Post tongue and lip tie, a timeline

For the first part of Jimmy's tongue tie diagnosis and revision, see here

Last time I talked about tongue tie, it was one week post revision, and things were still tough.

Week two:
It still hurts to nurse, Jimmy clamps on me and still has horrible suck blisters. Although the revision sites under his tongue and top lip are healed beautifully, we still have lots of tie symptoms despite doing rigorous stretches and following all post care instructions.

Two weeks after revision, I couldn't take the pain anymore, and at 2am in the morning, I emailed a private lactation consultant to come and see if she could offer any additional tips to get Jimmy to have a deeper latch. Luckily, I was able to find one who had an interest in tongue tie, and she was able to fit me in within a couple of days. I guess they're used to dealing with stressed out mothers who need help sooner rather than later.

Week three:

The consultant was lovely. She gave me some attachment tips, and it was great to have someone to chat to and be told that we were doing all the right things, even though there wasn't an immediate improvement. Sometimes, that's all I need to hear as a mama - that I'm doing a good job, that I'm doing all I can, that my baby is fine and that someone is willing to help me.

The bad news was that she thought he had further ties, which was why his latch was still bad and his muscle tone and suck ability were a bit woeful. I have to be honest, my heart just dropped. I don't think I could do it again, the stretches and the healing process is brutal. I felt like I was back at square one with the feeding process, as it was like having a new born again and training them how to feed properly.

I got in contact with the dentist who did Jimmy's revisions and told them what the consultant and the physiotherapist had said, as the physio also thought Jimmy was making slow progress and was still tight with low muscle tone. The dentist was a little cranky that I was questioning her work I thought, but still fit us in, which was nice of her, especially in the before Christmas rush. I just wanted to know what I was in for... but I am one of those people who need to know where I stand so I can take action.

The dentist stated there were definitely no further ties. She observed a feed, and wouldn't you know it, Jimmy latched perfectly and fed like an absolute angel with no fussing, no clamping and no spitting. The stinker! I was told that he just has a short tongue and that continuing with his stretches and exercises would help.

It was also suggested by the lactation consultant at the dentist, that Jimmy was feeding so often because he could. Like, he was snacking constantly and therefore never getting a full tummy because he had access to milk on demand. I was told to try wearing him (already on that!) and to have Mr Fork settle Jimmy after a feed so he couldn't smell milk on me and want more feeding because of that.

Dark eye bags are so 2015

Obviously, I should feed him if he is screaming, but really it's clear that he is having no shortage of milk, and is doing really well and looking healthy. I'll say - I have tendonitis in my wrists from having to hold him up to feed all the time!!

Week four:
We are pushing through. While the revision was not the immediate improvement that I wanted, it has made life easier and I keep reminding myself that this too shall pass. Jimmy is just lovely... and if I have to breastfeed him exclusively because he won't take a bottle... well, he is likely my last baby and I will enjoy the special bonding time we get. If I have to wake to feed him every two, three or four hours? It won't last forever and then he won't want me anymore and I'll miss that too no doubt. I will just live in the here and now and enjoy the moments.

My Christmas elves - it's obvious he's growing beautifully!

Week five:

If I am fair, there are probably more good latches than bad now. However, we still wake and feed quite frequently, and I still have to often correct his latch mid feed. Despite trying multiple bottle types, Jimmy still can't take one so I'm still the only food source, which is a little frustrating for me. Mr Fork feels he doesn't get to bond with Jimmy the way he did with Ellie as he does not get to feed him - nappy changing and burping aren't the same as providing food I know. I admit it would be lovely to get a little extra sleep or be able to go out alone for a little while without the pressure of needing to feed him too.

I do have to say that Jimmy is still continuing to gain weight beautifully and meet all his developmental milestones. This is partly because my supply is still hormone driven and so rather plentiful without him having to work for it... and partially because we feed so often that he gets his nutrients regardless! Look how smiley he is!

Its been suggested to me that most revisions take at least 6 weeks to recover from, which makes sense really. The later they are done, the longer the recovery too - you are essentially training new muscles and creating new neural pathways, which naturally takes time. I'm holding out for that six week mark, but honestly, if we are one of those duos that don't get a 'perfect' breastfeeding relationship post revision, at least it is 'good enough'. I know that I will have tried everything I could.  No one could ask for more.

Let's talk tongue and lip tie

Fair warning. This post is about breastfeeding. I talk about my nipples. There are pictures of my crying child because that's how I could best photograph his tongue. If that's not your thing, feel free not to read this post and maybe read about my kitchen instead :)

I've mentioned that with parenting the second time around, you just know when things aren't right. So I just knew that feeding little Jimmy wasn't going right. Sure, he was gaining weight. In fact, one month post birth he was over a kilogram heavier than birth weight. That's great! Not so great however, was convincing people that something wasn't right, because they all pointed out he was putting on weight and having the appropriate number of nappy changes.

Still... feeding took forever. He slept poorly, waking on a 1.5-2 hour cycle, around the clock. He was constantly gassy, and dribbling milk. My poor nipples were sore and bruised and little Jimmy's mouth was one big blister from gripping onto me for dear life. I'd had his mouth checked at the hospital before discharge and was told he looked fine and his latch seemed good if a little shallow. I never seemed to be able to get him to flange his lips or open as wide as I thought he should to latch on. When he cried, his little tongue would cup up and not poke out much at all.

At two weeks, I reached out to our community health feeding clinic, who watched a feed and told me I was doing everything right from a mechanical perspective. Of all the people I'd seen and asked about feeding, this lactation consultant was the only person who felt around in Jimmy's mouth and diagnosed him with a posterior tongue tie, which was also confirmed at my home midwife visit when I asked her. However I was advised that since he was gaining well, it likely didn't need treatment, and my sore nipples were normal newborn feeding side effects.

I'd never heard of tongue tie before to be honest. I googled the heck out of it, and joined support groups online. It made me feel better to know there were other people going through what I was going through - the sleepless nights, the painful nursing, all while hearing there was no problem "because baby is gaining weight"!

Captured! A sleeping moment

For me though, the pain was awful. My nipples would come out misshapen and I'd dread the next feed. I found a local dentist who was passionate about tongue tie and specialised in laser tongue-tie surgery. I scheduled a consultation and treatment as soon as possible - Jimmy would be five weeks old before we could be seen. Knowing I had that appointment kept me sane... ticking off the days until I could get help meant I was able to get through all those feeds.

The day of the appointment arrived and I have never felt such relief. Someone listened to me and sympathised with all my symptoms. Jimmy was diagnosed with a class IV tongue tie and a class III lip tie, which commonly occur together. Releasing the ties would help our nursing relationship, and further, would decrease the likelihood of future issues such as speech and eating problems, cavities and orthodontic work which are common disorders associated with tongue tie.

Jimmy was taken away and we were asked to step outside so that we didn't hear his reaction to the treatment and I could nurse him calmly afterwards (infants who are breastfeeding are typically revised without anaesthesia). I'm told he was swaddled and held tightly while the dentist used the laser, and that my Jimmy didn't cry at all. All up it took maybe five minutes maximum, and then I was taken to a quiet room, Jimmy was placed in my arms and we breastfed under the direction of the dentist (herself a mum and strong breastfeeding advocate) and a lactation consultant.

Before and after - look how high that tongue goes and how far the mouth opens now!

That first feed... what can I say. I'd always been told that breastfeeding was painless and pleasant. Although I fed Ellie for nine months, I can honestly say it was never completely pain free, but I grew to enjoy it. With Jimmy, I finally got what everyone meant. He latched beautifully, he drained my breast and I fed him without pain. And then... miracle... he slept, for three hours. And that night, he slept in three hour cycles, which meant, for the first time in FIVE weeks... so did I. Do you hear that? I slept longer than an hour. I felt like a new woman.

One week post procedure, it's still rough I'll be honest. We do some manual therapy to complement the release, because Jimmy needs to relearn how to use his mouth and nurse 'correctly' as opposed to coasting along off my let down and gripping me with his gums. We've been given exercises to do to improve his suck and help him develop muscles that he hadn't been using before. Essentially he is re-wiring his brain and learning new ways to control this extra movement he suddenly has, which is pretty amazing really.

Doing the stretches to make sure his ties don't reattach is heartbreaking. Constantly correcting his latch is frustrating, and knowing he is in pain is awful. We are getting there though. We still have bad feeds, but we also have good feeds as well. Just like we have good sleeps and bad ones where he is back to his 1.5 hour cycle. He is gradually starting to sleep longer though (hallelujah!) and he is much less windy because he is latching better and therefore swallowing less air. My nipples still get sore and he still has nursing blisters, but I'm confident that will improve as his muscle tone and mouth strength improve, especially as we continue with the physiotherapy and work with a lactation consultant.

It's hard having a growth-spurt, post surgery cranky baby and a highly energetic and attention hungry toddler, but this is where baby wearing comes in handy. I do adore snuggles and the little snores that happen when he falls asleep against my chest.

Snuggles for the win!

Tongue tie is a contentious issue I've found. Some medical providers don't believe they affect feeding. Some believe if you came poke out your tongue (Jimmy could) there is no issue, failing to consider a posterior, sub mucosal tie might be present. These sorts of ties can only be felt with a manual examination and often cause many feeding problems initially as the tongue doesn't reach the roof of the mouth for efficient drainage. They can be hard to diagnose as some babies continue to gain weight coasting along off initial good supply and strong let downs. Apparently, with the increase in formula feeding, lots of medical people stopped learning about tongue ties, but now that breastfeeding is increasing, a lot more ties are needing attention - after all, a bottle doesn't complain of pain.

I don't blame the medical people I saw at all, but what I did learn from this experience is to trust your instincts... if you don't get the answers you need, continue to seek help because no one knows your baby like you do.