When we left off last time, Katie and I were nursing better, but something still wasn’t working quite right.
Sheila (she gave me permission to use her real name), the IBCLC I had been working with, was puzzled. What we were seeing mimicked a tongue tie: the slower growth, the loss of suction, the odd shaping of my nipple after a feed… But Katie could very clearly stick her tongue out. What was going on?
She referred me to the director of breastfeeding medicine at one of our local hospitals: a pediatrician and an IBCLC all rolled into one. unfortunately, she wouldn’t be able to get me in for another two weeks. If there was a tongue tie, I needed to get it corrected immediately.
I called her pediatrician back. Her regular pediatrician was in Africa providing medical care to orphans. His partner, who happened to also be a lactation specialist, could see us that day.
Again, poor Katie had to deal with people poking around in her mouth. And again, we were told that there was no tongue tie.
That night, on my twitter feed, I happened to see some tweets regarding tongue tie that were a part of an #LCchat. One in particular stood out to me:
This was what was going on! I tweeted back to @NurturedChild and she sent me this link with pictures of the much more difficult to diagnose posterior tongue tie. This, especially the cupped tongue when she cried, really helped solidify my belief that we were dealing with a tongue tie. I just had to find a medical professional who would really listen and take my concerns seriously.
I called Sheila back and explained the situation. She told me that she had previously encountered one other really difficult case like this. She had referred this case to the breastfeeding medicine doctor who, in turn, referred them to an oral therapist who then referred them to a surgeon to get the tie clipped.
What if we skipped the middle man and went straight to the oral specialist?
That’s exactly what we did. She was able to see us the very next day, which was a Saturday.
This is what she saw:
Posterior tongue tie
Cupping of tongue as she cries indicating posterior tie
She very quickly agreed that the tongue was certainly tied. The posterior tie meant that she couldn’t life the back of her tongue to squeeze milk out of the breast. Instead of using her entire tongue to nurse, she was using the front of her tongue and her gums to scrape the milk out.
That explains the pain! It also explains why she was breaking suction. She couldn’t lift her tongue to maintain suction. She was having to break suction in order to swallow the milk and control the flow.
But there was more:
Tie on the lower lip
Tie on the upper lip
The ties on the lips were also interfering with nursing.
When a baby nurses correctly, her lips should be flared out in almost a trumpet shape. Katie couldn’t flare her lips out because of the ties. This added to the chewing action that she was having to use to get milk.
No wonder I was in pain! No wonder she was struggling to latch and nurse properly!
So what do we do now?
We get the tongue ties clipped, that’s what.
Stay tuned for Breastfeeding the Second Child Part 3: Tongue Tie Clip and Recovery.
Wow, I’ve never heard of lip-tied! My last baby had a hard time with nursing and it wasn’t until 8 weeeks old that the LC found he was posterior tounge-tied. By that point he had learned to latch on correctly and over the next few weeks he got better at not losing suction. I was thankful to not have to put him through being clipped.
Even now at a year old, his tounge looks funny when he sticks it out since it’s pulled in in the middle. Recently I’ve been thinking if it will cause speach probelms…. I guess I will have to see.
The clipping itself was very quick and easy and made an immediate difference. We haven’t looked back since!
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