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 *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html