on October 16, 2016,
our sweet daughter,
was born at 12:33 in the afternoon.
She weighed 7 lbs 10 oz and measured 20.5 in.
She has taken our hearts and taught us that…
the best things come in threes.
I’d finally figured out the cause of my struggle to breastfeed both of my babies and my three year old daughter’s speech challenges, but I didn’t know where to start when it came to getting my children evaluated for lip and tongue ties. So I went where I usually go for advice — Facebook. I joined a local support group for tongue and lip ties. The parents in this group were a wealth of support and knowledge and encouraged me to have my children referred to a “preferred provider” — one who had been vetted by the group and the IBCLCs associated with it.
The first step was bringing them to our highly respected pediatrician, who agreed with my assessment and trusted my intuition (side note: Find a pediatrician you can trust, who trusts you. This relationship is priceless.) and sent out referrals to a pediatric dentist, Dr. David Draper, in Apex (45 minutes from our home). Tricare gave authorization for the kids to be seen, and, with the understanding that if they required any procedures we would pay out of pocket and have to submit for reimbursement from insurance, I made their appointments.
The Evaluation and Frenectomies
We met with Dr. Draper, a pediatric dentist who decided to specialize in tongue ties after watching his own wife struggle with breastfeeding. I was instantly at ease and could tell he knew what we were up against. He quickly pegged me as a mom who had done her homework and was encouraged. He wasted no time and examined both children and requested to address both of their lip and tongue ties on the spot. I could have hugged him.
Madeline was up first. They swabbed the inside of her lip and under her tongue with a numbing gel, which really freaked her out. While waiting for it to take full effect, she kept gagging and even cried a little from the weird sensation. For the procedure she was swaddled and a nurse held her still. I had my hands on her the whole time and kept telling her I was right there and it was almost over. The procedure, a lasering of the upper lip frenum and tongue frenum, didn’t even take a minute. The dentist said her tongue tie was so thick he could hardly believe it — that when it released her tongue flew up and hit the roof of her mouth. I couldn’t see that part, but I saw the lip tie and it was really thick, too. Madeline’s scream during the procedure was one I’ll never forget, but she was soothed quickly and was okay after. She said “That hurts me mommy,” and I told her I knew and that she didn’t have to do it anymore. She was comfortable enough after and willing to go with my aunt to the waiting room. She ate two Popsicles and two lollipops right after. By the time my son’s procedure was finished, she was running around the waiting room happy.
My almost four month old really did quite well in the procedure. They didn’t give him any numbing gel, because he’d have had no chance of comfort nursing after if they had. He was swaddled and I was able to see the whole procedure since he was smaller and I was closer to his face. It took some serious work to break through his ties (much more effort than what I’d seen in YouTube videos of the procedure). As with Madeline, I talked to him and kept my hands on him. He cried hard, but, honestly, it was nothing I hadn’t heard from him before. Like my daughter, he was in my arms the second the procedure was completed. I attempted to nurse him, but he struggled to soothe. I was glad I brought a bottle with me. He took a little cold formula from the bottle and then was calm enough to latch on to nurse. His lips flanged well and it instantly felt different. Better.
After the procedures, the kids were in good spirits, so we went to a nearby park, then drove home and went to Madeline’s tumbling class. After tumbling she and I walked to the park by our house. By the time we got home she was exhausted. Foods of the day included yogurt, chocolate pudding, rice pudding, Pirates Booty, ice pops and lollipops. I did their first stretches that night and Madeline wasn’t into it, but I told her if I couldn’t do them we’d have to go back to the dentist. She reluctantly let me in, while crying. She was asleep by 6:15 and slept through the night (I didn’t wake her for Tylenol). The following morning she had a huge fat lip, but it didn’t stop her from eating rice cereal, drinking water, playing and eating a Skittle after her stretches (no crying from then on during them).
Benjamin was much sadder and more fussy than Madeline that first evening, requiring constant holding and rocking, but I believed part of it was gas in addition to his mouth hurting. He took his nighttime bottle (his one supplement bottle — 6 oz) so well. The fast nipple actually felt super fast, I suspected because he was actually latched on well and sucking hard. I could barely break the suction to give him a break to catch his breath. He was a little restless in his slumber, but his first stretch of sleep was four hours, then three and then two. He wouldn’t take his pacifier and actually comfort-nursed while sleeping next to me (this had never happened before). I only gave him Tylenol after his second waking. The next morning we started back up with an every 4 hour regimen of Tylenol and Hylands Teething Gel. Benjamin was extremely tolerant of his stretches.
For two weeks following, per doctors orders, we did their stretches faithfully and saw good healing of their wounds.
The ResultsMadeline’s new and improved smile is stunning and such a treat to see! Her speech, after just six months of private therapy post-frenectomy, progressed beyond our highest hopes! Her intelligibility has increased profoundly and her articulation continues to improve. Best of all, her confidence has sky-rocketed!
If I could and knowing what I know now, I would go back in time and have both of my children evaluated and treated very early on, at just days or weeks old. But as it were, I wouldn’t change a thing about our journey through evaluation, procedure and recovery from frenctomies. I am absolutely thrilled with the results!
Note: Upper lip and tongue ties may not be the cause of painful/dysfunctional breastfeeding for every baby, but if your story sounds anything like ours I strongly encourage you to look into it! Please consult with your local IBCLC, pediatric dentist or pediatrician as a starting point. If you have any questions about my experience with upper lip and tongue ties or the frenectomy procedure, I’m here for you. Please feel free to message me!
My daughter, Madeline, was a very poor nurser as an infant. From birth to two and half months old, she would breastfeed, clicking her tongue the whole time, for about three minutes (through my heavy let down) and then pull off screaming (seemingly in agony) and shaking her head. You could not get her to latch back on. My nipples were cracked, constantly sore and nursing was never pleasurable. It was always stressful. “It’s not supposed to be like this,” I’d say to my husband through tears. “Some babies fall asleep nursing!”
We were convinced there was something wrong — that I wasn’t producing enough, that she was starving, that there was a food allergy. I tried fenugreek supplements (which she ended up being allergic to), tried nursing more frequently, tried elimination diets — none had any effect on her nursing habits. Many moms in my life told me that this was so common — that a lot of babies just cried for no reason. Maybe she even had colic.
One night, in a moment of desperation after another failed attempt at nursing, we gave her a bottle of formula (one of the ones they send you home with from the hospital). The instant difference in her demeanor was night and day. Our baby was finally content. From that night on, I became a pumper. I ended up exclusively pumping for her between two and a half and four months old, before my supply dwindled and I finally switched her to just formula. She was an infinitely happier and chunkier baby girl (and we were happier, too!), but my goal of primarily breastfeeding my daughter as long as possible was a thing of the past.
The Turning Point
After Madeline’s first birthday, I happened upon an article on Facebook about upper lip ties. Recognizing all the classic symptoms instantly, I ran to check her. Since that day, I have been convinced that an upper lip tie was the reason for our breastfeeding issues. And at age two, when I started itching to have her evaluated for speech (she was struggling with articulation problems), I had a nagging suspicion that this suspected upper lip tie was to blame.
History Repeated Itself
Fast forward to the birth of my son, Benjamin. Armed with the research I’d done on upper lip ties and tongue ties (here‘s a good place to start…and here…and here), which I now knew go hand in hand, I had a plan for my breastfeeding relationship with my newborn — I wasn’t going to leave the hospital without having him evaluated for ties. The day after his birth, the on-call pediatrician checked him out and said all looked good to her. I disagreed, but my husband insisted that the doctor knew what she was talking about. Ready to go home, I hesitantly relented.
By one month old, nursing Benjamin still wasn’t “coming naturally,” nor was it “pain free.” So I made an appointment with a lactation consultant at the on-post hospital who thought his latch looked good, but noted he was gumming my nipple while nursing. While we nursed in front of her, he actually consumed three ounces from one breast in less than ten minutes (the LC remarked that I was producing enough for triplets at that point). She ended up suggesting some different holds to accommodate him better aka we had to nurse with him sitting up straight on my knee. Not ideal. Not cozy and comfortable for either of us.
By two months old, we had suffered two cases of thrush and I had had one agonizing case of mastitis. Benjamin was an extremely gassy baby who audibly swallowed air while nursing, sometimes clicked, bit down on my nipples (I suspect to slow my heavy let down), pulled off every thirty seconds to either gasp for air, shake his head or just re-latch more shallowly (which I constantly tried to adjust) and who spit up two to three times after every feed. I used to describe his nursing experience as him being waterboarded, but he did seem much more patient with the experience than Madeline was. He very rarely fell asleep nursing, often sitting up whining/crying until I could calm him down enough to get burps out. He would only poop once every day or two (mucusy- even when I cut dairy from diet for a month) and usually seemed to be in pain until he was able to go. My nipples were red/purple and super sensitive.
At his two month check up, I told the nurse about his issues and, after bearing witness to his “pain cry,” she recommended an upper GI. The result was that his anatomy was normal, but he showed evidence of acid reflux. He went on a daily dose of Prevacid — a total nightmare each day since the taste was so bad. Our insurance even stopped covering the liquid compound, which had offered him much gastro-relief. But the meltaway tabs that we substituted with proved much easier for him to tolerate and cheaper, as well.
At almost three months old, Benjamin started to refuse to nurse. He might nurse for one to two minutes on each side but seemed to get frustrated easily and was constantly pulling off, kicking and fussing. After trying cluster feeding (to no avail), I eventually caved and supplemented with formula for the first time. Again my baby was somewhat relieved and happy. Again I was torn between wanting to breastfeed and wanting a happy and healthy baby — the two did not seem to go hand in hand for me. Again I suspected that an upper lip and tongue tie was part of the problem.
By this time, Andrew was about to deploy to Iraq, and I was nearing my wits’ end. Benjamin had been a challenging baby up to this point, and now my husband was about to leave. I’d be parenting an infant and a two year old alone. Panic was rapidly setting in.
While I had gotten Benjamin evaluated for a tongue and lip tie at birth and gotten feedback that he looked normal (HA!), I never had Madeline evaluated. On my Deployment To Do List — get both of my children formally evaluated by a pediatric dentist for lip and tongue ties.
Note: Upper lip and tongue ties may not be the cause of painful/dysfunctional breastfeeding for every baby, but if your story sounds anything like ours I strongly encourage you to look into it! Please consult with your local IBCLC, pediatric dentist or pediatrician as a starting point. If you would like to know more about our experience with upper lip and tongue ties or the frenectomy procedure, please check out part two of our story here!