I've
had so many people asking about this I thought I'd blog about it - and if this
post helps just one person avoid the 7 awful weeks I had then I'm happy!
D (my
first baby) had posterior tongue tie. It's only looking back now I have another
(not tongue tied) baby that I can say with certainty what I can attribute to TT
rather than "just being a first time mum" (I heard that line A LOT
and it annoyed me then but now it annoys me even more that they were fobbing
off a genuine problem as me being inexperienced).
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My lovely little man |
I
said this would be an honest post and here is the first confession. I have
never had any training about tongue tie as a doctor. And to be honest before D was born
I had a similar opinion to most doctors I know - that every parent seemed to
think their baby had TT when usually they just needed more help to establish
breastfeeding...
So
what happened with us?
I
could waffle for pages about the ins and outs of the first 6 weeks so for your
sanity I have also précised it in a Summary/Bottom Line" at the end so you
can just skip to there if you want :)
After
birth D could not/would not/was not interested in latching. We were in hospital
for 3 days and every feed was a huge battle. He couldn't get on and if, by some
miracle, he did latch on he quickly 'slipped' off. He didn't seem able to keep
his mouth open for long so you had a brief nanosecond to get the boob in before
he clamped down with a vice-like grip (nothing like that baby in all the
leaflets who just hangs around with his mouth open waiting for the photo to be
taken...). Each feed was incredibly painful. I think every single midwife on
the ward tried to help but nearly all of them gave up after a few minutes
saying "oh he just needs to practise, it'll get better". I saw a
"feeding specialist" twice and I was encouraged to hand express every
3 hours and then feed D the colostrum by syringe. I went home after 3 days but
we hasn't really "established" feeding. I could just about keep him
on long enough to get just about enough milk in him (so he wasn't dehydrated)
but he never latched well, it always hurt and his poop was always green so he
was getting way too much foremilk and not enough of the fatty hind stuff :(
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This is NOT D. D could never have done this :( (nor is it me!!) |
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[above image from http://www.leicspart.nhs.uk/_OurServicesAZ-BreastfeedingandInfantFeedingsupport-HowdoIbreastfeed-Howtoachieveagoodlatch.aspx]
Looking
back now I realise D was constantly hungry. He wanted to feed all day every day
but the unbearable pain meant I just couldn't face doing it more than 3 hourly.
And each feed took at least an hour. I used to cry in anticipation of a feed. I
cried during the feed. And I'd cry afterwards as the pain continued for about
30 minutes post-feed due to vasospasm (not helped by him being a winter baby!).
I
first saw a lactation consultant at 2 weeks, just after I got out of hospital
(post mastitis bout number 1). She was amazing. Except for the bit when she
said feed D whenever he looks hungry... that was so hard to do because of the
pain. She suspected posterior TT but wasn't an expert so referred me to someone
else.
At
this point I was in two minds. I felt something was wrong and that
breastfeeding shouldn't be this hard or no one would do it! But I was naturally
dubious about TT and also had my midwife and health visitor telling me it was
normal to have this much pain and maybe I just had a lower pain threshold than
other people... Anyway I saw the "specialist" who said he did have TT
but his function was good so it probably shouldn't impact him. She offered to
snip it if I wanted but said it wasn't necessary. I (obviously in my mind!)
said no thanks then, if there's no need then please don't do it!
But
then followed 4 more horrific weeks of pain after pain after pain. I was in
agony. Even my bra touching me hurt. I was prescribed treatment for thrush as
that can cause agonising pain. D wasn't gaining weight, only just going past
his birth weight by 4 weeks, and by 6 weeks had fallen across 3 centiles.
Breastfeeding was dominating our lives but not in a good way. And then I got
mastitis again. Even more pain. Having to express every 2-3 hours - even at
night, even when D was sleeping. I was exhausted. I was miserable. I
wondered why I was so bad at breastfeeding. I was at my wits end.
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Super scrawny Doof. I didn't realise quite how thin his arms and legs were until I now see how "well-padded" his little sis is at the same age!! |
So
I saw the lovely lactation consultant again. She still thought there was TT and
so referred me to someone else. This person, to be fair, had the benefit of
seeing what had happened over the last 6 weeks - but she instantly said
"posterior TT" and advised snipping it.
The
snip
D
was about 7 weeks old. They swaddled him and then snipped the tie. Then
unswaddled him and gave him to me for a breastfeed. That was it. He probably
cried for 10-15 seconds max.
But
even that first feed post-snip... Completely different. He could actually open
his mouth wide, keep it open and latch on properly. A.M.A.Z.I.N.G.
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Ten minutes post-snip. Looks pretty happy to me :) |
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A month later... already cultivating little chubby cheeks! |
Afterwards
Oh
what a difference. I actually started to enjoy breastfeeding. It took a while
to be completely pain free as my poor traumatised nipples had to heal but there
was no new trauma to them. D started to put weight on properly. Our life was no
longer a horrible cycle of feeding-crying-feeding-crying. And I continued
breastfeeding until D was 13 months (here is my post about my thoughts when I finally stopped).
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Look what I can do with my tongue now!! |
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Thanks mummy for fixing my feeding problems! |
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Breastfeeding got so easy we could do it anywhere - this was in the backseat of our hire car next to the Hoover Dam :) |
******
Summary
D's
main symptoms
-
couldn't keep mouth open for long
-
couldn't latch properly
-
couldn't sustain a latch if we managed to get one
-
poor weight gain
-
green poop
-
always hungry
My
main symptoms
-
pain, pain, pain
-
compressed nipples after every feed
-
vasospasm (you see them turn white)
-
recurrent mastitis (because he wasn't managing to empty the breast properly)
******
Bottom
line
Do
I think some midwives/health visitors are very quick to blame TT when actually
the mum might just need more breastfeeding help?
Yes
Do
I think there are lots of babies with mild TT who can feed fine and do not need
anything doing and should not have problems blamed on their TT?
Yes
Do
I think there are a small percentage of babies who do have problems latching
and feeding related to TT?
Yes
definitely
Do
I think this can be missed by health care professionals?
Yes
(especially if it's posterior as that is much harder to spot)
Do I think all paediatricians and GPs should be experts in spotting/diagnosing TT?
No, not really. They have to be experts in pretty much everything else. But I would expect midwives or breastfeeding 'specialists' to be able to spot it and advise where to get help. Because of this my first port of call for help would be a lactation consultant, not a doctor (one of the few times you'll ever hear me say that!!)
So
what should you do? If you are having the problems I had with D above then it
is NOT NORMAL, it is NOT because you are a first time mum, it is NOT because
"breastfeeding is supposed to hurt a bit" as my health visitor told
me!! If you can afford it then see a private lactation consultant. The £200 I
spent seeing one was probably the best money I have ever spent. And I more than
recouped the cost by then exclusively breastfeeding until D was fully weaned :)
******
If you want any information I'd recommend KELLY MOM for brilliant, evidence-based information on everything related to breastfeeding.