Monday 24 September 2012

Tongue TIe Update

Rainbow has had his 'new tongue' two weeks, and firstly, yesterday he started smiling *at* us. He still likes smiling at the wall, the ceiling, etc, but it does make life a little easier now he visibly responds to us- its so sweet. I like a nice gummy grin!
(and if I catch one on camera I'll insert it here!)
So, hows the feeding going? Is it different?
Well, I'd say the feeding is going fine, thanks. No pain and he can open his mouth much wider. Saying that, he is still nipple feeding. I'll put an explanation as my blog has so many different topics, with different readers an explanation here is probably justified. Breastfeeding is really breast feeding- the nipple ends up in the mouth, but baby gums down on breast tissue rather than around the base of the nipple. Well, Rainbow is thankfully doing well on nipple feeding.

 I luckily have enough milk (this type of feeding can end up reducing supply, as well as blocked ducts, which lead to mastitis, etc) so he's growing. Somehow he's getting just a little more in is mouth so it isn't painful to me. Nipple feeding often leads to bleeding, cracked nipples, which I am eternally grateful I haven't suffered from yet. A good explanation I've found for what isn't working right with a tongue tie is here, particularly the lower half of the page.
I've been checked by several different feeding advisors and my position of Rainbow at the breast is great, but his attachment to the breast is poor. Often with general breastfeeding problems, good positioning leads to better attachment, which is the approach most feeding advisors (I've met in this process) have taken without checking thoroughly for tongue tie- until I asked. I feel this delayed me getting more information to try to decide what to do with, and I suspect I'll always wonder how different it would have been had I decided to divide it a fortnight earlier.

Rainbow is able to get his tongue out beyond his lips now (he could always reach his lips, but no further), and its now pointy, it was very wide and flat initially. But his tongue movements are not great. Well, they are great if the idea is to push everything out of his mouth- but it isn't. So we have tongue exercises to do, which hopefully will help. At least he is managing to generally swallow without choking, so its working enough for him now. This is something I wonder may become more of an issue when he starts solids, if he hasn't learned different movements by then.

He is also very 'orally sensitive'. When babies feed, the roof of the mouth is in contact with the areola/nipple. He's ok if something touches the roof of his mouth just behind his gum, but no further. If you look at that diagram above of optimal attachment (sorry, I couldn't find a better one quickly) all the hard palate has contact with areola/nipple- he just can't do that. On the rare occasion we manage to get a better latch, Rainbow gags as he can't tolerate the contact with the roof of his mouth. In babies with mobile tongues, the mouth shape is formed by the tongue swishing around in there, and they are used to that contact with the roof of their mouths. With tongue tie babies they have all the time in utero without that contact, which causes the roof of the mouth to be a very high arch, or bubble (yup, Rainbow has that) and until the tongue tie is divided there is no possibility of the tongue reaching up there. Then, once it is divided, they haven't necessarily got any interest in getting the tongue up there- they gag when anything touches it, so why make yourself gag?
So overall its better, but not perfect. Its a learning process, and I feel Rainbow still has a lot to teach me.

Hmm, I'm finding this all very interesting, and what Rainbow is doing is making sense to me. I'm glad feeding in the short term is ok, but I can't help wondering if we're going to have problems as he grows. I suspect his top front teeth with have a big impact on feeding if we haven't got a deeper latch going.

2 comments:

  1. This is so similar in many ways to my experience with Ernest, but you are already doing so much better than we did, still feeding at the breast.I hope you can keep going, you are doing great. x

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  2. Tthank you so much Jeanette. you're journey with Ernest has been so hard- I never truly appreciated exclusive pumping (despite my sister doing it for a year with one of her children) until I returned to work after 'Princess' and nearly went to peices. I know I still don't know what its like, but I know I'd really struggle to continue as long as you have done- you're amazing xxx

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