When she was six weeks old, Elsie was diagnosed as having a posterior tongue tie and upper lip tie. I’d suspected as much for a few weeks previously, but was told that there was just one lady in my home town that could assess and diagnose, and the breastfeeding group she runs is both a fair drive away and at an awkward time for school pick ups. Since Elsie was gaining weight ok and I was in no pain, I felt there was no rush to get her seen.
When I finally got to the group, a breastfeeding counsellor spent an hour and a half with me, advising me on optimum positions to feed Elsie, and showing me over and over again how to re-attach her after she had slid from the breast. What an eye opener this was! This was the day that I realised Elsie was not feeding well. I know how silly that sounds. Perhaps her being my 4th and my feeling that I knew what I was doing had blinded me to the issues we were having? Perhaps the fact that I rarely fed her without doing something else at the same time was to blame? Whatever the reason, I truly had not realised how bad things had become.
Our positioning was all wrong. Elsie’s body was at a funny angle and I was holding the back of her head so that she couldn’t stretch back and open her mouth wide enough to attach. Then when she did have her head in the right position, she couldn’t open her mouth due to her upper lip tie. And her tongue tie meant that within seconds she had slipped from the breast. Over and over and over and over this went. Eventually we agreed that she needed to be assessed for the tongue tie.
Elsie’s tongue tie was posterior, meaning it was at the back and difficult to diagnose because you need to feel for it. You can’t see it by looking. The tell tale sign of the tie was the fact that when she cried, her tongue appeared to ‘cup’ in her mouth. She was diagnosed within seconds and we were referred to Oldham hospital to have it revised.
The next day the lactation specialist called me and talked me through some of the issues we were having- the group had been so busy and by the time she’d got around to Elsie and I we needed to leave. We talked about Elsie’s IUGR and the fact that feeding needed to be spot on for optimum weight gain. Speaking to others on Twitter (thank goodness for @PumpingMummy and @ESasaruNHS ) I knew that there are other reasons why tongue tie division was important too. That, alongside the fact that I now knew how badly she was feeding, was enough to make the decision to go ahead with the referral.
In the weeks that followed, as we waited and waited for our appointment, I went over and over our decision in my head. I wasn’t sure it was the right thing to do. It seemed extreme for a baby that wasn’t really suffering with her tongue tie. And then things began to get worse.
Sleeping became a nightmare. It just didn’t happen. Some nights I spent four hours trying to settle her.
The grunting continued, escalating in the small hours.
Reflux symptoms began to appear.
Feeds became a torturous experience of frustration at being unable to latch, frustration at being unable to stay attached to the breast, and frustration at being unable to take a full feed. Most nights were one continuous feed, ending only when I gave in to the frustration and stopped the feed.
Elsie’s congestion became so bad through the night that her breathing was affected more and more, and became worse the more frustrated and angry she got.
Then her weight gain began to dip a little. She started to fall off her curve. Not a big deal, you might think- but huge for an IUGR baby just hanging on to the 2nd centile. She is now below that precious line.
So this week we arrived for our appointment, and were shown into the consulting office. We were given lots of information on tongue tie and some facts about the procedure and after care. There are no blood vessels or nerve endings in the tie itself, which is why babies do not feel pain when they’re snipped. It’s a quick procedure and of 20,000 babies across the UK that had it done last year, only one became infected.
We were then shown to another room and told that Elsie would be next door with the doctor. The doctor would quickly check that the tongue tie was indeed present, and if so she would snip it, hold a piece of gauze under her tongue and bring her straight next door to me for a feed. If there was no tongue tie, she would bring me in to show me. As the doctor and nurse left the room, they closed the door and I turned to my sister.
“Thank goodness I don’t have to see it being done!” I exclaimed.
Then the door opened and there was Elsie. A piece of gauze under her tongue, screaming wildly. I was assured that she was screaming due to having the gauze under her tongue, and not because she was in pain. She was given to me, positioned correctly and after a few seconds of fussing, she latched on and fed.
And that, was that.
Our breastfeeding journey can now finally begin. She is taking full feeds and she is looking and sounding satisfied afterwards. She and I still need to re-learn how to work together, and how to drop the bad habits we developed but one thing remains clear. What a fighter my little IUGR baby is! Despite her tongue being unable to move correctly for feeding, she still took what we could and kept herself nourished. Another reason why she is so amazing!
We’ve been told that lots of skin to skin will help us to reconnect once more, and the kids are delighted that we have been ordered to stick our tongues out at Elsie as much as we can. She is already responding my copying- how wonderful it is to see that little tongue poking out at last!
For more information on tongue tie, see here.