[muimuimolina]

Dear mummies,

My 4 months old boy has a heart shaped tongue which my lactation consultant says it's a tongue-tie.

However, I saw Dr. Maurice Leung in Central and he said medically, tongue-tie is not an issue. Then i search on the net and this problem is not common but it does cause nursing difficulties for both mom and baby. My little boy is not gaining weight well, not even 14lbs at 4 months, that I've blocked ducts and sore nipple, aren't these obvious enough? On Kelly mom's website there're tones of info on tongue tie.
http://www.kellymom.com/babyconcerns...tonguetie.html

Dental development may also be affected, with severe tongue- tie sometimes causing a gap between the two lower front teeth.
Of more immediate importance is the negative impact that a tight frenulum can have 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.

My sons has never been an efficient nurser. He would suckle really hard at the first few minutes and get tired, unlatch, then show little interest to nurse again. I didn't know it's because of his tongue tie problem until I saw the lactation consultant recently.

I wonder any mummies have the same experince. Does your little one have the frenulum clipped? By which doc? Desperately need your advice. I feel sooo guilty that I didn't discover the problem earlier and my little boy has been frustrated all along for 4 months.

Thanks.

[barbwong_130]

A friend of mine was told to visit a paediatric surgeon for the same problem. The one she saw was Dr. David Man.

Dr. David Man
Specialist in Paediatric Surgery
Tel: 28100338
Pager: 82010383
1009 Lane Crawford House
70 Queen's Road Central

[muimuimolina]

Thank you very much Barbwong, I would definitely call the paediatric surgeon.
btw, has your friend decided to have it clipped? If yes, could you tell me how's her kid recovering?

Thanks a lot.

[LLL_Sarah]

I've seen babies have their fraenulum clipped. It is really quick. After it has been clipped breastfeed immediately and this will help your baby get over any discomfort he experienced.

If the baby has it done while very little (within the first week) there is usually a dramatic improvement with the breastfeeding. When the baby is older the improvement may take longer as the baby needs to learn to feed with his tongue over the bottom gums. Sometimes cup feeding is suggested - the baby uses a lapping movement to get the milk when using the cup and this helps him to push his tongue forward and over the gums.

Best wishes,
SARAH

[barbwong_130]

In the end it turned out that Dr. Man didn't recommend my friend's baby have her tongue clipped. So I'm sorry I don't know anything about the recovery time.

[Honkyblues]

Hi there

both my sons had tongue-tie to a certain degree. It's a genetic thing. I'm slightly tongue-tied. My mother is very tongue-tied.

The elder one could not latch on at all and in the end I used nipple shields for 6 months (exclusively breastfed him for the first 3 mths then slowly introduced formula). It wasn't easy, he was slow to gain weight, my milk supply kept dropping as he didn't milk the ducts very effectively (but I used motilium to improve my supply).

The second child could latch on but kept slipping off as his tongue couldn't extend very far to cup the areola. He ended up using his gums a lot as his tongue would slip away and my nipples were extremely traumatised! But then I found the solution of holding my breast with my free hand (using cradle-hold so one arm was under his head/neck/body, the other hand -opposite to the breast being fed on - was free). By taking the weight of my breast, it stopped it being dragged out of his mouth by gravity.

With both children I researched the surgical option of having the frenulum clipped. With the elder child, his tongue-tie was so tight, there was no frenulum to clip (it's a special type of tongue tie called type IV). With the second child, my paediatrician discouraged it. I wished I'd followed my instincts in the first couple of weeks after he was born, but my paed said he was barely tongue-tied because my son could extend his tongue on to his bottom lip. He couldn't extend beyond his lip though, and had the classic heart-shaped tongue.

By the time I was really desperate to have the surgery for my son, he was nearly 8wks old and it seemed a bit late for him to re-learn how to feed. then the "hold my boob" solution came to me and really helped. Plus, as the child grows, the mouth and tongue grow, the frenulum stretches a bit and it all becomes easier.

I hope that helps you a little bit. You are not alone. You're doing a great job and if you're worried about weight gain, you could consider topping up with formula or expressing your hind milk after a feed and topping up with that.

But don't worry about speech development etc. That's very rare. My elder son is now 2yrs 8mths and speaks very clearly. More so than many 3.5yr olds that I know!

HTH
Honkyblues

[muimuimolina]

Dear all,

sorry for the late reply, was busy running around to see peds and specialists.

Thanks for the info Sarah.
Barb, we saw Dr. Man and other peds, they all said my son's case is not that serious to have a frenetomy, and also it's a bit late (4 mos) for him to re-learn feeding again.

Honkyblues, thank you so much for your sharing. You are a great mum with lots of courage and patience. You are right, tongue-tie is inherited, my husband is slightly tongue-tied. He has problem pronouncing "s" and "th" but without the classical heart shape tongue like our son.

I've tried holding my breast with the free hand, it has improved a bit but bub still keeps unlatching and pulling my nipple at the same time, it hurts sooo much. He can never concentrate during nursing, 5 mins is the maximum and he never empties my breast even nursing only on one side. About his weight gain, different peds have different opinions. One says it's fine as long as he's putting on weight on his own curve(merely meet 25%), while the other urges me to help him gaining weight, or changing to a more "nutritious" formula, like S26.
Problem is my son hates any plastic in the mouth, so no bottle, no pacifier. He would rather starve himself if i leave home for a few hours.

Last week I saw my lactation consultant and she said I have yeast infection which may be the cause of blocked ducts. She gave me Diflucan, a bottle of nutribiotic and lactobacillus. I was not at ease to take Diflucan without any priscription, so I went to see an ob/gy in Central for a vaginal swap test and seek advice.

To my great disappointment, first thing he said was "why do you still breast feed him at 4 mos?" He also said the breast milk does not have enough iron, vitamin and protein, and I should start giving bub those brand ready to eat jar food. He then called his ped and asked his opinion. I couldn't hear what the ped said on the phone but I was pretty sure that he just confirmed that BF is recommended for the 1st 6 mos as the ob changed his attitude to like "it's up to you if you want to continue BF your son, but the pros of the yeast infection do not justify the cons"
I was really shocked and left with no words. He also suspect me having a systemic candidaisis, so he refered me to a dermatologist.

I haven't seen the dermatologist yet but my concerns are,
-if I have yeast infection in the breast(got all the symptoms), does the milk contain yeast? If yes, is it safe for the baby?

-my bub has this white patch on his tongue n ped says it's probably yeast infection too. He's taking Nystatin. Does he have pain when he suckles which makes him fussy on the breast?

-should i stop bf until the yeast is gone?

Sorry for the long post but as a new mum and all these problems coming up one after next, I'm really tired and frustrated. Any advice are appreciated.

[jenayds]

Oh my God I am appalled at that idiot doctor telling you you shouldn't be breastfeeding at four months. Words fail me!!!!!!!!!!!!

My sister had thrush issue and tongue tie issues with her son too, I will see if I can get her to get an account here and PM you. Her son's tie was clipped and things improved.

You poor thing, you shouldn't have to deal with crap medical advice on top of the very real problems you are managing!