Greetings wise ladies. I wanted to share an experience I had over the last
few weeks with a tongue-tie case - I have permission to post from the mom,
who is eager to have her story shared. As a caveat, you should know that I
am not a lactation professional, and most of my knowledge is self-taught,
but I do follow the literature closely and consider myself well-educated
about breastfeeding issues. As such, I offered myself as a resource person
to my neighbor when she was expecting her first, and signed on in a very
informal post-partum doula role (after assessing that she was not going to
seek out a "real" doula). Birth was by planned C/S due to a previous
botched uterine surgery - docs didn't want any pushing to stress the
perforation site.
Birth went well, baby latching and nursing right away. I visited the day of
the birth, about 8 hours post-op, and mom was tugging breast out to baby,
so I helped a little with positioning, while trying not to step on the toes
of the "lactation nurses" in maternity (no IBCLCs). Mom reporting some
discomfort - I really tried to get baby into a more assymetrical latch,
(football hold) and that seemed to help, but still reporting pain on latch
that "got better after a while". luckily, her edema was mostly from the
knees down! Day 2 I saw the baby cry when mom was in the loo - first
thought: "wow - that's tongue-tie!". I don't mention it. Day 3, family goes
home, misses seeing hosp. IBCLC because she's only in weekdays and the
birth was on Friday. Ped says something about baby's tongue, and his need
to "grow into it", and is taking wait and see attitude. Incidentally, mom
is flying high, hasn't really slept since the birth, and is in the
rapturous-love stage of new motherhood.
Day 4, I drop by the house, mom has crashed, nipple pain is worse, she's
very emotional. Paternal grandmother reports that baby's dad has his tongue
clipped at day one or two! Here comes the part where I mess up - mom is
sleeping, I encourage dad to proceed with tongue clipping, say how easy it
is, baby will nurse better right away, etc. I have no personal experience
with this -- but everything I have read, including Dr. Jack's BF book of
answers, confirms my feeling that this is the right thing to do, and better
sooner than later. Mom gets up, I do a little more positioning help, that
seems to ease mom's discomfort. Talk to her about frenotomy, how easy it
is, not at all like circumcision (which they didn't do), baby will nurse
better right away. Way to pushy, in hindsight.
Day 5, highly esteemed IBCLC makes a home visit at my recommendation to the
family. Confirms diagnosis of tongue-tie, recommends seeing ped, and makes
some positioning changes that really seem to help. Teaches mom side-lying
position - such a blessing! Mom is doing much better, starting to feel
comfortable with breastfeeding.
Day 6, family goes to ped's office, has recommendation from me to clip,
recommendation from IBCLC to evaluate tongue, and is armed with the recent
AAP newsletter with the report on tongue-tie
<http://www.aap.org/advocacy/bf/8-27newsletter.pdf> - that I gave them.
We're all expecting resistance from the ped, who surprises us all and clips
on the spot!
I call the family that evening, mom is really distraught. The clipping did
NOT go well. Baby cried "inconsolably" for almost 30 min, then wouldn't
nurse at all for several hours. Baby did breastfeed once they got home, but
reluctantly and had a lot of trouble figuring out what to do with the new
tongue. Mom's pain is now worse, and she's feeling like she was really
railroaded into getting this done. I am able to help with positioning and
latch again, but mom really feels like she's backsliding, and is very
discouraged. It took a full 2 days after the surgery for her nipple pain to
get back to where it had been pre-frenotomy, and as long for breastfeeding
to feel comfortable again.
So - jump ahead, baby is nursing great, nipple pain is gone, and 2 days
after the surgery (day 8), mom was very engorged, after no noticeable
engorgement up to that point (she was a "is your milk in?" - "I think
so..." case). So - the end result - I think the frenotomy was a good
thing. Baby ended up nursing much better, mom is more comfortable - she
feels like breastfeeding is going very well and baby is gaining very
nicely, things are settling. So - why tell that 8000 word story?? Well - it
was a really challenging time for this mom - she has a history of surgeries
that didn't go all that well, she really likes to research things for
herself, none of use were expecting the ped would clip on the spot, and she
really felt railroaded into it. I apologized, which she appreciated, and
she agreed she did feel pressured and didn't feel supported in her
uncertainty and wasn't given time to make the decision for herself. I
wasn't doing my job as a doula in supporting her, because I was so sure she
needed the tongue clip and was going to have to fight for it.
So - I apologize for the epic length, but since everything I read about
frenotomy makes it seem so effortless, I felt the need to post that
sometimes it's very difficult for mom and baby, can feel quite traumatic,
and they need really good support during the decision-making and post-op
time. The fact that she expected "barely any crying", "immediately more
comfortable latch" and other lines that I fed her, made the whole procedure
(as it went in their case) much more difficult. I think if she had been
armed with better preparation about how there can be an adjustment period
after, she would have been happier with the outcome.
Any thoughts??
Kirsten Berggren
LC wannabe in Vermont
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