Friday, May 1, 2009

Lip tie clipping

Brighton and I have had some breast feeding issues from the beginning. Him being my 6th baby, I could not figure out what I was doing wrong! He sucking in a LOT of air, made clicking sounds, and got nervous about the big gulps of air he anticipated sucking in. I was in a LOT of pain and kept trying to get a better latch with each nursing session. After a few weeks, I realized that something else must be going on. I did some research (LOVE Google and Mothering!) and came to the conclusion that he must be tongue tied, as we were exhibiting all the symptoms. I looked under his tongue to see if it looked like the frenulum (that little piece of flesh that attaches your tongue to your mouth) and it did look small...but he was just a tiny baby...everything on him looked small! I read that if a baby is tongue tied, they can't stick their tongue out. When Sebastian was a baby, we had great fun sticking our tongues out at him and watching him copy us and stick his little tongue out. I employed this "game" with Brighton, anticipating being able to figure out if he could actually stick his tongue out past his lips. After a few sessions of this game, he was sticking his little tongue out pretty darn far! Obviously, tongue tie was not the issue. I asked my midwife what she thought could be the problem. She thought maybe he could be getting too much milk and suggested I try nursing him laying back a hook him up and then sort of recline back. I tried it, but the situation did not improve. My midwife recommended I speak with a lactation consultant she knew. This lactation consultant happens to run a great little store that sells breast feeding supplies (pumps, pillows, covers, pads, bras, etc) and slings ( so I stopped in the store on my way home from the midwife's appointment. Brighton was full and sleeping peacefully in the sling so she couldn't observe him nursing, but she did suggest a problem I had not really thought about before. She suggested he could be lip tied. A lip tie is the same situation as a tongue tie; the frenulum (again, the little piece of skin that attaches your lip to your gums) is too short/tight. After researching it a bit, this diagnosis really seemed to fit...he had never puckered his upper lip out and was never able to get a good seal while nursing. I got a referral to an oterlarynlologist (I had NEVER heard of this term before and still can't quite pronounce it!). Yesterday was our appointment. Scarlett, Haven, Brighton and I had fun riding the elevator up to the office. :) He looked at his upper labial frenulum and thought it looked a little short and noted that it was extremely thick, as well. He said since we were still having breastfeeding issues (pain for me, mostly) that it should probably be clipped. He said we could either do it under general anesthesia or do it in the office with a bit of spray-on pain killer. I did not feel comfortable having my little guy put under general, so I opted for the office procedure. He sprayed a bit of the numbing agent on the frenulum right tasted GROSS (the Dr. said) and Brighton made an AWFUL face and sort of tried to cough out the taste. Poor guy! We immediately moved to a procedure room. They brought in a papoose board and I helped wrap him in it. He was not freaked out about being so tightly wrapped and restricted in that way, like most babies might, because this is how I wrap him for his naps. The Dr. came in and sprayed more numbing agent and then got the scissors out. Brighton was already crying from the yucky taste and because the nurse was holding his head still. Haven and Scarlett were commenting about how it was going to hurt and I reassured them that Brighton would be okay. They just stepped back and watched. The Dr. made the cut while I was looking the other way, talking to the girls. When I looked back, the Dr. was holding gauze firmly against the wound. He had anticipated a lot of blood, since the frenulum was so thick. There was a bit more blood than I had anticipated. Brighton cried and cried as the nurse and I continued to hold him still and the Dr. applied pressure with the gauze. He saw that it was still bleeding a lot, so he got out this little Q-tip type of deal with black stuff on the end and cauterized the cut with it. This is when Brighton screamed and cried louder than I have ever heard him. Poor little sweety pie!! The bleeding stopped almost all the way then. We un-velcroed him from the papoose board and I scooped him into my arms. He stopped crying almost immediately...he was still fussing a bit. The Dr. suggest I nurse him to calm him down and they all left the room. He nursed and then behaved like his regular self; smiling and squaking and cooing to the girls. He fussed a bit on the way home...fussed in an "I'm in pain" sort of way. We stopped at the grocery store to fill his antibiotic prescription (the Dr. felt that he needed it to prevent any infection since so much flesh was exposed) and get him some baby acetaminophen. He was happy in the store while he snuggled against me in the sling and the girls helped me get a few groceries. When we got home, I gave him a dose of acetaminophen (the first time he's ever had anything other than breast milk!) and put him down for a MUCH needed nap! He slept for 3 hours! When he woke up, I noticed that his lip was swollen (see above photos) and he had two little bruises on his lower lip, I think from it being held down during the procedure. Today, day 2, his lip is even slightly more swollen. He doesn't seem to be in a lot of pain, however. He is playing and putting all sorts of things in his mouth and even rammed my face with his face a few times (bumping his upper lip) and didn't even flinch. I, however, get a feeling of loosing my stomach every time I look at his swollen lip and think of the cut on the inside!! I'm not sure if I've noticed a change in breastfeeding him yet. I think it will take a week or so to get him to change the way he is used to nursing and for the swelling to go down. He is such a brave, sweet little guy!!


  1. Ohhh, poor little guy! It seems harder when they are older to have procedures like that done. I can relate to this....Hayden was tongue-tied, and thankfully they noticed early (his first week)...I was having a hard time with him nursing as well, and was SO sore!! He was clipped early, and it was an easy procedure. I have been to that lactation consultant at Alliance, she is awesome, and was so helpful to me when I was having some issues. I am glad little Brighton is ok! :)

  2. I'm glad Brighton is doing ok! Sounds like quite the ordeal. Good to have over!

  3. Hi Heidi,
    My wife and I have some breast feeding issues as well. We were suggested to do the lip tie clipping but we are a bit scared and your story didn't help... :)
    I didn't understand whether it actually helped or not, has it?

  4. Oren,

    I think the procedure did help. After a few weeks, he seemed to get a much better seal while nursing and stopped sucking in so much air. I think it took awhile to teach him to latch on better, since he was used to not being able to latch on. He is now almost a year and I am glad we had the procedure done! Good luck with your baby! See several lactation consultants if need be!


  5. Heidi-
    How old was Brighton when you took him to get the procedure done? How small would you say his frenulum was? My DD is 2 1/2 months and we have an appointment next Tuesday to get it clipped but the oterlarynlologist we saw wants her to be under general which scares me to death AND I'm not 100% convinced a small frenulum is our problem. I've tried EVERYTHING to alleviate the pain, but nothing has helped. I can't get her top lip to flange out no matter what I do...did you have the same problem with him? A lactation consultant actually recommended we get it checked so I've been to them too.
    Any other insight would definitely be appreciated.
    Thank YOU!!!

  6. Jennifer,
    Brighton was 6 months old and I wish that I had done it at 3 months when I first realized that was probably his problem (I am the biggest procrastinator!) I have heard it is less painful the younger the baby is. I don't know how small his frenulum was, but his lip would not flange out at all, like your was just too tight. His frenulum was also thicker than normal, which I think made it more painful for him to get it clipped with just the topical anesthetic, but it was better than him going under general, in my opinion. If your Dr. is not willing to do with topical, maybe you could get a second opinion. If I were you, I would want it done under topical (it will be painful for her, but not emotionally damaging...Brighton was fine and his happy old self immediatly afterward and especially after nursing!) and done while she is young and it will be easier to teach her a proper latch. For me, it took a few weeks to get him to grab more flesh than he used to be able to before the pain got better, but it did get better.
    Hang in there!! Keep breastfeeding (the football hold was the least painful for me, by the way)!! I hope you find the solution that works for you and your sweet baby!


  7. Thanks Heidi, I really appreciate it.