Tuesday, December 9, 2014

12/8/14 Tongue Tie

Since one day old, we knew Timothy had a tongue tie. We had it evaluated by a lactation consult who referred us to his pediatrician and told us we could also go to an EENT if we preferred. At his first Dr. appointment we were referred to another doctor in the clinic that actually does clip procedures. Today, we had that appointment. We learned she clips anterior tongue ties on infants up to 2 months old and refers the more complex ties and older babies to an EENT.
She asked about his symptoms. We told her how painful nursing is even with a nipple shield, how he does a lot of biting when he tries to latch, that it can take him up to 2 minutes to latch even with the shield, how he has trouble taking a pacifier, how he fatigues with nursing, how he looses suction frequently while nursing, and about his weight loss with only minimal gain back. (His weight today is the same as at his doctor's appointment Friday 7lbs 11oz, no increase.)
The doctor examined Timothy by checking his suck on her finger, watching him cry, and feeling around in his mouth. She said that his tie isn't horrible but is limiting his upward movement quite a bit and his forward movement somewhat. She said she wouldn't know for sure if he had a posterior tie until she clipped the anterior one, but that he isn't showing obvious signs of one. She said that if he does have a posterior tie they would refer us to an EENT doctor that does those. I am assuming that would be the same one that the lactation consultant mentioned.

She gave Timothy sucrose prior to the procedure saying it helps with the pain. She didn't do any numbing, maybe so that he could nurse afterword. I was a bit nervous about the lack of numbing, but trusted that she does these ties pretty frequently and if she didn't think it was necessary she was probably right. She told us most parents are surprised how smoothly it goes and how little discomfort the baby has. She swaddled him in a sheet, had her MA hold his head, she used something to hold his tongue up and clipped his frenulum with a shears. She held pressure for a minute or so until the oozing stopped. Bryan said that part seemed more uncomfortable for Timothy than the cut. She watched him cry a bit to see if she had released it enough, and then he was handed to me to nurse.
He nursed fairly well. He latched much more easily.  He was able to nurse much more deeply than before. He still lost suction a couple times. I kinda wonder if that's more the fault of the nipple shield than the tongue tie. I don't remember at all if that happened with Josiah. When Timothy was done and I saw the inside of his mouth, there was no blood, he can stick his tongue out and it goes up to the roof of his mouth sometimes when he cries.
The doctor came back in after Timothy nursed. I told her how he did, and she was pleased. She doesn't think he needs anything more done. She said it's mostly about how he nurses that determines if this procedure is enough or if we need to do anything more. She is hopeful this will be it, and now we'll watch for weight gain. She asked me to weigh him Wednesday (because that's when I can use the lactation clinic's scale) and call her with the number so she can make sure he's doing ok.
Over all, it seemed about the same amount of trauma that a baby goes though with shots without the lethargy afterword. He has not been fussy at all today, and he has nursed really well. He was even able to achieve a good latch without the nipple shield! I wasn't brave enough to try it more than once, only when conditions are perfect. I am still sore enough that I don't want to get bit. We'll take the weaning process slowly.  Overall, I am quite pleased.
Timothy loves to stare at the christmas tree. 
Josiah playing with the tow truck Christmas ornament. 

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