Jennifer writes:
My own baby's tongue also looked "normal" at first glance, in that there
was no visible frenulum, but she caused me unbelievable pain and shredded
my nipples within 12 hours of her easy, unmedicated homebirth.
~~
Debbie and all,
Oddly enough just this Thursday I followed up with a baby, now 1 month, who
had a shallow, painful unworkable latch that transferred no milk, and baby
had lost lot of weight in the first 6 days before I saw him and his mom.
In the meantime, baby has had some CST for pretty severe right-side
tightness all along the trunk, shoulder and neck. He started gaining but continued
to have classic posterior tongue tie issues: no workable latches,long
bottlefeeds with milk loss and fatigue with lots of breaks, trouble managing
even slow flow assistive feeding devices and no energy/patience for assistive
tube feeding, mild laryngomalacia, and some congestion as feeds progress
and afterwards. I checked under the tongue at our first visit and neither
saw nor felt anything. Baby's tongue extension was really good, but only with
mouth small, unable to gape normally unless yawning, then tongue was way
back behind gumline. I kept thinking there had to be something there but I
palpated nothing that day, the underside, center of the tongue was smooth
and relaxed. THEN, Thursday, when the baby was crying really hard (after a
brief attempt at breast again, he latched for a few seconds with a NS and
actually got almost half an ounce, but then became
disorganized/fatigued/stressed.)I wanted to see if he could tube feed on a finger, and he could only
get flow going for a few seconds before giving up, and got angry/frustrated
fast. Hence the crying, while we readied the bottle. SO I looked again,
and for some reason with the tongue under tension during the crying, THEN I
felt the frenulum, small,short and very tight and even slightly off-center.
( Maybe has something to do with the neck muscles being so tight and
pulling the hyoid and therefore tongue?) Anyway, mom was able to get an
appointment that afternoon with our dedicated, skilled, and really supportive local
Ped ENT who the other ENTs think is nuts for releasing that little piece of
skin. Right afterwards baby latched with NS and we all went HEY when for
the first time ever we all heard a swallow at breast. Baby still has other
issues to work out, but at least has a better shot, and it struck me as odd
that I really know what to palpate for, and when the tongue was resting and
relaxed that day it was not under tension enough for that teeny little
piece of skin to show its presence and restrictive nature. It reminded me of
something Dr. Coryllos always said when I was learning to recognize the
restrictions: "If it looks like a duck and quacks like a duck, it's probably a
duck." This baby's tongue totally "acted" like a physically restricted
tongue and the baby's muscle issues just didn't seem to be explaining his
feeding issues enough for me. Hope that helps.
Peace,
Judy, off for vacation Sunday.. aaaahhh...:)
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