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Thread: Breastfeeding After Tongue Tie

  1. #1

    Default Breastfeeding After Tongue Tie

    LO was born was low blood sugar, and they immediately took him to the NICU. They allowed me to BF, but also made us supplement with formula to make sure his blood sugar would go up. They also gave him a pacifier. He was there for 3 days. This might not be important to my issue, but I thought it was worth including just in case.

    He had a painful shallow latch ("lipstick nipples") the entire time I was in the hospital, but being a first time mom, I didn't really know what I was feeling wasn't normal. LO continues to have a shallow latch and creates sore nipples as he flicks his tongue against them. Since bringing him home, I've gone to two BF support groups sponsored by the hospital. The first time I went to the BF support group, the two LC's basically just told me that I needed to "ride it out," that the latch looked great and it would feel better eventually (ugh!). I couldn't accept this answer and did my own research, landing on tongue tie. I asked the pediatrician at the next appointment, who confirmed my suspicions, and referred me to an ENT doctor to preform the frenulotomy for tongue tie.

    So, with that back story, my question is... how long after a frenulotomy can I expect LO's latch to improve? It's been a week, and it's still as painful as it was before the procedure. I did some more research today and discovered more mouth/tongue exercises to do with him, which we've done twice today. I feel like I'm at my breaking point though - I don't know how many more nights of crying through BFing I can take. Is there a point after this procedure that if his latch still hasn't improved, I should just quit trying?

  2. #2
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    Default Re: Breastfeeding After Tongue Tie

    Latch issues of any type can take quite a while to resolve, and even if tongue tie was part of the problem and has now been effectively treated, then latch issues may continue. In other words, I would certainly say, don't give up.

    My first suggestion (if possible) is to seek more in person help but with someone who is going to roll up their sleeves and work with you and baby on latch, rather than dismiss your problems as a temporary situation to ride out. Latch pain is never acceptable and always points to a problem. Just because the problem does sometimes get solved by mom on her own does not mean there wasn't a problem!

    Of course this will usually be an IBCLC, but some LLL Leaders or other such volunteer support can also be helpful.

    You could also talk to the ENT, because sometimes a second procedure is indicated.

    Here is a description of a "complete" consultation with an IBCLC. It is an intensive process and not something that can typically be done during a breastfeeding support meeting with others around. http://cwgenna.com/lconsult.html

    If you want us to try to help here, can you tell us what you have tried so far as far as latch process and positioning? Anything help at all? Can you describe the pain in more detail and also any injuries/healing etc.?

    Also I assume baby's gain is ok now? Any supplements? Pumping? Does baby seem to handle the milk flow well? Seem calm or satisfied after nursing ever? How many times in 24 hours does baby nurse and how old is baby now?

  3. #3

    Default Re: Breastfeeding After Tongue Tie

    I guess I was just wondering if anyone had gone through this particular issue before and had a general idea of how long relearning generally takes (days, weeks, months). I understand that it's not something that will happen instantly and takes work, but I thought it would help if I had some sort of goal to get me through the rough parts.

    I've gotten a few recommendations for a specific IBCLC to see, but unfortunately, this is a holiday week, so I have to wait until next week to see her.

    Baby is a few days shy of 4 weeks, and has been gaining weight within the normal range. It's hard to say if he's fully satisfied after eating, because sometimes I can go 3 hours on one feed, and other times, I can only make it 30 minutes before he's crying for more. He almost always stays on each breast for 20+ minutes (both sides each feeding). I hear the gulping/swallowing sound maybe every 3-4 sucks typically, but occasionally he will choke (maybe once or twice during the entire 40 minute feeding). Based on pumping, I seem to be producing plenty of milk, and he generally empties my breasts after feedings.

    I'm not sure how to describe the pain. Thankfully, I haven't had any sort of cracked, bleeding nipples since the first week. Now, the nipples are just really sore and sensitive (I understand there's a process of getting used to BFing, but I feel like this is more than that based on my past ability of handling pain). After feeding, they're a light pink color (no clue if that's normal), and like I mentioned previously, they are always smashed when they come out of his mouth. I've found that the football position works best, but have also tried cross cradle and laying down. I'm a DDD/E with large nipples/areolas, so football position has been the easiest to use the "hamburger" style nipple technique of getting as much nipple as possible in his mouth. His lips stick out around the breast, they're not tucked into his mouth. I can feel his tongue switching between rubbing the bottom of my nipple and flicking the nipple.

    I'm just really frustrated. I know I can pump and switch to a bottle, but BFing has been my goal for so long - I've worked so hard at it that I feel I need to see it through!

  4. #4
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    Default Re: Breastfeeding After Tongue Tie

    Ok, first off I suggest encourage baby to nurse more often. If your baby is audibly gulping and choking and your pump output is high, I think you have a little oversupply (probably a very good thing in this circumstance with the TT) and when that happens, the flow may cause baby to clamp a bit at the breast, or to pull back a tad so your nipple is no longer in the "comfort zone" in baby's mouth. The easiest and safest way to help baby with a fast flow is to nurse frequently. I know it seems counterintuitive to nurse more often when nursing hurts, but ultimately nursing more often should help. (Pumping -unless it is during a separation from baby- may increase your milk production beyond what you and your baby can comfortable handle so be aware of that when pumping.)

    Does baby always want to nurse both sides or is that your idea? There is nothing wrong with nursing both sides (unless a mom has bad enough over production it is causing problems) but it is not necessary assuming baby nurses often enough and is not interested in both every time. Basically, assuming good weight gain and frequent enough nursing, it is ok and may help to let baby nurse one side at a time if and when baby prefers.

    I think you want to at least consider and (hopefully) rule out thrush as a factor based on the nipple color: see: http://www.breastfeedinginc.ca/conte...agename=doc-CP

    Ok so you are trying breast sandwich already, great. Here are many other ideas. If football is working best, then do that. If you are uncomfortable in the neck and shoulders or want to try leaning back to help baby with the flow, Try latching baby in the football and then relaxing back while baby is on you. Yes you can do football and laid back breastfeeding together. If you need room for baby's feet beside you, place pillows directly behind your back so you are pushed out some from the couch back or whatever it is you are leaning back on.

    article many ideas http://feedthebabyllc.com/latch-and-positioning/

    video http://globalhealthmedia.org/portfol...rtfolioID=5623

    large breasted moms using laid back https://www.youtube.com/watch?v=584n...Nggkqw0aWCfRD3

    Hopefully someone with personal experience will post.
    Last edited by @llli*maddieb; July 2nd, 2015 at 09:01 AM.

  5. #5

    Default Re: Breastfeeding After Tongue Tie

    Quote Originally Posted by @llli*maddieb View Post
    Ok, first off I suggest encourage baby to nurse more often. If your baby is audibly gulping and choking and your pump output is high, I think you have a little oversupply (probably a very good thing in this circumstance with the TT) and when that happens, the flow may cause baby to clamp a bit at the breast, or to pull back a tad so your nipple is no longer in the "comfort zone" in baby's mouth. The easiest and safest way to help baby with a fast flow is to nurse frequently. I know it seems counterintuitive to nurse more often when nursing hurts, but ultimately nursing more often should help. (Pumping -unless it is during a separation from baby- may increase your milk production beyond what you and your baby can comfortable handle so be aware of that when pumping.)
    Duh. That makes total sense to me now that you mentioned it! Thanks! Although it makes me cringe at the thought of waking him up now that he's finally starting to [sometimes] sleep in longer stretches, I'm definitely going to try it to see if it makes a difference.

    As far as him feeding on both sides, I offer the other side to him to see if he's interested, and he almost always is. Should I try stopping after one side to see how long (or if) he stays content?

    Thanks for the video links. The woman in the large breasted video made me laugh... "I can't imagine having a 9-10 lb newborn and trying to hold it up." Mine was 8 lb 11 oz at birth I'm going to try out the position she was in though; maybe that'll help!

  6. #6
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    Default Re: Breastfeeding After Tongue Tie

    Should I try stopping after one side to see how long (or if) he stays content?
    First It is possible that nursing more often may lead to baby taking one side at a time more anyway. Some moms have such bad overproduction they need to block feed in order to quickly reduce production- this means, they "make" baby stay on one side for a length of time...but I do not get think block feeding is appropriate in your case at least not at the moment.

    I think it is fine to follow babies lead while nursing even if you are sort of not following baby's lead by waking baby a bit more often to nurse more often overall. So if baby stops nursing but is still alert I think it is fine to offer the other side, but if baby falls asleep nursing on the first side, then let baby do that? (usually?) Pay attention to how you feel too- if baby has nursed on the right and you are feeling really full on the left, go ahead and encourage baby nurse on the left if you like.

    Another variation is that If baby stops nursing on one side and pulls off, you can also offer the same side again...what is "right" will typically change nursing session to nursing session...you and your baby will probably get a feel and know what is best at the moment. Breastfeeding rhythm really is more or an improvised couples dance than a choreographed one.

    Here is something I learned early in my breastfeeding struggles with my oldest- Use all videos/ pictures/descriptions as touchstone suggestions to experiment from, not rules to follow minutely...you and your baby will fit 'best' together in a way that is unique to you and your baby.

  7. #7
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    Default Re: Breastfeeding After Tongue Tie

    Sorry to hear about your difficulties. Both my 2 babies had a TT. With DS, his was corrected at 9 days but not before I had cracked nipples and mastitis. His latch continued to be shallow and lipstick shaped for about 2 months. I was also doing the football hold. Then a local LLL leader came to observe and helped. She had me do cross cradle position, using lots of pillows to prop baby up to the breast. She also showed me how to gently tug baby's chin down to encourage a deeper latch. It seemed that by 3 months the pain had gone and the cracks had healed.

    With DD, I recognized the TT early and had it corrected. Cross cradle is working well--I think it's helpful to be able to hold baby with one hand and breast with another. This time the latch became comfortable by the end of the first week. Again I made sure to bring baby to the breadth using supportive pillows, adjust the latch by tugging her chin down to get more breast in to form a deeper latch.

    Not sure if this is helpful to you, but I wanted to share.
    Last edited by @llli*andie613; July 3rd, 2015 at 01:23 PM.

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