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TONGUE-TIE
Wenzday:
I breastfed my 16 month old son until about two months ago. I
am now pregnant and suddenly I am considering not nursing! I am
so shocked myself because I never even allowed my son one bottle
of formula! I think the reason I have these reservations is because
my son was born with a tongue-tied tongue and he always had a
very bad latch. He got his first teeth at 3 months old and our
nursing included many injuries and me being bitten! I did talk
to a lactation consultant but I found her to be no help at all!
I am scared to get into this again if we have these same problems
and the pain all over again! I just KNOW I'll nurse this one but
is it normal to have these feelings? I feel like I don't want
to! I have just joined LLL.
Anne:
There is nothing abnormal at all about having concerns about nursing
this new baby after what you went through with your first one.
Check out questions number one and two if you don't believe me.
Nipple
soreness is one of the main reasons that mothers give for weaning
their babies early, and this is very unfortunate because most
cases of nipple soreness have a logical cause (improper positioning,
for example) and a solution (correct positioning). It is a fact
that most women experience some degree of soreness when they start
nursing. Breastfeeding is a natural, instinctive behavior, and
healthy babies are born with a strong sucking reflex, but they
have to 'learn' how to latch on correctly, and you have to 'learn'
how to position them. There is an adjustment period for new mothers
during which they have to figure all of this out, and the majority
of mothers and nursing babies do work through these problems during
the first couple of weeks of breastfeeding.
There
are some causes of nipple soreness that aren't resolved by simply
improving your breastfeeding techniques and giving your nipples
a couple of weeks to adapt to nursing. Tongue tie is one of them.
Nursing a tongue-tied baby can present insurmountable obstacles
to successful nursing, unless you have expert help and advice
from the very beginning.
Tongue-tie
results when the frenulum (the band of tissue that connects the
bottom of the tongue to the floor of the mouth) is too short and
tight, causing the movement of the tongue to be restricted.
A
tight frenulum can have a profound negative effect on a baby's
ability to breastfeed effectively. In order to extract milk from
the breast, the baby needs to move his tongue forward to cup the
nipple and areola, drawing it back in his mouth and pressing the
tissue against the roof of his mouth. This compresses the lactiferous
sinuses (the pockets behind the areola where the milk is stored)
and allows the milk to move into the baby's mouth. The tongue
plays an important role in breastfeeding, and if the baby's frenulum
is so short that his tongue can't extend over the lower gum, he
may end up compressing the breast tissue between his gums while
he nurses, which can cause severe damage to the nipples.
Tongue-tie
can cause feeding difficulties such as low weight gain and constant
fussiness in the baby. Nursing mothers may experience nipple trauma
(the pain doesn't go away no matter what position is used), plugged
ducts, and mastitis.
If
it is determined that tongue-tie is causing breastfeeding difficulties,
there is a simple procedure called a "frenetomy" that can quickly
correct the problem. In a relatively painless in-office procedure,
the doctor simply clips the frenulum to loosen it and allow the
tongue full range of motion. It takes less than a second, and
because the frenulum contains almost no blood, there is usually
only a drop or two of blood. The baby is put on the breast immediately
following the procedure, and the bleeding stops almost instantly.
Anesthesia and stitches are not necessary.
In
most cases, the mother notices an immediate improvement in both
her comfort level and the baby's ability to nurse more efficiently.
If tongue-tie is causing severe breastfeeding difficulties, then
the sooner the frenulum is clipped, the better.
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