22 December 2010

Tongue Tied

Nursing is one of the hardest things a woman can do- with or without obstacles. We've had our share of those around here lately.

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Before Lyla I didn't understand why many women give up on nursing. Sure it's demanding but it's better nutrition for a baby than formula (as well as cheaper, more convenient, etc). Shame on me for feeling this scorn; there are elements to nursing that can easily be too much for a woman. Even I, who have passionately committed myself to nursing my kids, have contemplated giving it up in the last few days. Let me explain~

Every nurse and doctor who has seen Lyla has commented on her tongue. She was born with a congenital anomaly known as ankyloglossia or tongue tie. Basically the membrane connecting the tongue to the bottom of her mouth (called the frenulum) was unusually short and thick- her tongue pretty much tethered down. 2 in every 100 children are born with this. It can stretch itself out in time but also affect speech, oral hygiene, and breastfeeding. Nursing seemed to be going well in the hospital and after, so it seemed reasonable to leave it alone.

Last week I realized something was really wrong. They tell you nursing can hurt at the beginning before your nipples toughen up, so I thought that any pain I was feeling was normal and would go away. But that pain should only occur at the beginning during letdown; I was having pain all the way through, especially on my left side. It was increasing every day to the point where I was wincing, bracing, even crying. Not normal. Last Friday morning I was in so much pain (and no end in sight- I have to feed her) that I was seriously considering quitting and switching to formula.

I scoured books and the internet for information and I was brought back to the tongue tie, the short frenulum. When Lyla opened her mouth you could see how short it was, and she couldn't stick out her tongue at all. The tongue is very important in the nursing process and she couldn't use it. Basically she was biting down, gumming my nipple in order to eat. She was getting food and gaining weight, but was hurting me a lot in the process.

The solution: a frenotomy, an in-office procedure performed by a pediatric ENT to clip the frenulum and allow her tongue proper movement. It's a pretty common procedure; the nurse practitioner who assisted told us they do at least one per week in that office alone. Lyla was given a bit of sugar water and some numbing medicine before the clip and was able to nurse immediately after. Successful procedure, excellent. And I thought things would immediately be perfect- no more pain and she'd know exactly what to do right away. I'll blame this silly notion on sleep deprivation. I have enough nipple damage that it couldn't be pain-free immediately. And my infant has a new muscle in her mouth that she needs to learn to use! We saw a wonderful lactation consultant yesterday to help both of us- some tongue exercises for Lyla to learn how to use it, and help for me to properly position her and also to relax myself.

Today things are a little better. I can tell when she is positioned correctly and sucking as opposed to gumming, and she's becoming more familiar with her tongue and its role in helping her eat. If she doesn't latch properly, I take her off and try again. I'm trying to relax more, and while my left side is still sore its not getting worse each time and its more bareable now that she's not biting me all the time. Hopefully it's healing and will continue to do so.

I've heard there are women with tongue-tied babies who elect not to have a frenotomy and nurse through the pain. I have to say from my perspective that it was totally worth it, for both of us.

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