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The Great Debate: Tongue Tie Aftercare May 7, 2014

“My baby screams so hard when I perform stretches, are they really necessary?”

 

“My doctor/dentist/IBCLC told me that I can manually rip open the revision site after it has reattached, but, that feels barbaric.”

 

“My baby seems to have an oral aversion . . . at least to my fingers.”

 

“My IBCLC/doctor/dentist said oral aversion is worth the risk of aggressive aftercare.”

 

“My toddler is so strong, I can’t seem to get under the tongue without being bitten.”

 

“I was told my baby’s tongue/lip tie reattached because I didn’t stretch aggressively enough (or did not stretch at all).”

 

“I stretched aggressively and the ties still reattached.”

 

“I did not stretch and the ties did not reattach.”

 

To be perfectly honest these sorts of comments make me angry. I am not angry at the parents, but, angry at the professionals that keep insisting aggressive aftercare is the only way to prevent reattachment, when we are not even sure it prevents it at all!

 

To back up briefly, not even professionals seem to agree one what reattachment is when it comes to tongue and lip ties, or when it becomes problematic. The thoughts seem to range from any frenulum with any symptoms mean problematic reattachment, to some frenulum and reattachment is normal and even some remaining symptoms are normal. It is important to realize that not all breastfeeding problems are caused by tongue tie and that even if a particular baby’s problems are all tie related, it can still take a long time for the symptoms to improve after release.

 

I am going to share my story, with names of professionals intentionally left out, and conclude with some links to aftercare articles written by professionals that I trust understand the emotional and physical trauma aggressive aftercare can cause.

 

I have two children that have had their ties released. My son, C, (3 years old at the time) and daughter, N, (several releases during her first year).

 

I started out stretching C’s revision site aggressively, but, he was strong and fought hard so I quickly reduced the frequency of stretches and performed them more and more gently until I stopped. His tongue healed perfectly and 18 months later he has no symptoms.

 

N has had multiple “revisions.” Her tongue tie was first released at 7 weeks old and I used gentle “sweeps” under her tongue (no stretching or bleeding and she hardly flinched). Her tongue healed without any reattachment.

 

At 10 weeks old N’s lip was released, I did not touch the wound, it reattached, though it was closer to a class 3 than class 4.

 

When N was 5 months it was determined she had remaining frenulum (not reattachment!) under her tongue and remaining symptoms so it was released again. I did slightly former stretches. At this point I had joined some tongue tie support groups online and had connected with some professionals (one in particular) that put significant emphasis on stretching to avoid “reattachment.” When I saw frenulum under N’s tongue again I panicked and broke it open (looking back I am not even sure if it was true reattachment). I called the dentist who released the tie and he suggested not stretching, but, using a gentle massage. My understanding of what he said that reopening the wound would slow down the healing process and increase the risk of reattachment. I am not sure he still advises that or maybe I misunderstood him, but, when I switched to the gentle massage her revision site healed within 2 weeks without reattachment. I did not consider at that time that the gentle massage may have been more beneficial in preventing reattachment than aggressive stretching.

 

Over the next few months I followed the professional that was placing major influence on aggressive stretching to prevent “reattachment” and insisting it did not cause oral aversion and any upset or pain to the baby was worth it. Much to my shame I followed and participated in the person’s advocacy of aggressive aftercare. I became literally blind to the trauma it was causing parents and children and followed this person like a cult.

 

N still had many symptoms at 10 months so we returned to the dentist, this time he released the lip and the tongue (which had not reattached, but, he released deeper). I had become so consumed by the paranoia of reattachment that I was terrified of it happening to my baby and willing to do anything to prevent it. I blindly followed the advice of a professional whom I trusted . . . ignoring some of the blogs which had begun to pop up warning against aggressive aftercare.

 

The professional watched me and instructed me stretch/rub the revision site to the point that I removed more tissue from the lip frenulum than was revised. I continued to stretch, rub, and break up tissue multiple times a day for 14 weeks. N was so traumatized she would cry as soon as I begun preparing to stretch her. Symptoms had briefly improved but began to get worse and worse and it seemed the more aggressively I stretched the more it reattached.

 

I stopped stretching and rubbing at 14 weeks, within about 2 weeks her tongue and lip had healed. Her lip did reattach some (but even less far down the gum line) and her tongue did not reattach at all. All of her symptoms improved significantly within the first few weeks after I stopped stretching and continue to improve 18 months later.

 

N must have broken her lip frenulum on her own a few months later because one day I noticed it was completely gone . . . since I had no idea it had even ripped I had not touched it . . . yet it was perfectly healed.

 

The worst part is that N still has not forgotten, she still does not fully trust fingers near her mouth, or being put in “stretching position.” I no longer believe stretches prevent reattachment, but, even if I thought they did, I feel it would be less traumatic to have more revisions than endure aggressive aftercare.

 

How to avoid oral aversion from aftercare: Tongue Tie – Gentleness and Compassion for the Baby Part 1 and Tongue Tie – Gentleness and Compassion for the Baby Part 2

 

The danger of and lack of evidence for stretching: What Is Appropriate Aftercare Following Tongue Tie Treatment? PART 1 and What Is Appropriate Aftercare Following Tongue Tie Treatment? PART 2

 

***I will have no problem approving comments from the apposing point of view, but, personal attacks against me, especially without real contact information of the person commenting will not be approved.***

 

Mama and Papa See Me Through (PTT through Baby’s eyes) November 2, 2012

Squeezed and pushed I tried so hard to rotate through. It took some time, but, finally the shape of my passage changed and I slid through into warm, expectant, hands. These hands belonged to my Grandma, who was gazing lovingly into my eyes.

I heard familiar voices, and smelled my Mama and heard her heartbeat as I was laid on her chest. I felt safe, and laid there for a long time. After a while my Mama put me near something soft and round, it smelled sweet and I tried to suckle on it . . . I did not know why, but, it seemed so natural.

After a while my stomach started to bother me – I had never felt hungry before. Inside my Mama’s womb I was constantly fed. I kept trying to suck on my mother’s warm, round, breasts, but, it was so much work for so little reward. Over the next few days I decided I preferred to sleep –  to conserve my energy.

Soon I realized if I sucked a few times milk would flood my mouth briefly. I liked that feeling and it tasted so good. I cried and cried when my Mama gave me a rubber nipple without milk instead of breastfeeding me, but, it relaxed me, and I drifted off to sleep.

My skin began to hurt, itch, and flake off . . . this had never happened before. I felt so hungry, but, I was too sleepy to cry for milk – it was too hard and painful to suck for it anyway.

One day Mama gave me a different type of rubber nipple; this one had milk in it. It was scary to drink from the bottle – I kept choking, and it was still a lot of work to suck the milk out, but, after a few days my belly felt full, and my skin felt comfortable, but, something else happened. My throat started to burn as the milk came back up, I did not want to lose that milk so I would swallow it back down and it burned again.

One day a man looked in my mouth, and then he put something hot under my tongue. It made my tongue feel funny, and Mama stopped offering so many bottles. I was happy that I could get more milk from her breasts . . . but I still felt hungry all the time, and my throat still burned. We saw another man who did something similar to my lip; I felt I could drink really well for a few days before things got worse and worse.

One day Mama started giving me bottles again after I breastfed, I felt less hungry, but some of the bottles tasted so bad, I think I heard someone call them “formula,” it made my tummy hurt, and sometimes all of it came back up my throat. One time so much came out Mama screamed!

Some time passed, Mama and Papa fought a lot and I sensed so much tension in my house. They kept using my name, and I felt it was my fault.

One day I had to stay in my car seat the whole day, we stayed at my Titi’s house far away. The next morning we had another long car ride to another doctor’s office. I had seen so many. I could not understand why.

The doctor looked in my mouth and then took me away, once again I felt something hot under my tongue. When the doctor brought me back I drank milk from Mama’s breasts. It felt easier, and did not hurt so much, though I still found it hard to coordinate sucking, swallowing and breathing. I often would forget to breathe and have to gasp for air. Feeding was still stressful.

Mama took me to a sweet lady who rubbed my head and did funny things with my body. Sometimes I did not like it, but, I felt better afterwards. It seemed like the more times she brought me there the easier it was to drink milk from Mama’s breasts and before long I was not drinking from many bottles at all.

I felt the tension in my home release, and even my tummy and throat stopped hurting for a while.

After more time passed I began feeling hungry again; my ears, tummy and throat began hurting too. I would cry for hours. I could tell something was bothering Mama, but, I did not hear her say much until she told Papa, “he thinks more frenum came forward from craniosacral therapy,” whatever that means. Mama started giving me bottles again. The bottles made my tummy feel full; I did not want to suck on Mama’s breasts anymore. It was too hard to get milk.

One day I had to ride in my car seat for a long time and went back to the doctor again. This time he put the hot thing under my tongue and my lip. When he brought me back to Mama I decided to try to suck on her breast. I found I could open my mouth wider and somehow that gave me more milk. I decided I would keep trying to suck on her breasts.

Mama would stretch and rub her fingers under my tongue and lip. I did not like the feeling of being held down and it hurt a little bit; but, I let her, because she always told me so calmly that she had to do this so I could drink easier. I trusted her.

We went to another kind woman who rubbed my head and neck and moved my body around. She talked a lot while she was doing this, and Mama asked questions. I did not understand what they were talking about, but, I think it made Mama feel happier, and I felt better too.

Another lady kept watching me eat. She talked to Mama a lot too, than she kept trying to put a tube in my mouth while I sucked on Mama’s breasts. I felt Mama was stressed and the tube felt funny so I decided not to breastfeed anymore. I was really hungry for a few days because Mama stopped giving me bottles. One day I decided I would try the tube. The tube had milk in it! After that, I decided I liked drinking from Mama’s breasts again. I liked it so much I drank from them constantly for a few days. It seemed the more I drank from them the more milk there was – this was new to me and I loved it.

Now I drink from Mama’s breasts all the time. My ears, throat, and tummy have started feeling better. I have even learned to say some words – I love the reaction I get! The tension in my house has relaxed and I can see how much Mama and Papa love each other – and love me. Things have been hard for me since the moment I tried to exit Mama’s womb, but, they are getting easier . . . and I know my Mama and Papa are loving enough to see me through whatever lies ahead.