I once read a fascinating article on the web about tongue ties and related dental issues. I cannot for the life of me find that article again and sadly I never bookmarked it anywhere. At least I remember what it's about. If anyone finds the article I'm discussing, I'd love it if you posted a link to it in the comments so I can properly quote the author.
A lactation consultant was writing about her epiphany that occurred during her middle aged years. For years she's suffered from severe tooth decay and was constantly required to get her various teeth problems treated. What she didn't know (until later) was that it was all due to an uncorrected tongue tie!
How did this happen? Think of what happens after you eat popcorn. Or salad. You know how you wiggle and flick your tongue all around your teeth to clean them? Think of how amazing your tongue can be when you lack a toothpick. It's awesome the way your tongue can reach so many areas of your mouth to clean away leftover food particles after a meal. But what's if your tongue just can't get into all those nooks and crannies? What's if you have a tongue tie and your tongue can't reach so far?
All that can lead to tooth decay and other dental problems. It's easy to see why. If food remains for long periods of time, it wears away the enamel and starts to break down the tooth, resulting in cavities. If those don't get dealt with right away, a root canal treatment may be next in line.
This lactation consultant only realized the connection between tongue ties and tooth decay when she began to diagnose babies with tongue tie. Lately this condition is much more well known than it ever was. Maybe more people have them these days (since there is a genetic component involved).
So if you ever wonder if a tongue tie should be corrected or not, this may be one more factor to consider.
Showing posts with label tongue-tie. Show all posts
Showing posts with label tongue-tie. Show all posts
Monday, May 18, 2015
Tuesday, February 17, 2015
Hungry? Or not?
I met a cousin of mine over the weekend. She is a new mother to a 6-week-old baby. When I casually inquired how breastfeeding was going, she smirkingly answered, "Oh, my baby gave up on me after a few weeks!" Then she explained that her baby was always "hungry" after nursing and "she always wanted a bottle afterwards" so "I wasn't going to starve her."
After hearing that I really felt bad that this happened. Of course every mother knows what's best for her child but sometimes a bit of myth-y information can really lead her to make uneducated guesses and then decisions that probably aren't best for her baby. Let's see if we can figure out what went on with my cousin's baby.
My cousin was able to pump normal amounts of milk so she did not have a milk supply issue. Her baby was able to suck ok and transferred milk fine. Her latch wasn't a problem either. So then what happened? Babies love to suck. If a baby is given a pacifier, he'll probably enjoy it! A bottle is like a pacifier in that sense so many babies will gladly take a bottle at any time if offered (although Sam was NOT that kind of kid) even if they aren't hungry. Think of yourself after having eaten a delicious dinner of rib steak, fries and vegetables. You're probably feeling well-sated and going "ahhhh". But if I then served you a gorgeous dish of gooey chocolate brownie and mocha ice cream with fudge sauce, would you honestly turn me down? Babies love a good dessert too (and formula tastes great).
My cousin nursed her baby. Her baby was probably satisfied with the feeding, but probably not overly full (like bottle-fed babies tend to become after a feeding). Her baby cried for any of the following reasons: gas, general fussiness, the need to burp, dirty diaper, wanting to nurse for dessert, wanting to be held, or one of the other thousand inexplicable reasons why baby cry. She assumed her baby was hungry and offered her a bottle, which she slurped down (think of yourself attacking your dessert plate with gusto). Was her baby truly hungry before the bottle? No.
There's actually a condition called "Perceived Insufficient Milk" (which I believe I've experienced at some point!) where a mother honestly thinks she doesn't have enough milk for her baby. This happens when a mother misinterprets her baby's cues for hunger and she therefore thinks her baby is always hungry even though she isn't. This often causes premature weaning because the mother will just end up supplementing, assuming there are no solutions anyway.
After hearing that I really felt bad that this happened. Of course every mother knows what's best for her child but sometimes a bit of myth-y information can really lead her to make uneducated guesses and then decisions that probably aren't best for her baby. Let's see if we can figure out what went on with my cousin's baby.
My cousin was able to pump normal amounts of milk so she did not have a milk supply issue. Her baby was able to suck ok and transferred milk fine. Her latch wasn't a problem either. So then what happened? Babies love to suck. If a baby is given a pacifier, he'll probably enjoy it! A bottle is like a pacifier in that sense so many babies will gladly take a bottle at any time if offered (although Sam was NOT that kind of kid) even if they aren't hungry. Think of yourself after having eaten a delicious dinner of rib steak, fries and vegetables. You're probably feeling well-sated and going "ahhhh". But if I then served you a gorgeous dish of gooey chocolate brownie and mocha ice cream with fudge sauce, would you honestly turn me down? Babies love a good dessert too (and formula tastes great).
My cousin nursed her baby. Her baby was probably satisfied with the feeding, but probably not overly full (like bottle-fed babies tend to become after a feeding). Her baby cried for any of the following reasons: gas, general fussiness, the need to burp, dirty diaper, wanting to nurse for dessert, wanting to be held, or one of the other thousand inexplicable reasons why baby cry. She assumed her baby was hungry and offered her a bottle, which she slurped down (think of yourself attacking your dessert plate with gusto). Was her baby truly hungry before the bottle? No.
There's actually a condition called "Perceived Insufficient Milk" (which I believe I've experienced at some point!) where a mother honestly thinks she doesn't have enough milk for her baby. This happens when a mother misinterprets her baby's cues for hunger and she therefore thinks her baby is always hungry even though she isn't. This often causes premature weaning because the mother will just end up supplementing, assuming there are no solutions anyway.
Monday, December 22, 2014
Finger-feeding a baby who can't breastfeed
Sometimes a baby is born with some sort of difficulty which makes it hard for him to nurse properly and or obtain a good latch. Sam was like that. Due to his tongue tie he wasn't able to latch onto my nipples or even suck that well. Only the second day did he attempt a little sucking and by the third day he was able to actually nurse for an entire feeding. So what happened during this time? The hospital staff fed him bottles. I had no choice, really. They did not tell me anything about hand-expressing colostrum (idiots) and they just found it easier to feed him formula, so that was what happened. My sister did give me great advice about that, though. She said to have the nurses use a breastfeeding-friendly method when administering the bottles.
If you read what the internet has to say about that, you'll see all kinds of suggestions from using an SNS (supplemental nursing system), to cup-feeding, spoon-feeding, dropper-feeding, and finger-feeding. The SNS is a really helpful tool (based on what I've read online and heard from mothers who have used them) but I don't have much info since I've never tried it out. Cup-feeding and spoon-feeding sound very messy to me. I know that Sam couldn't easily drink from a cup until he was several months old so no way could I see that working when he was a few days old! Droppers don't sound bad, and I've resorted to using that at times when he was reluctant to eat (I have plastic pipettes).
Which leaves finger-feeding. How does this work? You (or whoever is feeding the baby) wash your hands (important!) and fills a bottle with milk or formula. Then you attach a lactation aid which is really a thin tube that can attach to the baby bottle. Tape the other end of the tube to your finger and let your baby suck your finger as if it's a nipple or pacifier. Release the milk into the tube and your baby is now being fed!
This was a great method to use in our case because Sam was able to build up his sucking muscles while eating, but without the nipple confusion a regular bottle would have caused. I wanted him to learn to suck on skin, not silicone. I actually never did this because the nurses in the hospital were doing it for me, but the technique did work to help Sam suck better, and it got him fed without a bottle!
So if you're in such a situation where your baby can't nurse for whatever reason, don't give up hope. You probably can sort out your breastfeeding issue, whether it's a physical issue like tongue tie, or a milk supply issue. But in the meantime, there is no reason your baby has to be given a bottle. Bottles don't help as well as other breastfeeding-friendly methods do. Plus you can give your baby your own milk most of the time!
If you read what the internet has to say about that, you'll see all kinds of suggestions from using an SNS (supplemental nursing system), to cup-feeding, spoon-feeding, dropper-feeding, and finger-feeding. The SNS is a really helpful tool (based on what I've read online and heard from mothers who have used them) but I don't have much info since I've never tried it out. Cup-feeding and spoon-feeding sound very messy to me. I know that Sam couldn't easily drink from a cup until he was several months old so no way could I see that working when he was a few days old! Droppers don't sound bad, and I've resorted to using that at times when he was reluctant to eat (I have plastic pipettes).
Which leaves finger-feeding. How does this work? You (or whoever is feeding the baby) wash your hands (important!) and fills a bottle with milk or formula. Then you attach a lactation aid which is really a thin tube that can attach to the baby bottle. Tape the other end of the tube to your finger and let your baby suck your finger as if it's a nipple or pacifier. Release the milk into the tube and your baby is now being fed!
This was a great method to use in our case because Sam was able to build up his sucking muscles while eating, but without the nipple confusion a regular bottle would have caused. I wanted him to learn to suck on skin, not silicone. I actually never did this because the nurses in the hospital were doing it for me, but the technique did work to help Sam suck better, and it got him fed without a bottle!
So if you're in such a situation where your baby can't nurse for whatever reason, don't give up hope. You probably can sort out your breastfeeding issue, whether it's a physical issue like tongue tie, or a milk supply issue. But in the meantime, there is no reason your baby has to be given a bottle. Bottles don't help as well as other breastfeeding-friendly methods do. Plus you can give your baby your own milk most of the time!
Tuesday, June 10, 2014
How a tongue-tie is resolved
The proper term is actually "revision". Tongue-ties are revised. On a fine Monday morning when Sam was about five months old, we took him to Dr. Tali Lando of ENT Faculty. She checked his mouth and agreed that he has a posterior tongue-tie, but it's not one of the bad ones she's seen. Still, the good doctor claimed, it pays to just deal with it now while he's a baby and the procedure is no big deal to perform and recover from. Here's how it went.
We laid Sam down on the examining table and held his hands and feet. An assistant held his head down so he faced the doctor. Dr. Lando gave him a quick shot to numb the area (Sam cried for just a few seconds after that) and then snipped the offending frenulum, which took just a few seconds! Then she pressed a gauze on that area to stem the bleeding. When she removed it, the gauze just had a pale peach-colored stain - no bleeding! I was told that I should try to nurse him right away as that would help the area heal quicker. I was only too happy to oblige. Nursing really comforts Sam (and me!).
I nursed him and didn't see any remarkable difference yet. His suction felt like it always did. For the next few days after the procedure, Sam nursed a little less than normal and it did not feel any different than it did before. THEN we noticed a change. A few days later my nipples got sore! Oh boy, did they get sore! Sam also went from nursing for 15 minutes to about 7-10 minutes. By now, at 8 months, he nurses for about 5 minutes. His lips also flange out the proper way, surrounding the nipple in a proper latch. No more lipstick nipples either.
I wondered why I didn't see a change in his feeding right away. Then it occurred to me. He was using brand new muscles that had never yet been within his range. When using them in the beginning, just after the revision, these muscles would tire easily until he exercised them enough to endure an entire feeding.
We laid Sam down on the examining table and held his hands and feet. An assistant held his head down so he faced the doctor. Dr. Lando gave him a quick shot to numb the area (Sam cried for just a few seconds after that) and then snipped the offending frenulum, which took just a few seconds! Then she pressed a gauze on that area to stem the bleeding. When she removed it, the gauze just had a pale peach-colored stain - no bleeding! I was told that I should try to nurse him right away as that would help the area heal quicker. I was only too happy to oblige. Nursing really comforts Sam (and me!).
I nursed him and didn't see any remarkable difference yet. His suction felt like it always did. For the next few days after the procedure, Sam nursed a little less than normal and it did not feel any different than it did before. THEN we noticed a change. A few days later my nipples got sore! Oh boy, did they get sore! Sam also went from nursing for 15 minutes to about 7-10 minutes. By now, at 8 months, he nurses for about 5 minutes. His lips also flange out the proper way, surrounding the nipple in a proper latch. No more lipstick nipples either.
I wondered why I didn't see a change in his feeding right away. Then it occurred to me. He was using brand new muscles that had never yet been within his range. When using them in the beginning, just after the revision, these muscles would tire easily until he exercised them enough to endure an entire feeding.
Tongue-ties
Myth: It's normal for breastfeeding to hurt for the first few weeks.
Fact: It's not.
I thought I was normal when my boobs were sore, uber-painful, bleeding, cracked and chafed at three months postpartum. Everyone said they'll stop being painful at around 3 months. It's true that they got better then, but this is NOT the norm. There must have been an underlying problem.
When Sam was 3 months old, I called Chonyi Glassman, a lactation consultant and IBCLC. After a full assessment of his mouth and sucking capabilities, she determined that he had a posterior tongue-tie which isn't so visible to the eye when you look at him face to face. Also, she said he doesn't suck well, probably because of the tongue-tie. She recommended asking my pediatrician about it. I asked him and he said that since his tongue can't reach past his lips, I should take him to a pediatric ENT. Then she measured how many ounces Sam consumed in a feed. It was 1.5 ounces - but he wasn't so hungry at the time. Still, that amount in 10 minutes is hardly efficient. These are the pacifiers she recommended to help his sucking become stronger.
So what is a tongue-tie? Grab a mirror and stick your tongue out at it (say "ahhhhh"). Notice that string-like band connecting your tongue to the floor of your mouth? In some babies it's either too short or too thick, and this restricts the movement of the tongue. If it's further back, it's a posterior tie. This doesn't let a baby suck properly. It can even cause speech and feeding problems later on. It's also genetic. In fact, people with an MTHFR gene mutation are prone to midline defects, and tongue-tie is one of them. I know this runs in my family and a niece/nephew or two has had a tongue tie.
Other signs Sam presented that can be tied to tongue-tie (at the time I did not realize they were all connected to his condition):
Fact: It's not.
I thought I was normal when my boobs were sore, uber-painful, bleeding, cracked and chafed at three months postpartum. Everyone said they'll stop being painful at around 3 months. It's true that they got better then, but this is NOT the norm. There must have been an underlying problem.
When Sam was 3 months old, I called Chonyi Glassman, a lactation consultant and IBCLC. After a full assessment of his mouth and sucking capabilities, she determined that he had a posterior tongue-tie which isn't so visible to the eye when you look at him face to face. Also, she said he doesn't suck well, probably because of the tongue-tie. She recommended asking my pediatrician about it. I asked him and he said that since his tongue can't reach past his lips, I should take him to a pediatric ENT. Then she measured how many ounces Sam consumed in a feed. It was 1.5 ounces - but he wasn't so hungry at the time. Still, that amount in 10 minutes is hardly efficient. These are the pacifiers she recommended to help his sucking become stronger.
So what is a tongue-tie? Grab a mirror and stick your tongue out at it (say "ahhhhh"). Notice that string-like band connecting your tongue to the floor of your mouth? In some babies it's either too short or too thick, and this restricts the movement of the tongue. If it's further back, it's a posterior tie. This doesn't let a baby suck properly. It can even cause speech and feeding problems later on. It's also genetic. In fact, people with an MTHFR gene mutation are prone to midline defects, and tongue-tie is one of them. I know this runs in my family and a niece/nephew or two has had a tongue tie.
Other signs Sam presented that can be tied to tongue-tie (at the time I did not realize they were all connected to his condition):
- Narrow and painful latch
- Vasospasms (spasmodic nerve-like pain in the nipple)
- After a feed, nipple looked like the top of a lipstick
- He would latch and unlatch repeatedly during a feed
- He couldn't stick his tongue out past his bottom lip
- Top lip curls under and cannot stay curved outward during a feed
- Breasts never really felt empty after a feed
The early days
When Sam was just born, the nurses handed him over to me and encouraged me to nurse him then and there, in the delivery room. I was waiting for this bonding moment for so long, and now it was finally happening! I would provide liquid gold for Sam to enable him to grow and thrive. But Sam had other plans. He was licking my nipples like they were lollipops, but not sucking at all. Aren't babies supposed to be born already knowing how to suck? That's what I had read, but that's not what was happening here. The nurses then whisked him out of my arms and went to measure him, weigh him, and all that.
They brought Sam to me a few hours later and still, he wouldn't suck at all. I held him and we did lots of skin to skin contact, and no go. A few hours after that, a really persistent, pushy and stubborn nurse tried to force Sam's mouth over my nipples and squished my breast into his mouth. He just cried. What a moron of a nurse. You can't force a baby to nurse, and even Sam knew that. Then the nurse tells me that since he hadn't eaten a thing since he was born (about 9 hours), they have to give him formula. Nobody mentioned the concept of hand expressing. Why not? I did know enough to tell the nurse to finger-feed him, rather than using a bottle. This would encourage Sam to suck properly and learn the texture of a finger, rather than a silicone nipple.
So Sam had formula for a day in the hospital. The second night we got an amazing nurse who happened to be training as a lactation consultant (she just wasn't a certified one yet) and she showed us both how to nurse. It was so great to have an educated and patient person showing you what to do, and working along with you, till you got it. By the end of that training experience, Sam was sucking. Not perfectly yet, but definitely doable.
I could have stopped then and just continued with formula. It was definitely easier than getting him to latch on and have him stay interested for long enough to get an entire feed. But I'm pleased and proud to say that we stuck it out. By the time we left the hospital, Sam could breastfeed!
They brought Sam to me a few hours later and still, he wouldn't suck at all. I held him and we did lots of skin to skin contact, and no go. A few hours after that, a really persistent, pushy and stubborn nurse tried to force Sam's mouth over my nipples and squished my breast into his mouth. He just cried. What a moron of a nurse. You can't force a baby to nurse, and even Sam knew that. Then the nurse tells me that since he hadn't eaten a thing since he was born (about 9 hours), they have to give him formula. Nobody mentioned the concept of hand expressing. Why not? I did know enough to tell the nurse to finger-feed him, rather than using a bottle. This would encourage Sam to suck properly and learn the texture of a finger, rather than a silicone nipple.
So Sam had formula for a day in the hospital. The second night we got an amazing nurse who happened to be training as a lactation consultant (she just wasn't a certified one yet) and she showed us both how to nurse. It was so great to have an educated and patient person showing you what to do, and working along with you, till you got it. By the end of that training experience, Sam was sucking. Not perfectly yet, but definitely doable.
I could have stopped then and just continued with formula. It was definitely easier than getting him to latch on and have him stay interested for long enough to get an entire feed. But I'm pleased and proud to say that we stuck it out. By the time we left the hospital, Sam could breastfeed!
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