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Thread: What to expect from frenotomy?

  1. #1

    Default What to expect from frenotomy?

    My daughter is 12 weeks old and after a lot of problem solving, I have discovered she has a posterior tongue tie and mild upper lip tie. I have had vasospasm caused by bad latch, thrush in my breasts, and badly damaged nipples. I breastfed exclusively for nearly 4 weeks then had a 3 week break to get my head together before trying again. I returned to feeding with shields (in a bid to widen latch), and as soon as I did so she began to reject the bottle. We've been feeding with shields for nearly 3 weeks and her gag reflex is getting more and more hyperactive. Now if I touch even the tip of her tongue she gags, which may lead to nursing strike at some point? She's also developing colic type symptoms from her inefficient, air gulping style of feeding.

    So...seems that tie release is warranted, but I want to know what I'm in for. Would appreciate advice/info from anyone who has had a posterior tongue tie released. Was it worth it - why/why not? What kind of after procedure 'stretches' did you use? How did baby cope? Did you get back to EB? Particularly interested to hear from anyone whose baby also had a strong gag.

    Thanks in advance.

  2. #2
    Join Date
    Aug 2016
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    35

    Default Re: What to expect from frenotomy?

    I don't know anything about this topic, but just wanted to say good luck! You sound well informed.

  3. #3
    Join Date
    Oct 2009
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    2,710

    Default Re: What to expect from frenotomy?

    My daughter did at 7 weeks or so. They had a baby restraint jacket and quickly clipped it, no anesthesia because then she was able to nurse afterwards , small amount of blood . Sadly it didn't help her milk removal issues but at least we tried. Her baby brother has similar oral structures and nursed 2 yrs without it causing a problem . I know moms who have immediately noticed a difference though and it absolutely helped .

    P.s. I don't think a shield should help her latch. I would really try to get away from them. Are you working with an IBCLC ?

  4. #4
    Join Date
    Jun 2009
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    10,754

    Default Re: What to expect from frenotomy?

    Unfortunately there have not been good studies on the impact on breastfeeding from tongue tie nor lip tie and whether surgical correction helps. Even the definitions/diagnosing criteria of tongue and lip ties is not agreed upon.

    What appears to be the consensus among breastfeeding experts including doctors who are also breastfeeding experts is that tongue tie CAN (but does not always) cause issues for nursing- meaning primarily, pain and injury from latch for mom and/or poor milk transfer by baby, and that surgical correction CAN (but does not always) improve the situation. There is less such consensus as regards lip tie. There is also consensus that properly performed surgeries are not likely to cause any harm. But no harm does not mean there will be improvement.

    I would suggest talking to whoever is recommending surgery and whoever is going to do the surgery for the experience of their clients and their recommendations for after care. This protocol on treatment of tongue tie from the Academy of Breastfeeding Medicine (doctors writing for doctors) may also be helpful to you: http://www.bfmed.org/Media/Files/Pro...yloglossia.pdf

    I do not know anything about gag reflex tongue tie, but certainly a nipple shield might cause a baby to gag if it is too big (the tip is too long) for baby. A nipple shield would also cause air swallowing, particularly if it is too large.

    Colic occurs in babies with no feeding issues. It is very common. I know that some say air swallowing and fussiness and colic is a reason to have tongue tie corrected but as far as I know there is no evidence surgery helps this issue or that it is a good reason on it's own to have surgery. You have latch pain and injury and baby has issues latching, correct? That would be reason enough to pursue surgical treatment of the ties, if it is clear (or as clear as it can be) the ties are part of the problem and other corrections (working on latch, different positioning, encouraging baby to nurse frequently, and body work (also not sufficiently studied but still recommended by many IBCLCs and less invasive than surgery) have not worked.

    Nipple shields give a baby who cannot get a good latch on the bare breast something more prominent and firmer to latch onto. They are meant to be used as a way to help baby nurse while mom and baby figure out latch. I have not heard of them being used to "widen" a latch.
    Last edited by @llli*maddieb; September 24th, 2016 at 03:32 PM.

  5. #5

    Default Re: What to expect from frenotomy?

    Hi there,
    My son is 7 weeks old and we have struggled hard with breastfeeding from day 1. His latch was shallow and he would not open his mouth very far at all. The LCs at the hospital pretty much insisted that I use a nipple shield to help him out because his pallet was high and my nipples are "soft" (though subsequent LCs have told me "there is nothing wrong with my equipment.")
    My LO's posterior tongue tie was IDd inthe hospital and they cut it with scissors while we were there, but I never noticed a difference with his nursing. We saw another LC as soon as we left the hospital and she advised me to entice my baby to latch with expressed milk in a feeding tube with a syringe. This didnt seem to make much of a difference either, but I worked hard to learn proper latching technique and during the second week of his life I thought I had finally mastered it. The next day I was severely engorged and I noticed my baby hadn't been wetting enough diapers and I began to worry. I wondered if the new latch was the problem, so I let him nurse the old (painful) way, and he did soften my breasts, but still no wet diapers. I pumped to see if I could get some more milk to syrenge feed him, but ai could only express 4 drops. I panicked amd called the Drs office. The pediatrician asked us to come in asap, she weighed him and advised us to give him formula in the SNS at the breast. I cried and cried and began my rigorous pumping regimen(which I am still performing at 7 weeks) to get my milk back. My out of hospital LC must have felt like she had done all she could for us because she mentioned "exclusive pumping" if I could get my supply back, and then referred me to an occupational therepist/ craniosacral specialist and to a different LC. The therepist gave us some excersizes, which my son hated and they didnt seem to help,so she told us to see the new LC and have her look at my son's tongue. The new LC had a 2nd look at my son's tonue tie and said it hadn't been properly addressed- it was "a nasty thick posterior tie" and she highly recommended that we see a dentist a few towns over who performs laser frenecotmies. We did. He evaluated my son and ended up lasering 3 lip ties and his very deep tongue tie. I went in the room with my baby while it was done and I eould not be honest with you if I didnt tell you it was the 2nd most difficult thing I have ever had to watch- the 1st being watching my mother suffer and die over a 1 month intensive care stay after a horrible car accident. It was excruciating. My son did calm down somewhat quickly and his latch did improve almost immediately, though the dentist warned that there would be ups and downs and that we should do his stretches 4-5 times daily (gently touch the side lip ties, use a "rolling pin" motion on the middle lip tie, and placing my index finger "in the pocket" of the tongue tie wound, gently stretch the tong back for 3-4 seconds. I did these religiously for the first 4 days, and every day my baby seemed more and more upset. Everything made him cry and eventually he stopped wanting to nurse. He was a totally different child. I contacted both the dentist and my latest LC both of whom agreed that my son has a very rare and sensitive temperment (I agree) which seems to make him respond very badly to all of this in the mouth trauma. They advised me to do the stretches only twice a day. The LC advised me to use gauze frozen in breastmilk to stretch so there would be a soothing pain relieving element. This seemed to help by the next day and my little guy settled down. Within 3 days he was back to his sweet old self and nursing much more willingly. After a week of 2 stretches daily, I noticed that his tongue wound seemed to be re attaching, and his nursing was getting worse every day. We are almost three weeks out now from his laser frenectomy, and it has indeed reattached somewhat. He nurses badly most of the time, and still doesnt transfer more than one oz when he feeds. I have gotten my supply back (YAY!) but he still has to have a supplement at the breast every time he nurses. He does occasionaly manage a really good and painless latch- which seems to indicate that he CAN do better, his technique is just terrible.We have been going to OT/craniosacral and seeing the new LC and we haven't really made any progress. My nipples are SO SORE. Our last hope at this point is to see a very expensive local chiropractor who specializes in infant feeding problems. I really hope that helps, otherwise I will be nursing my baby with an SNS and the sorest nipples ever, because I just can't give up on this, and there is no way I am putting him through that ordeal again.
    So, was it worth it.... no, not yet anyway. Honestly, I do think ours is a very rare case, but my advise to you would be to see a speech therepist or occupational therepist, a craniosacral body worker, a lactation consultant AND a chiropractor BEFORE you try the frenectomies. Just keep it as a last resort if you can,and then if you do it, make sure you do the stretches as often as you can as gently as you can, otherwise it may have been for nothing. From the bottom of my heart, I wish you the best of luck!

  6. #6

    Default Re: What to expect from frenotomy?

    Not sure where you live but the Tongue and lip tie support group Australia on FB has amazing info and resources. Good luck! I had my boys tt snipped at 3 weeks and it's made a great difference. He is now 9 mo and has a severe upper lip tie I am getting lasered by one of the groups recommended docs. Wish I'd known about them 9 months ago so this wouldn't have been ignored! Will be much tougher to deal with at this age but the gap in his teeth is huge and I do not want him to have speech or postural problems, which are both possibilities

  7. #7
    Join Date
    Aug 2016
    Posts
    13

    Default Re: What to expect from frenotomy?

    My baby had her lip tie revised 4 weeks ago. I was so scared that she would be traumatized. But she bounced right back. Vaccine are harder on her. Yes, she cried but settled when she nursed. Then, she sat up and giggled. She is 6 mo and still not flanging lip. But she has more motion on lip. She can stay latched on in side lying (noticed that right away). I think it's helped her reflux.

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