With August being breastfeeding awareness month, I wanted to bring light to a topic strongly related to breastfeeding and the struggles that may come with it – frenum. This word is otherwise known as the tissue membrane that connects the surfaces of the mouth (tongue to the bottom of the mouth, lips to the gums, and gums to the cheeks). While the exact cause of cheek, lip, or tongue ties is not 100% known, it is to believed to be related to genetics and the MTHFR gene mutation. It’s been confirmed that I have this mutation and therefore it didn’t come with much surprise that my first born had a significant tongue tie and my second born had all three types; buccal, labial, and lingual. I’ve mentioned the tongue tie revision that my first born received soon after birth and our struggles with nursing here. However, I wanted to expand on this topic and our experience with multiple ties in today’s post.
~ ~ ~ ~ ~
On November 19th, just after 1 PM, our son John Miguel was brought earthside at home with the help of my great midwife and doula team. Upon physical examination, it was determined that he had a weak suck and possible tongue tie. While he was very interested in nursing, the midwives observations proved to be true and he could hardly stay latched. In the days to come, this caused a lot of pain and soreness when feeding and eventually caused me to bleed. With my first, her tongue tie that went unrecognized at the hospital proved to cause issues in the form of acid reflux and spitting up. I never experienced pain or bleeding with nursing and she stay latched rather well, which just goes to show how signs of a tie may vary with the baby. While she tried to adapt to her anatomy, she still swallowed air while eating, causing acid reflux. This caused us to have issues with traditional breastfeeding positions (such as across the body or “football” position), and I was forced to nurse with her and I both practically sitting straight up. I also had to make a point to keep her in an upright position atleast 30 minutes after feeding. This may sound simple, but to a breastfeeding mom, this is not only exhausting, but difficult for both mom and baby. I personally did not want her to continue suffering which is why we chose to do the frenectomy at her pediatrician’s office.
~ ~ ~ ~ ~
While Miki did not have any signs of indigestion, he clearly was getting frustrated when it was time to nurse. In turn, he wasn’t getting enough to eat, which made him fussier all around. Much like with Allie, I wasn’t messing around, and decided to have the. a lactation consultant come to the house to do a thorough examination. Jane determined that not only did Miki have a tongue tie, but also a strong lip tie and cheek ties. This caused him to have a very weak suck, which is why he would frequently bite my nipples when trying to get milk. His chin was also noticeably receded and his ability to fully open his mouth was limited. Due to the multiple ties that he had (and the fact that his NP couldn’t see him for another 3 weeks), we decided to do a laser revision at a local cosmetic dentist’s office. While both laser and regular revisions have proved to be effective for our family, laser revisions are touted for having a quicker healing period and a more precise cut. Overall, the procedure took around 5 minutes with minimal bleeding and Miki calmed rather quickly afterwards. While no parent likes having to put their child through hard things, I knew doing the revision at such a young age would be best for everyone. The craziest part is that his facial expression and appearance was noticeably different immediately following the operation. Not only were his cheeks and lips much more relaxed, his cry was much louder since he could actually open his mouth to let the sound out (we always noted he was such a soft crier – not anymore!). Healing took time and I spent almost 3 months doing the post-revision care exercises with him every 3 or so hours (including at night). He hated every minute of it but I am so thankful to say he has become a nursing pro. We no longer struggle with feeding and his suck has gotten noticeably stronger. Not only that, but he gets compliments on his lips all the time (I guess thats an added plus for him once he’s older? haha)
~ ~ ~ ~ ~
Overall, while some people choose to opt out of a frenectomy despite extra tissue noticeably present, it truly is up to the parents discretion on what should be done. That being said, it’s always important to make sure the baby is not experiencing low weight due to inability to feed properly. Outside of issues with nursing, one may also choose to get a revision due to the fact that the excess tissue can later cause speech issues, jaw pain/clicking, a space between the two front teeth, etc…Personally, I could tell by the look of my son’s face that there was a great deal of tension being stored in his mouth and jaw even at 3 weeks old. I myself deal with a great deal of neck and jaw pain (likely do to my lip tie) and didn’t want him to have to deal with the same if I could help it. All things aside, if you’re a mamma dealing with a painful breastfeeding experience, I highly encourage you to have your baby evaluated. Tongue, lip, and cheek ties are more common than most of us realize and can have a big impact on a child even past nursing years. Please feel free to reach out if you have any questions about our experiences with tie revisions!
Matthew 18:15 ““If your brother or sister sins, go and point out their fault, just between the two of you. If they listen to you, you have won them over.”