Our Lip Tie and Tongue Tie Story
Most people know what tongue tie is, but have you ever heard of lip tie?
Before Matthew was born, I noticed that a relative has a tongue tie so I made sure to read up on the topic and also told my husband that we would need to check our baby for a tongue tie as it can be hereditary. At the hospital a few hours after delivery, we asked one of the lactation consultants to check Matthew and she pronounced him 'normal' and I thought I didn't have to worry about the matter anymore.
After we got home, the first few days were literally hell as baby was crying non stop and we didn't know what to do. Friends asked if the baby was gassy or colicky and suggested different ways to calm him down; some said just to let him cry it out. (We couldn't bear to and it went against what we felt would be the best for our child.)
The lactation consultant in our area came once but the nursing didn't improve that much. It was only after her second visit when she gave me more tips on positioning that we managed to get a deep enough latch. (Spoiler: in nursing, a deep latch is everything...) We then realized previously that he was crying so much mainly because he wasn't latching right and he was very hungry. (Can you imagine if we had let him cry it out earlier? To be desperately hungry AND to feel abandoned! How pitiful would that be?!)
Things seemed to go well after that and at the one month baby wellness check up, Mathew's weight was right on track but I did have a couple questions for the PD. One: baby seems rather gassy and would keep on farting, two: he's nursing almost round the clock and what I should be doing about it. The doctor said that baby's gassy-ness was due to my diet; anything that would make me gassy would make my baby gassy (I found out later that this is inaccurate information) and that I should try other ways of comforting the baby as he was using my nipple as a pacifier and that my nipples would be sore if I allowed him to nurse round the clock. (This is also wrong; if the baby is latched on right, he can nurse 24/7 and the nipples would still be fine.)
Nursing 'round the clock
After Matthew turned one month, he started a really intensive nursing schedule. During the day time, he would nurse 50 minutes, nap fitfully for 10 and then nurse 50 minutes and then sleep for 10 and repeat the cycle over and over again. Needless to say, it was exhausting but he didn't seem content. He would pull at the nipple and kick at the end of nursing sessions and cry and cry and cry...I mean, I didn't mind nursing him so much if he was happy but something seemed to be very wrong.
I messaged the lactation consultant and sent her a video of Matthew nursing and asked if she thought there could be any issue with the supply or latch. Her opinion was that it was a growth spurt and Matthew would revert to 'normal' feeding patterns in a few days. The 'few days' stretched into two long weeks. This growth spurt was seriously long!
Fortunately (or not), my husband and I had read in a baby sleep book that babies can get extra fussy at week six and that the husband should take leave at that time to help the wife out. So he was around during that time and what we ended up doing was stretching out the feedings to at least an hour, optimally two. Dennis would carry Matthew and try to soothe him but oh, his wails were heart-wrenching and we were both getting burnt out by the crying and sleep deprivation.
So, I thought I should ask friends for advice again and see if we had missed out anything that could possible help with the nursing or crying. One friend suggested pumping and possibly formula, another asked me to check for a tongue tie. I was not very convinced that there was a tongue tie but she pointed that another friend's baby recently underwent a procedure to release the tie and asked me to speak to that friend about her experience.
A lip tie?!
That friend said it was not a tongue but lip tie and she asked me to flip my son's lip and check. Guess what? The lip tie stared at me right in the eye. I couldn't believe it!! What is a lip tie, for goodness' sake? I read up quickly and to my horror, my little boy had all the symptoms! Nursing round the clock, dissatisfaction after nursing, pulling/ tugging at the nipple, a crease in the upper lip after nursing, gassy-ness, sleep deprivation and of course, I also had the sore nipples to prove it...(a lip tie can hinder a deep and secure latch and baby was swallowing a lot of air and getting that much milk that's why he was so gassy and needed to nurse so often to compensate for the small amounts of milk he was getting. It's like someone was drinking from a pinched straw with holes!
Oh and on hindsight, that initial delay in passing meconium at the hospital was also a red flag...no wonder a large percentage of those babies would suffer with constipation into childhood! They could all have unreleased tongue and lip ties! I'm pretty sure the neonatal specialist didn't know about ties too.
The very next day, we had an appointment with the pediatrician to check some rashes on his skin and we thought that we'd ask the doctor about the lip tie as well. The nurse weighed our little guy and to our shock, his weight had gone down from the 50th to the 20th percentile...(I had thought his weight was still ok but the three weeks of suboptimal latching had taken its toll..) The doctor looked at me and said, "maybe you are not producing enough milk."
I can't be sure if I glared at him or not but I said rather calmly, "That's why I suspect he has a lip tie. He might not be able to empty the breast to stimulate milk production properly." (I really don't think the doctors here know much about breastfeeding; this is a different doctor from the one that had given us wrong information earlier.)
Then the PD checked Matthew and said the tongue was fine but the lip was obviously tied so we decided to go ahead with a laser release at a pediatric dentist. The check wasn't done properly and the doctor didn't know about the laser option - he was going to refer us to an ENT specialist for surgery and that would have required sedating the baby and stitches. The doctor offered to make the appointment for us as he said he most probably could get an earlier one if he told the dentist that baby's weight was going down percentiles...Dennis blurted out that we had already made one for the next day at 8am...I had asked around in the morning and called the dentist for an appointment before we even saw the PD.
When there's lip tie, there's also tongue tie
Throughout that day I did more research and found out that where there is a lip tie, the tongue is also usually tied. And to my horror (yes, I have been rather horrified multiple times in the last few days!), I saw an example picture of a tongue which was tied at the back and it looked identical to Matthew's! So he could be tongue tied after all!!!
The next day, we saw the dentist and he confirmed the lip tip AND tongue tie and we went ahead with the laser. Matthew was able to nurse immediately afterwards and the difference was instant! My nipples, though sore, no longer hurt when he latched on and we could hear him swallow more milk.
From the guidelines that I found from a tongue tie support group on FB, body work was recommended 48 hours before and after the procedure and so we brought Matthew to an experienced chiropractor in our town to be adjusted. Apparently being tie tongued causes a lot of tension in the body during nursing and the body work is to release that tension and any imbalances.
Personally I didn't really believe in chiropractor work and was worried about Matthew having to be a life long client but both the husband and I could felt a difference in our baby's body after the adjustment- his back felt more relaxed, his back felt straighter, his swallow was stronger during nursing and he could hold his head up for much longer. The chiropractor also informed us to our relief that Matthew would need another three to five sessions and be done.
It's only two days post the procedure so I can't say we are completely out of the woods but here are the takeaways so far...
1. If a latch doesn't feel right to mummy, it is not right, no matter what anyone else might say. And actually that goes also for anything related to your child- I didn't subscribe to the 'mother knows best' adage before but now I do! I spend countless hours with my child and examine his every little detail- I really do know him very well. And in doing research for lip ties/ tongue ties, I was never more motivated in my life...I didn't really sleep on Sunday and spent the wee hours wading through information online.
2. Lip and tongue tips are really common!! Some sources say one in five babies have it!! So check your baby today if he has any of these symptoms: trouble nursing, marathon nursing sessions, tugging at your nipple, trouble gaining weight, excessive gas, constipation and snoring. Mummy's symptoms might include: sore nipples, blocked ducts, low milk supply - by the way, this list is not exhaustive!
3. Not many health care professionals know about lip or tongue ties!!! I have a dentist friend even try to talk me out of releasing the tie!! I know my friend means well but I am really glad we went for the procedure!!! So you might have to 'fight' your doctor, dentist and even lactation consultant for a proper diagnosis. (If you think I sound angry, you are right...I feel really let down by the health system here...not too sure if it's any better in Singapore but yeah, I really wish I don't have to double guess the health care providers here and do research like a paranoid person after seeing them...)
4. Formula is never the solution for a breastfeeding problem. No matter what anyone says, your doctor or other experienced mummy friends, do not supplement. Why? Breast feeding is all about demand and supply. Once the demand goes down, supply does too. And with a baby who is already struggling to latch on, the end result might be breast refusal altogether. (Breast feeding is much more than physical nourishment- there's a strong emotional bond between mama and baby too and in my personal opinion, it really helps with babies being able to feel safe and secure. Babies who are frustrated at the breast seem to be more insecure and less trusting.)
Even if supplementing with formula does not impact supply, a baby's gut is immature and 'open' before six months and introducing formula affects the gut bacteria and research is just emerging on the importance on preserving the integrity of the 'virgin' gut. If baby needs more nourishment, the second best option after breast feeding at the breast would be supplementation with mother's breast milk with a lactation aid at the breast. If that is not possible, a syringe, finger or cup and if the mother's milk is not available, then the third option is donor milk. Formula is the fourth option and shouldn't be pushed onto or offered to parents so flippantly. It IS a big deal.