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.
We did it. A week ago we had it snipped. Literally. Ann has a pair of curved scissors with blunt ends (apparently designed for eyeball surgery- can you imagine something as huge as scissors mixing with eyeballs? I can’t) and very quickly snipped it and he fed straight away afterwards. She and Charlie were lovely and I didn’t really cry, honest!
Rainbow was a little more easily upset than normal for the rest of the day, but was back to his usual sunny self the next day. It was funny Ann suggesting Calpol, when it was Charlie who started us off when Flower was tiny on how awful Calpol is (the additives in it are banned in most EU countries) but it can be so hard to get infant paracetamol on prescription without the additives. (There’s Medinol to ask for at the pharmacy, if you need something).
I was having dilemmas after making my mind up the week before, as the week leading up to the snip was much better feeding-wise. Afterwards Charlie said that with tongue ties it can often improve for a bit, get worse for a bit, then improve again- she’s had people make and rearrange appointments a few times, but they usually decide to have it divided in the end.
Its hard to make a decision which can have such long range consequences. I hope that by snipping now its been a much more minor procedure than trying to persuade a toddler or 5 yr old to have an injection in their mouth. I hope that by having it snipped he’ll be less likely to have speech issues related to it, and be able to lick an icecream or whatever else he feels like, easily.
The potential problems with having it snipped- well, pain for him, obviously, risk of infection (tiny, I asked), risk of it reattaching when healing, and it making feeding even worse- well that was the sticking point. I mean, feeding hasn’t been dire, no blood, no shredded nipples for me, no weight loss, colic or reflux for him- all very usual side effects of a tongue tie. I decided the feeding had been bad enough for me know I wouldn’t feed long term like that, which I suppose had my expectation only been 6 months, it might have been something to think about (though not really, it did really hurt) but I feed my kids for years, not weeks.
My other consideration was how would I feel not doing it. Doing nothing. Not trying to fix a breastfeeding problem. Looking at it that way, I had to try. I had to try to achieve the ease of feeding I’ve had with my other children. It wouldn’t be fair to Rainbow not to try. To suffer breastfeeding him when it was such a breeze with the others- to soldier on, probably complaining when it hurt, yet not doing the only solution offered? No, that wouldn’t be right for us. No one could tell me how bad the bad days would be in the future, or how much easier it’d be without intervening.
It hasn’t been a magic wand for breastfeeding, but then as I’ve said, it wasn’t awful feeding him last week either.
What I have noticed is how WIDE he can open his mouth- noticeable the instant it was cut and he shouted about it. He makes different noises as well. Unfortunately he hasn’t (yet) figured out that by opening his mouth wider the rest of the time, it’d be quite nice if he fed with a bigger mouthful too. It is a little better, he must have more breast tissue in his mouth as he slips off much less, gets less air in when feeding (that clicking sound happens less) but it itsn’t as resilient a latch as I remember with the others. I can’t move while feeding- not that I really want to do much, but leaning to pick up a drink or reading material shouldn’t mean a two-handed job to re-attach every time, IMO. I used to be able to answer the door feeding if I had to! However that may well be how breastfeeding works out with Rainbow, and thank goodness I haven’t got clear memories of that pain anymore- I really have to think to remember how bad it was, so I must have got some sleep since then.
We were also strongly recommended to take him to an osteopath. Apparently not being able to move tongue means not being able to move jaw fully leads to tensions, and very often babe has colic, reflux and a stiff back that osteopathy can help. Lucky for Rainbow he has apparently a lovely shaped head, and not much tension so a couple of visits should sort him out, and fit in a look at my back too. Phew (I knew he wasn't suffering!).
He’s also learning to move his tongue more. When he sucks on a finger I can feel how his tongue movement is one that tries to push my finger out of his mouth (despite it being in the place where he should be automatically sucking in) and I imagine that’s why his latch keeps being so shallow- how else could it be if he keeps thrusting boob out of his mouth? So I need to figure out how to encourage him to use his tongue to pull boob in. We’re doing tongue exercises, and sweeping the snip site to hopefully stop it re-attaching ( a common problem with tongue ties, unfortunately).
I’ve been pointed to a youtube vid to help with latching, which I guess just takes practice.
So, we’ve done it. We’re working on it. Its going ok. Thanks for asking!
I feel the need to blog about sleep. I have a 2 month old baby. Hmm, but I’ve had a nap this afternoon and can’t remember the gems of wisdom that seemed so important when I was even more sleep deprived.
Its funny, you can look normal (well, pjs at 4 pm is normal, right?) hold a superficial conversation- mostly, but the distraction could just be multiple children, right?
I’ve managed not to try to pay at the supermarket with my rewards card too often (my bank card is the same colour, in my defence) and this time I don’t think I’ve left the house door wide open (or just unlocked), the van door ajar in a carpark, nothing like other times when I had only one baby to care for. Hmm, having older kids mean they remind me of the basics more, perhaps that’s why my mistakes haven’t been so obvious.
Having more kids around does mean for higher noise levels, and I do find background noise seriously impairs me when I’m tired, but nodding and smiling gets me though conversations amazingly well.
Sleep, its a five letter word. Breastfeeding- that has too many letters to count. Last time around with Flower (renaming children- my blog, my prerogative) cosleeping and breastfeeding made life fabulous- sure babies feed through the night, but what a revelation it was that mums don’t have to really wake up to do it! Perfect!
Well, Rainbow (yup, another renamed child) and I have to sit up for some of the night feeds, though that is improving. Actually, its more the lying down feeds aren’t always so great for him, so I need to sit up to wind him which means I wake more, but its still better than either walking across the room to sit up for every feed, or figuring out the instructions for making formula safely in the middle of the night (I recall it involves boiled water cooled to no less than 70 degrees- too hot and you denature the nutrients in it, too cool and risk taziki bacteria, or something like that- thanks formula companies for not making formula powder sterile, so its the parents making it up wrong that poisons the kids, not the nice friendly international moneymaking companies).
Decision making is a problem though. I think my agonizing over whether to get Rainbow’s tongue tie snipped was partly due to sleep deprivation. I wanted to evaluate all the information I had, but struggled to remember the information, let alone evaluate it. I’m feeling pretty lucky though. In the grand scheme of things, I haven’t had to make huge decisions like stopping breastfeeding, or deciding about organ transplants or consent to serious surgery for any of my loved ones- I’ve just let a trusted professional hopefully give us a serious chance at long term breastfeeding. I couldn’t help DH decide what tea was going to be though, that was too hard.
Anyway, I’m rambling a bit, Oh wait, I’m talking about sleep- of course I’m rambling. At the moment 3 hours in a row is a luxury, but overall I think I’m coping. We’ve just had a growth spurt ( I think!) which meant going back to feeding 2 hrly half the night, then every hour for the last half. By 2 hourly I don’t mean a 2 hour gap between feeds, I mean from the start of one feed to the start of another- so in that 2 hours there’s the feed (anywhere between 10 and 40 mins), nappy change if you have a super wee machine (so we do that half way through the night, not every feed) settling him to sleep, settling me to sleep, then a bit of sleep before he’s ready for the next feed.Sigh. I remember first time around with Princess (yup, renamed child No 1 as well) when I could get 4 hours straight I felt amazing!
Babies 2 months old shouldn’t sleep through the night as a rule. That’s dangerous. Feeding through the night does helpful things like stopping periods for longer. Scary things like SIDS happen. Part of the reason I like sleeping with my baby means I can tell their breathing without getting up, sneaking into their room, and hovering until I end up poking them to make sure they breath (Sorry, Princess, I read mainstream parenting books back then), though thinking about it she was around 3 months when she moved rooms.