. Biovati. He took one look at Isaiah, and said that he definitely had a tongue-tie and that only about half of the frenulum had been cut. I held Isaiah, while Dr. Biovati used this contraption that looked like a metal tongue depressor with a slit in it to hold Isaiah's tongue in place. With one snip, Isaiah was no longer tongue-tied. He had me nurse him a bit to wash out whatever blood was present, and immediately his latch felt different.
The next day, Tuesday, we had a weight check. 6 lbs. 6 oz. He had gained about 1/2 an ounce per day. Considering the issues, not too bad!
Over the next couple of days, it seemed like things got worse. Dierdre had warned me that it may be like that for a couple of days. Isaiah had to get used to the ability to move his tongue more - and regain control of that movement. She said that it would take 36-48 hrs. typically to adjust.
It took us about a week, but at that one-week point, Isaiah started latching on a lot better, my nipples began to heal, and I was definitely in a lot less pain. Weight at this point: 6 lbs. 10 oz., so still about 1/2 an ounce per day.
The next week, he was 7 lbs. 1 oz. We're up to about an ounce per day of weight gain!!
This week, he weighed 7 lbs. 7 oz. at the doctor...again about an ounce per day!!
Things are definitely not perfect, but they're better, especially in comparison to where we were. We are not at the point of pain-free nursing yet, but like I said, it's better. There are still times that Isaiah gets lazy or is tired, and reverts back to lazy tongue-action (using the front instead of the back) which causes some soreness, but I know that over time his tongue will get stronger and using the back of his tongue won't be work anymore. We also still have the upper lip tie issue, which is causing us to still show a lot of the symptoms of a tongue tie. I've just in the past couple of days realized this, so I'm just learning about it. I read this blog, which was very helpful. It has a lot of good information from a chiropractor who has dealt with all the things we are dealing with in breastfeeding her kids.
I'm actually beginning to somewhat enjoy this whole breastfeeding thing. Definitely not loving it, but I'm not hating it either. The little accomplishments are what keep me going. I've never been excited about acne - ever - but when Isaiah broke out with baby acne, I did a happy dance, because I knew that acne meant a good dose of hormones, which meant he was getting a good amount of milk. Seeing the wrinkles in his thighs disappear a little bit at a time, watching him fill out more and more, and finding proof on the scale with consistent weight gain couldn't make me happier.
Maybe this time around I'll eventually get to experience the bonding associated with breastfeeding that I've only heard about. Perhaps we'll keep going strong and I'll be able to meet my goal of nursing for an entire year. We'll see. Right now, it's one step at a time, but I'm loving every step of the way.
Back to the question about the other two kids being tongue-tied:
Balian has a tied tongue and a tied upper lip.
Bella's upper lip is tied, but her tongue is not.
So welcome to my world of breastfeeding challenges. Praise the Lord that this time around we have had people around us to teach us about this thing called a tongue-tie. It has given me hope and demolishes the feelings of disappointment and inadequacy from not being successful with breastfeeding in the past. Knowledge is a wonderful thing!
For more general information about tied tongues go here.
For more detail, check out the blog I mentioned above.
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