Part two. Read part one here first!
The ENT visit
After being told the girls had tongue-ties, I went online to find an ENT or some other provider in the Portland area who specialized in treating the condition. We were able to get in with Dr. Hertler on a late afternoon cancellation.
We checked into the office and waited for almost an hour before finally being called back into the exam room. The doctor was a pleasant, soft-spoken man who apologized for taking so long, and that he had been cleaning out ear wax. I don't think it was a joke. We all sat down and he asked me questions about my concerns and the girls' breastfeeding habits. He explained the different types of ties and the complications that went along with them.
After our interview, Ruthie was the first to be examined. He lowered the exam chair into a tabletop position and had Andy hold down both her arms, while the nurse held her head, and the doctor checked her nose, palate, tongue, and lips. He confirmed that yes, she had a significant posterior tie, explained what he would like to do, and asked if we'd like to go ahead with the procedure. He took a pair of sterile scissors, and, according to Andy (I was holding Afton in the other chair) made three little clips in the skin under her tongue.
Ruthie was already uncomfortable having her arms held down, and Andy said he could see the moment the pain registered in her eyes. Not a happy girl, so not a happy mama. I could feel tears welling up in my eyes as she cried, but Andy picked her up right away and comforted her while holding a paper sheet against his shoulder to catch the blood. He handed her to me to nurse right away, and it was Afton's turn.
Same story with her, although she didn't bleed as much. I hated to see her so sad, but knew it was for the best. Andy comforted her while I finished with Ruthie, and the nurse led us into a separate room with a rocking chair so I could nurse Afton more comfortably. Andy cuddled Ruthie while I nursed, and all the teary girls (including me) felt better.
That was it!
Our post-op instructions were to swipe under the tongue 4-6 times per day to prevent the tissue from re-fusing. The scissor method doesn't remove the tissue (although the laser method does) and so there is the possibility of it growing back as it was before, and we'd need to do the whole thing over again. There was a small red diamond shape under their tongue where the tissue was cut, and it has since turned a grey-white color as it heals. The doctor also recommended that we follow up with an LC to check their latch and do any problem solving.
After the procedure, the girls had a rough night and next day. They were uncomfortable and fussy, and I didn't blame them! I think about when I bite my lip or tongue hard, or cut it with something and it is painful! I've been giving them some Hyland's teething tablets and some Arnica for the pain, as well as some Rescue Remedy, all on the suggestions of knowledgeable and caring friends.
As far as comfort while breastfeeding, I could tell a difference with Afton almost immediately. While nursing her it feels like slight tugging instead of uncomfortable pulling. I haven't been able to tell a noticeable difference with Ruthie, but I think that might be because I need to heal.
We're seeing the Melissa from Luna Lactation on Wednesday for a post-op visit, in the meantime, we're doing the finger swiping AND the stretches she recommended. She can also do some craniosacral work to help the healing process and realign their "pull" while nursing. Some babies do need to be retrained to suck. I have a feeling this might be Ruthie.
How can you tell if your baby is tongue-tied?
This is a quick self-diagnostic article.
How to spot tongue/lip ties from the Mommypotamus
Breastfeeding a Baby with Tongue Tie from KellyMom
Why Our Mothers Shouldn't Have Listened to Theirs (about tongue tie) from the Mommypotamus
Find an ENT in your state who specializes in TT on lowmilksupply.org
Complications of Tongue-Tie on Tongue-Tie.net
More resources listed on the "part one" post
Possible complications of tongue-tie:
- Low milk supply (depending on the severity of the tie)
- Painful nursing
- Early weaning
- Tooth decay due to improper tongue mobility, milk sits in their mouth causing decay
- Colic, reflux, gassiness due to swallowing extra air
- Problems with introducing solids
- Sleep apnea
- Abnormal sleep patterns due to baby's inability to fully drain the breast, so he's always hungry!
- Speech difficulties
- Gap between teeth and/or jaw issues due to tightness
- Difficulty latching or inability to stay latched
- Fussiness at the breast
- Gumming or chewing nipple while nursing
- Poor weight gain, "failure to thrive"
- Excessive drooling
- Unable to hold pacifier or bottle
- Creased/blanched/flat nipples after nursing
- Cracked/blistered/bleeding nipples
- Discomfort while nursing
- Plugged ducts
- Low milk supply
- Depression or a sense of failure
(from the Mommypotamus & TongueTie.net)
Part three after our lactation visit on Wednesday!