Happy Mothers Breastfed Babies
Results 1 to 8 of 8

Thread: Upper lip tie- what to do?

  1. #1
    Join Date
    Nov 2013
    Posts
    14

    Default Upper lip tie- what to do?

    To give you a little background, my baby was born 6 weeks premature and was in the NICU for 12 days. He was given mostly the bottle while there. I was only allowed to nurse him once a day and I was not very successful at getting him to latch. I have been pumping ever since he was born. He is now about 2 months adjusted (it's been three months since he was born) and ever since I brought him home I have been trying to nurse him and it has been very difficult. Lactation consultants told me he had just gotten used to the bottle and that's why he had trouble nursing. He wouldn't open wide and would fall asleep quickly. He clamped down on my nipple and made me sore and lipstick shaped. I always secretly hoped that he had a tongue tie, because I heard that snipping it could make things better instantly, but I was told he didn't have one.

    Now I nurse him as much as a I can during the day and I pump 4 times a day. Nursing still isn't comfortable, but it doesn't make me as sore as before. It's definitely tolerable. However, my baby doesn't get on very deep and during letdown when he's feeding he often loses suction and sort of pops off. He reattaches immediately and keeps sucking, but his latch is usually even more shallow after this. He also doesn't take in very much usually. I rented a scale to see how much he takes, and he usually gets somewhere between 1.5-2 ounces and then he sort of stops, even though I have loads of milk. Sometimes he does take more, especially when I push him a little by putting him on multiple time in a row (he's gotten 4 ounces once, but mind you I had a huge supply then so it came out very easily). With the bottle he will take 3 ounces or more.

    I went to see Maryanne Ohara of Seattle Breastfeeding Medicine. She is supposed to be one of the best in the city. She diagnoses and clips tongue ties. Well, she thinks my baby has a significant lip tie and that it quite possibly could be contributing to his difficulties. My husband hates the idea of cutting our baby and I don't like the idea either, especially since there's no guarantee that it will even help. I'm thinking of just continuing as is and hoping it will work out. Is his intake okay? Right now I have an oversupply, so it concerns me that he never gets the hindmilk, because he drinks so little and I have so much milk. If I stopped pumping would my supply regulate down to meet his needs better? Dr. Ohara said she thought I would lose my supply because he isn't an efficient nurser, but I have my doubts. I think maybe we'd be okay, but I'm scared to try, because what if I lose my supply and there's no turning back?

    One other important thing to note is that I only nurse him on the left breast, because my right breast has been damaged by the pump and it has always been more painful to put him on that breast. I'm not even sure how to latch him on that side. I've tried recently and it felt so awkward, because I'm not used to it. And I'm still red and sore on the right nipple, because I'm still pumping it. I'd be willing to exclusively nurse my baby on the left breast only. I don't mind that I would be lopsided. But I would feel more confident about exclusively nursing and stopping pumping if I could heal the right breast and learn to nurse on that side as well.

    This is such a long post. Hopefully someone will read it. Any input?

  2. #2
    Join Date
    Nov 2013
    Posts
    14

    Default Re: Upper lip tie- what to do?

    Today he took 2.6 ounces at one feeding. 3.2 ounces at another (I burped him in the middle and encouraged him to relatch to take more). Is this doable? Is it okay if he often take only about 2 ounces? Maybe I'd just need to feed more often.

  3. #3
    Join Date
    May 2006
    Posts
    21,117

    Default Re: Upper lip tie- what to do?

    "Only" 2 oz is a normal feeding at the breast. An average feeding for a breastfed baby is just 2-4 oz, which is why breastfed babies tend to nurse frequently. The average daily intake for a breastfed baby is between 19 and 30 oz per day (reference: http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/). So if a baby takes 2 oz at a time and nurses 12 times a day, he's getting 24 oz per day, which is right in the middle of the range for intake. If he takes just 3 oz when nursing and nurses 8 times a day, he's getting 24 oz.

    Your scale indicates that your baby is taking a variety of feeding sizes- sometimes 1.5-2 oz, sometimes 2-3 oz. To me that suggests that a high nursing frequency, and offering both breasts, is what would work best for you. But you're sore, so it sounds like nursing all the time would be really tough for you. Consequently, I think it makes sense to get the lip tie released.

    I totally understand not wanting to have the baby experience pain. But here's why I think you should:
    1. Getting a lip or tongue tie released is said to be a minimally painful experience.
    2. If getting the tie released means that the baby stops hurting you, you'll want to nurse him more and breastfeeding should become more enjoyable for you.
    3. If getting the tie released means that your baby becomes a better nurser, he may take somewhat more milk when he feeds, leading to you being able to nurse exclusively and ditch the pump. Once you're exclusively nursing, your supply and baby's demand will come into sync.
    4. Lip ties can impact your child's future dental bills. A tight upper frenum can actually cause your child's front teeth to come in with a big gap between them. And believe me, it's more emotionally difficult to explain to your older child that the dentist might come after her lip with a laser than to have it done when she's a baby and won't get anxious or remember. (If only someone had noticed my daughter's lip tie when she was a baby...!)

    I'm a bit concerned when you say that pumping damaged your right breast. Can you tell us a bit more about what that looks and feels like?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4
    Join Date
    Aug 2011
    Posts
    81

    Default Re: Upper lip tie- what to do?

    I really recommend getting the tie taken care of. Also, can you get a 2nd opinion on the possible tongue tie? Specifically from a pedi dentist who takes care of ties regularly. Very often when there's a lip tie there is also a tongue tie, and people you think should be able to tell you (pedis, some lc's, etc) really have no training in them. Having my first baby lasered saved our nursing relationship. This time around, my daughter has a lip tie and we are going in a couple days for a consult and will laser right then if need be. It really does make a world of difference! And mommal is right- they won't remember the experience and I really believe it's harder on us than them!
    7/28/11, weaned gently and gradually at 21 months

    1/9/14, enjoying having a little nursling again

  5. #5
    Join Date
    Aug 2011
    Posts
    81

    Default Re: Upper lip tie- what to do?

    Btw- if you're on Facebook, check out tongue tie support group. So many informed moms and even some docs who specialize in ties can help you. They also have a list of preferred providers so maybe you'll get lucky and there will be one relatively close to you.
    7/28/11, weaned gently and gradually at 21 months

    1/9/14, enjoying having a little nursling again

  6. #6
    Join Date
    Nov 2013
    Posts
    14

    Default Re: Upper lip tie- what to do?

    Hello again!!

    Thank you for your replies. I'm a bit disappointed, though, that you both recommend getting the tie released, because my husband and I were leaning very strongly towards not doing it. The lactation consultant and occupational therapist that I saw before who is supposedly one of the best in the country at helping young babies with feeding issues told me that, in her opinion, lip ties are not important in breastfeeding, and she seemed to think that my little boy was doing great at the breast and that we could be exclusively breastfeeding soon. I got stressed about the whole process before and stopped going to her for a while so I could do things at my own pace, but now I'm starting to think that she might be right.

    Here are some reasons why:

    My baby no longer hurts me when he breastfeeds. Sometimes my nipple still gets pinched, but it doesn't bother me. I actually like the feeling. Also, I feared that his losing suction and popping off the breast could be because of the lip tie, but I'm thinking now that it might be more related to how engorged I am. I've noticed that if I've pumped recently when I nurse him then he doesn't lose suction. He seems to stay on the breast just fine when I don't have an overwhelming amount of milk in my breasts.

    I'd like to try exclusively breastfeeding without getting the tie released. The woman I saw who wanted to release his tie does not do laser. She only uses scissors. I didn't feel very comfortable with this woman and I can't justify cutting up my baby when we don't even know if it will help. My whole family seems to be against him getting the tie released. I seem to have very responsive breasts. I'm still overproducing even though I only pump every 6 hours. I'd like to try exclusively nursing and stopping pumping, but I'm scared about losing my supply. A friend told me I could easily increase my supply again if I needed to by pumping a bunch. Is this true?

    I think the main issue I need to address at the moment is getting my right breast healed. Ever since I started pumping (which was right after my baby was born, I have had pain on my right nipple. I tried all sorts of flange sizes, but they all seemed to suck too much of my breast tissue into the flange and make me puffy by the end of the session. I have been red, sore and a bit swollen on that side for a while now. I also appear to have tiny bumps on the nipple (almost like tiny skin tags). You can only see them when you look closely, but I don't have them on the other breast and I think they might be making my nipple more sensitive. I saw a dermatologist about 3 week ago. She tested my milk and determined that I had a bacterial infection. I am currently taking antibiotics and applying antibacterial ointment. But the pump still seems to rub my nipple and cause some discomfort. When I try to nurse on that side, I have difficulty latching my baby. I think partially this is because I'm just not used to it. But also the nipple is wider and more flat. My baby usually doesn't get on very wide or deep and he pinches the nipple. This hurts because I'm already irritated.

  7. #7
    Join Date
    May 2006
    Posts
    21,117

    Default Re: Upper lip tie- what to do?

    I totally understand why you're not into getting the lip tie released. The idea of someone sticking scissors into your baby's mouth... That feels creepy, right? You might want to look into seeing a pediatric dentist or ENT. They may have a different technique which makes you feel more comfortable about having it done.

    Now, I personally am on the side of clipping ties when they cause mom pain. I don't care what the dad or the extended family has to say about it- it's not dad or grandma who is nursing the baby! But if you choose not to release the tie, it is absolutely possible to nurse with a tie in place. My older daughter had one and we ultimately got to a place where her nursing was both effective at getting milk out and comfortable for me. As you transition to exclusively nursing, you want to do the following:
    1. Be alert for increased pain or damage to your nipples.
    2. Keep a careful eye on the baby's diaper output and weight gain. If these are sufficient, the baby is getting enough milk when nursing.
    3. Be prepared to change your strategy if things start to go south.

    Pumping can definitely be used to increase supply. Whether or not it can "easily" increase supply... Well, that depends on the mom! Some moms are very responsive to pumping, particularly in the early weeks/months of breastfeeding. Some moms aren't. If you respond well to pumping, you'd have little trouble increasing supply. If you respond poorly, pumping to increase could be a hard slog for you. Since you don't really know which mom you are, just revisit the 3 steps listed above. If you have a lot of pain and damage, if baby isn't producing diapers or gaining weight as he should, then you think about changing your strategy and pumping again. Hopefully it would just be a temporary measure while baby gets a bit larger and more adept at nursing.

    The things you describe on the right- nipple looking red, skin tags, pain with pumping- makes me think that there is something infectious happening on that side. It sounds like it's bacterial, but it could also be thrush. You might want to use some antifungal treatment if using the antibiotics doesn't improve things.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  8. #8

    Default Re: Upper lip tie- what to do?

    My daughter was diagnosed with a class IV lip tie at 4 weeks old. We had it revised with a laser about 9 days ago. I wasn't in the room, but my Husband stayed with her. He said it was VERY fast, and she handled it very well. I was very worried that she would be uncomfortable and in pain, but to be 100% honest, she never acted like anything was wrong. She wasn't fussy, she never stopped wanting to eat (which they warned us could happen). She handled it very well.

    I still have pain with breast feeding, but after seeing the lactation consultant again yesterday, she determined there are some other things going on with my daughter, besides the lip tie.

    Oh, we saw a pediatric dentist to revise her lip tie. There was no blood, and there is almost no chance for infection with the laser revision.
    There can be complications later in life if the tie is not revised. Gap between their front teeth, tooth decay, speech difficulties. I know of at least two people in my immediate life that had lip ties and ended up with gaps between their front teeth and braces.

    Good Luck

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •