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Tag Archive for: tongue tie

26 Ways to Calm a Fussy Newborn

Babies, General, Mom Talk

Trying to calm a fussy, or inconsolable, or screaming newborn can be a very stressful time for parents. Throughout the pregnancy, the focus is most likely on the growth of the baby, preparations for birth, and setting up the nursery. Being up in the night with a fussy and inconsolable baby is probably not something a new parent thinks to plan for…but it should be.

With our first born, Ruby, we were blindsided by her fussiness and felt like we didn’t have enough tricks up our sleeves to calm her down.

I remember one night, after she had been screaming and inconsolable for hours and hours, we called 9-1-1 (after trying her pediatrician first). When the firefighters came stomping up our three flights of stairs and barged into our little condo, Ruby was instantly mesmerized and of course stopped crying. I saw the firefighters chuckle to themselves and heard them make some comments to each other about new parents. It’s funny now, but I was sleep deprived and terrified then that something might be dreadfully wrong.

After Ruby, we learned many more ways to calm fussy babies (besides just going for long walks or drives), but it wasn’t until after baby number five that I’ve finally feel like I have a full arsenal of ways to calm fussy babies at my fingertips.

One of the most important pieces of advice I have is to be proactive. Many of the tips and tricks I’ll share have to do with preventing fussiness and the rest will give you a bag of tricks to pull from if and when your baby is fussy.

1. Avoid Coffee

I’ve never completely eliminated coffee while breastfeeding until Jack, and let me tell you it has made a WORLD of difference. When I learned that the half life of caffeine elimination in a newborn was 97.5 hours, I was finally convinced to give up the java. With every other baby, I just expected that being up in the night was a normal part of caring for a new baby. Jack is almost two months old now, and I haven’t been up in the night even once with him. If you’re looking for a good coffee substitute, I recommend teeccino.

2. Chiropractic Care

The other reason why I think Jack is so calm is because we took him to a chiropractor shortly after he was born. I was having trouble nursing him on the left side, and apparently it was due to a misalignment in his neck. (During birth he was posterior, turned into the correct position right as I was about to push, and was born very quickly – all of which probably contributed to the misalignment.)

For the procedure, the chiropractor laid him on his back for the adjustment (which was basically like a massage), and he was very calm and happy during the whole thing. Afterwards, he nursed like a champ on both sides. When looking for a chiropractor, I advise looking for a holistic one who specializes in working with infants.

Check out this amazing video of an infant getting immediate relief after chiropractic care.

3. CranioSacral Therapy

CranioSacral therapy (CST) is a gentle, noninvasive form of bodywork that addresses the bones of the head, spinal column, and sacrum with the goal of releasing compression in those areas to alleviate pain. It is especially helpful for babies who seem unwilling or unable to nurse properly. When Julian was a newborn, we took him to a CranioSacral practitioner to help him with his tongue tie. It didn’t really help with the tongue tie, but we noticed a huge difference in how calm he was afterwards.

Going through the birth canal or being delivered by cesarean can misalign a baby’s delicate structure and cranial sacral therapy helps to realign everything.

4. Honor the 4th Trimester

After spending nine months in the womb, the outside world must be a real shock for a new baby. By making the outside environment as “womb-like” as possible, it will help to prevent fussiness and create a smooth transition.

  • Skin to Skin: I love doing skin to skin as much as possible after birth until my babies are adjusted. It helps with nursing, bonding, and maintains the same comforts as the womb.
  • Feeding on Demand: There is no need to worry about a feeding schedule, just nurse whenever your baby is hungry. Newborns generally need to nurse about every two hours, but may cluster feed at certain times and sleep longer and not eat for longer times.
  • Baby Wearing: Using a baby sling or carrier is a great way to keep your baby close so he or she can be close to your skin, beating heart, the sound of your voice, and the gentle swaying of your motions. My favorite carriers are the Moby Wrap, a ring sling, and an Ergo Carrier with an infant insert.
  • Co-Sleeping: Feeding on demand is made much easier by co-sleeping. In most parts of the world (except the United States), co-sleeping is the norm. New research shows how it’s actually safer than putting a baby in a separate room and bed.

I find it fascinating that in other more primitive cultures, fussy and crying babies are a rarity. This is because babies in these cultures are treated like an attachment to the mother and aren’t “trained” in any way. (Source)

5. Check Basic Needs

Whenever my babies get fussy, the first thing I do is cycle through the basics. Does he need a diaper change? Does he need to burp? What about nursing? Maybe he’s tired? As a mom, my sixth sense sometimes just knows what my babies need, but this amazing woman, Priscilla Dunstan, figured out how to decipher the meaning of a baby’s cries.

The five sounds in the Dunstan Baby Language are:

• “Neh” – meaning, “I’m hungry”
• “Owh” – meaning, “I’m tired”
• “Heh” – meaning, “I’m uncomfortable”
• “Eairh” – meaning, “I have lower gas”
• “Eh” – meaning, “I need to burp”

6. Warm Bath

Being naked in a warm bath with you is as close to a womb experience as you can create. Within the first few hours after birth, I always like taking a nice healing herbal bath with my newborns. This is a great time for us to relax and bond after birth, and my little ones always enjoy nursing in the water. When I was having trouble getting Ophelia to latch when she was three days old (I tried a pacifier with her too early, and it created nipple confusion.), we took a bath together it she latched on right away. My babies love it when I hold their heads so they can move their arms and legs freely in the water.

7. Don’t Keep a Baby Awake

When our firstborn, Ruby, was an infant, I had this crazy idea that if I kept her awake more during the day, she would sleep better at night. But then she would get overtired, and getting an overtired baby to go to sleep is not an easy task.

The best rule of thumb to remember with babies and sleep is that the more they sleep, the better they’ll sleep. Trying to get a newborn on any type of schedule or predictable routine is just not going to work. The best thing to do is to just go with the flow and let our little ones sleep whenever they’d like and for as long as they’d like.

8. Red Light at Night

As for lighting, red lights are the best because they keep the pupils from dilating which allows your baby to remain in a sleepy state while allowing you to see during late night nursing sessions. Something like this salt lamp or this tree lamp (we unscrew the other bulbs so only the reddish lights are on) would be perfect. The soft glow of a fireplace in the winter is great too!

9. Not Too Hot or Cold

Newborns don’t have a lot of body fat to keep them warm and struggle to maintain their body temperature if the environment is too cold. That is why it’s best to dress babies in one more layer than we do to keep warm. So if you’re hanging out in a t-shirt, your baby will probably want to put your baby in a footed sleeper with long sleeves. I typically like to keep my babies a little under-dressed, however, so that I can wrap them up in one of my homemade silky blankets! But beware of overdoing it as well. A little bit of sweat is normal, but if your baby is in pools of sweat, he or she is too hot! Babies dressed in too many layers are at a greater risk for SIDS (sudden infant death syndrome).

10. Swaddle

Swaddling helps to recreate the tight environment of the womb. Some of our babies have totally loved this and others didn’t much care for it. These aden + anais cloths are great for swaddling and so are these summer swaddlers, but really any receiving blanket will do. Just make sure that you are following the guidelines for the new swaddle that keep the legs more free so that your baby doesn’t get hip dysplasia. Watch this video to see the proper way to swaddle.

11. Sucking

Sucking releases oxytocin (the bonding hormone) in both the mother and the baby, which is nature’s way of rewarding them both for breastfeeding. 🙂 In between feedings, newborns might also enjoy sucking on your pinkie (nail side down).

I would avoid using a pacifier for the first few weeks because it can create nipple confusion and make breastfeeding more difficult, but once breastfeeding is established, pacifiers are just fine. There is no evidence that pacifiers affect baby teeth and they have actually been proven to reduce SIDS. Just look for some that are BPA free.

12. Get the Boogers Out

Babies can get really fussy if they can’t breathe because boogers are blocking their nasal passages. When they are first born, babies have this white sticky boogers that you’ll need to pull out. I like to take a kleenex and twist a piece of it into a little swirl. Then I spin it into the nostril and spin it out. This usually catches the booger and drags it out.

If there’s any congestion or lots of boogers, I like using saline and a Nose Frida. My babies always HATE this, so I have to hold them snugly, give a quick squirt up each nostril, and gently use the Nose Frida to suck out the boogers. I also keep a kleenex close by to wipe the nose and then I use it to catch the boogers as I blow them out from the Nose Frida.

13. Nose Rub

Every single one of my babies (and even toddlers) love the nose rub. When they are tired, but not wanting to go sleep, I gently run my fingers down the bridge of their nose in a way that also lets my fingers shadow their eyes. Every time my fingers go over their eyes, they close for a bit, then close for a bit longer, and then finally shut. If I stop and they open their eyes, I keep going. Sometimes I’ll also rub their head and cheeks.

I love this video that shows a little baby falling asleep as a light cloth is repeatedly swiped over its face.

14. Shushing

A harsh shushing sound mimics the sound of the mother’s blood flow that babies hear in the womb. This is why using a box fan for white noise is so great, but if you need to take things to the next level, this shushing technique is really effective. Basically, you get really close to the baby’s ear and make a shushing sound as loud as you can and for as long as you can.

In his book and video, The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Baby Sleep Longer, Harvey Karp explains how the best way to calm your newborn and get him or her to sleep is by re-creating the noises, movement, and snug environment of the womb.

15. Calm Music

Calming music can also provide a very soothing type of white noise. With every baby, I’ve enjoyed listening to something new. Sometimes I’ll get into Enya on Pandora, other times I like Rockabye Baby! Lullaby Renditions with the iTunes visualizer turned on, and right now, I’m really liking this lullaby mix on YouTube that has some great visuals which are mesmerizing for me as well as Jack.

16. Mother’s Voice

Starting at 23 weeks gestation, babies can hear sounds in the outside world – including the sounds of voices. During the last 10 weeks of pregnancy, research has proven that babies can actually distinguish the sound of their mother’s voice. At birth, babies recognize and prefer the sound of their mother’s voice.

I love talking to my babies, singing to them, and whispering in their ears telling them how much I love them. Jack is 7 weeks old now and we’re enjoying the best conversations with each other while I hold him close and gaze into his eyes. He is completely transfixed. If someone else is holding him and he hears my voice, he’ll quickly turn his head to see me. If he gets a little fussy, I’ll sing him a little song and all of the troubles in the world melt away.

17. Bounce and Pat

For this maneuver, place the baby in an upright position with its head resting on your shoulder and bounce while gently patting the baby on his or her back or bottom. This position is particularly good if the baby is gassy. While holding the baby, you can bounce on an exercise ball, walk around, dance, or sway back and forth.

18. Rocking

I highly recommend investing in at least one good rocking chair. I currently have three set up and Jack loves the rocking motion while I nurse. First of all, I have an old fashioned wicker rocker (that I got at a garage sale) in our bedroom that Scott and I take turns using while holding Jack (primarily during our bedtime routine with the older kids). This type of rocking chair has a great sweeping up and down rock that is very calming for a fussy baby.

In our mini living room, I have a gliding rocker (I call this one my throne because I spend the most time here). The gliding motion is mostly back and forth, not up and down, so it’s not as soothing, but it’s very comfortable. Then in our main living room (where Scott and I hang out after the kids go to bed), we have the most luxurious rocking and reclining arm chair (we just found one at a thrift store, but I linked to one that looks really special). This is the kind of chair that I love to criss-cross my legs and snuggle into at the end of the day.

With all three I like using this nursing stool and My Breast Friend.

19. Swinging

There are times when I’m just too tired to rock and bounce and dance, and a nice swing has been a life saver. I really like this small portable swing the best. I can easily carry it from room to room, it’s not a battery hog, the swinging is silent, and the motion is subtle and gentle. I also really like this Fisher-Price Cradle ‘n Swing. It takes up a bit of room and has a bit more noise, but it offers many different swinging options and the mobile is very distracting as well. And while not technically a swing, I LOVE putting my little babies to sleep in this vibrating bassinet.

20. Tummy to Chest

Little babies love sleeping on their tummies with their heads nestled near your neck and little legs tucked up on your chest. This is a great way to do skin to skin as well. In this position, the baby is near your heart beat and voice, and you can gently pat his or her back to help get out any gas. I think the pressure of being on their tummies feels good if they have a little gas.

If you’re looking for a way to recreate this with a machine, check out this video of a fussy baby being settled with the Babo Cush. You can buy both the rocker and the cushion at the Babo Cush website here.

21. Tummy Rub

I can tell when Jack has to poop or pass gas because he’ll start grunting and squirming. When I put my hand on his stomach for a gentle massage, it really calms him down. I will rub my hands in a downward motion, rub in a circular pattern, or just leave my hand there to gently apply pressure to his tummy.

I can only imagine what it must be like to have to learn how to poop, and even though babies have an automatic defecation reflex, sometimes the muscles of the anus don’t relax at the proper time so your baby will push hard with the diaphragm and belly muscles while holding the anus tightly closed.

When this happens, you can rub their tummy, pump their legs in a bicycle motions, hold them upright on your shoulder, or lay them down to let nature take it’s course.

22. Colic Calm

Colic is technically defined as a baby who cries for more than 3 hours a day and for more than 3 days a week. Although the cause is unknown, it is believed to be due to some sort of intestinal cramping. Dr. Harvey Karp believes colic is a myth and that newborns really need a 4th trimester to develop with conditions similar to those in the womb. In any case, when my babies have been really fussy, and I suspect intestinal troubles, I love using Colic Calm. It is a natural homeopathic oral remedy designed to help with colic, stomach pains, reflux, and gas. It is made with charcoal, so don’t be surprised by the black color of your baby’s next stool.

23. Water Dropper

I learned this little trick from my midwife, Laurie Zoyiopoulos, who learned it from some of her Amish clients. When the Amish are dealing with a fussy newborn, they simply give him or her a little bit of water, and it calms the baby down right away. Maybe it’s because the colostrum just isn’t satisfying enough, or maybe it helps to soothe an upset tummy, but for whatever reason, this trick really really works! When Julian would get really fussy and nothing else would soothe him, I would give him a little dropper of water, and he would calm right down. My husband really appreciated knowing this trick as well!

24. Hair Tourniquet

In rare occasions, an adult hair can become wrapped around a finger or toe and cut off circulation. (Read more here.) I always like to give my babies a physical once over to see if I can spot something that is causing them pain. Maybe a cookie crumb is lodged in the crook of their neck, maybe a fold of skin has some gunk in it that’s turning into a rash, or perhaps a hair has become wrapped around one of their extremities and is causing pain. It can be quite a guessing game!

25. Tongue or Lip Tie

If a baby is tongue tied or lip tied, it means that there is an extra flap of skin that makes it hard to nurse properly. Julian had a pretty severe tongue tie and as a result he had a hard time latching correctly which made him take in a lot of air. This caused him to be gassy, very fussy, and up in the night every 45 minutes to eat. A lip tie can have the same effect. If you suspect a lip tie or tongue tie, check out my blog here for more information.

26. Thrush

For the mother, thrush can mean sore nipples and painful nursing, for a baby thrush can mean white patches of painful sores in the mouth. If your baby has thrush, it means that you probably had a yeast infection during a vaginal birth. Milk spots in the mouth will go away on their own, but white spots from thrush will remain. If you want to learn more about remedies for thrush, check out my blog here. (And if you’re still pregnant and reading this, check out my blog about curing a yeast infection while you’re pregnant so you can avoid thrush.)

In Conclusion

You are not a bad parent if your newborn cries. Yes, they cry as a way to communicate and it’s our job to figure out what they’re trying to say, but it’s a big adjustment moving to the outside world from the womb and there are going to be a few tears shed. The best things you can do are to: 1) be proactive by taking measures to prevent fussiness in the first place, 2) be prepared with a variety of tricks up your sleeve to use when your baby does get fussy, 3) stay calm, and 4) be patient. If you keep rotating through a variety of strategies, you will eventually find something that works. Then, when you know what has been troubling your little guy or girl, you can make a plan so that things will get better in the future.

Time goes by fast, so enjoy these precious moments with your newborn and know that by the time they are 3 months old, they will finally be settled into their new world and things will be a lot easier. You’ve got this!

April 30, 2017/by Stacey Maaser
https://embracing-motherhood.com/wp-content/uploads/2017/04/newborn.png 400 810 Stacey Maaser https://embracing-motherhood.com/wp-content/uploads/2018/01/EM_Logo.png Stacey Maaser2017-04-30 09:37:292020-11-18 15:55:3026 Ways to Calm a Fussy Newborn

How to Identify and Deal with Lip Tie and Tongue Tie

Breastfeeding, General, Mom Talk

After having problems establishing a breastfeeding relationship with our first three children, I discovered what a lip tie was. After having our fourth child, I finally learned what a tongue tie was. Had I known about these two conditions from the very beginning, it would have made things a heck of a lot easier! This is the information I have gathered doing extensive research, talking to experts, and through my own experience. This is the information I wish I would have had with my first child from day one and what I would like to tell anyone else who is going through the same thing.

Let’s Talk About Frenula

Frenula is the plural form of frenulum. A frenulum (also called frenum when in relation to the upper lip) is a small fold of tissue that secures a mobile organ in the body. The maxillary labial frenum is the membrane that attaches the gums to the upper lip and the lingual frenulum is the membrane that attaches the base of the tongue to the floor of the mouth.

When a baby is growing in utero, the tongue starts to develop at about 4 weeks. By 6 weeks, the frenulum cells attaching the tongue to the floor of the mouth begin retracting from the tip of the tongue increasing the tongue’s mobility. Disturbances during this stage cause ankyloglossia, or tongue tie. The tip of the tongue will continue to elongate after birth which is why some people believe that the tongue will “stretch” with age and growth, although that is not the case.

Look at Your Frenula

Before going any further, I suggest that you look in a mirror and lift up your upper lip. You may notice a stretchy piece of tissue hanging out up there, and you might even be able to feel it with the tip of your tongue. You may also feel nothing. Next, lift up your tongue and look for the stretchy piece of tissue lying underneath. Move your tongue around and notice the range of motion you have. Then try sticking your tongue out. Notice how far you can stick it out. Can it go down the length of your chin or up to the tip of your nose or does it barely leave the confines of your teeth? After you explore your own frenulums, examine your spouses. The two of you will probably be much more willing participants than your children, and it will give you a good insight as to what to look for since genetics will probably play a role in the type of frenulums your children have.

Are the Frenula Causing Problems?

The mere existence of frenula does not constitute a problem, it is when they are so restrictive that they prevent breastfeeding from occurring that is a problem. When the frenum of the upper lip or the frenulum of the tongue start to cause problems, they are referred to as lip ties and tongue ties. If there is a lip tie, there is probably a tongue tie also, but a tongue tie does not necessarily indicate that there will be a lip tie.

What is a Tongue Tie?

Being tongue tied is medically defined as having ankyloglossia, which is caused by having an unusually short or thick membrane under the tongue that is attached abnormally close to the tip of the tongue and causes restricted movement of the tongue. People with more severe cases of tongue tie cannot stick their tongues out very far beyond their teeth.

Baby Julian's Tongue Tie

Baby Julian’s Tongue Tie

This can cause breastfeeding problems with babies and speech problems as they get older. As an adult, the worst of the lingering effects are typically the inability to French kiss properly and the inability to lick an ice cream cone. Here’s a great 2 minute video describing what tongue tie is, the symptoms associated with it, and what it looks like to get it removed using the scissor method.

What is a Lip Tie?

Having a lip tie occurs when the membrane under the top lip is unusually thick and attaches under the gum line. It is not as common or severe of a diagnosis as being tongue tied, although it does have its own host of problems. I’ve read that severe lip ties will usually correct themselves by the time a child reaches adulthood due to tripping and falling or any other number of accidents that can lead to the lip tie being torn, but Dr. Kotlow, a leading expert in tongue and lip ties, believes this is not the case. He explains how if a severe lip tie is not corrected, “it can lead to dental decay on the upper front teeth, gaps (diastemas) between the two front teeth, orthodontic or periodontal problems later in the child’s oral development, and poor lip mobility or function, especially during smiling and speaking.”

Baby Julian's Lip Tie

Baby Julian’s Lip Tie

Other resources that I’ve looked at say that once all of the permanent teeth come in, the gap may just fix itself. Here’s a great 2 minute video describing what a lip tie is, the symptoms associated with it, and what it looks like to get it removed using the scissor method.

Classifications of Tongue and Lip Ties

Although you cannot diagnose tongue and lip ties by looks alone, it’s a good place to start. One of the first things to look for to see if your baby is tongue tied is to see if your baby’s tongue makes a heart shape when he or she cries. This is a tell tale sign that it is being tethered too tightly to the floor of his or her mouth.

One of the best ways to look for a tongue tie is to lie the baby on his or her back on your knees with his or her head facing towards you and his or her feet facing towards your knees. Then, tilt the baby’s head back and stick your fingers underneath the tongue to elevate it. You can also get a pretty good look when he or she is crying. To look for a lip tie, look to see if the top lip flanges out while nursing. You can also simply lift up the top lip and look.

These pictures below have been compiled by Dr. Kotlow, one of the most renowned pediatric dentists, known for his skill at correcting tongue and lip ties. He comes highly recommend by Mommypotomus who also has a great blog about tongue ties. You’ll notice that there are many different classifications.

how-to-diagnose-tongue-and-lip-ties-3

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Symptoms of Tongue and Lip Ties

Looking at the symptoms related to tongue and lip ties is actually the best way to diagnose them. So here are a list of symptoms to look for in both mom and baby that could be the result of tongue and/or lip tie.

  • Symptoms to Look for with Mom
    • Nipple pain and/or erosions
    • Nipple looks pinched, creased, bruised, or abraded after feeds
    • White stripe at the end of the nipple
    • Painful breasts/vasospasm
    • Low milk supply
    • Plugged ducts
    • Mastitis
    • Recurring thrush
    • Frustration, disappointment, and discouragement with breastfeeding
    • Weaning before mom is ready
    • Tired momma, from being up in the night every hour for feeding night after night after night
  • Symptoms to Look for with Baby
    • Poor latch and suck
    • Unusually strong suck due to baby using excess vacuum to remove milk
    • Clicking sound while nursing (poor suction)
    • Ineffective milk transfer
    • Infrequent swallowing after initial let-down
    • Inadequate weight gain or weight loss
    • Irritability or colic
    • Gas and reflux
    • Fussiness and frequent arching away from the breast
    • Fatigue within one to two minutes of beginning to nurse
    • Difficulty establishing suction to maintain a deep grasp on the breast
    • Breast tissue sliding in and out of baby’s mouth while feeding
    • Gradual sliding off the breast
    • Chewing or biting on the nipple
    • Falling asleep at the breast without taking in a full feed
    • Coughing, choking, gulping, or squeaking when feeding
    • Spilling milk during feeds
    • Jaw quivering after or between feeds
  • Symptoms I Had: With our fourth baby, Julian, I was not getting very much sleep because he was up every hour or two (or sometimes every 30-45 minutes) to nurse. And when I would nurse him, I wasn’t able to just lay down and nurse, I had to either sit up on the edge of the bed or in the rocking chair to help him latch on. My nipples weren’t really sore (after four babies, they got pretty tough), but he was rolling the nipple around in his mouth and falling off the nipple repeatedly. When he would nurse, there was a noticeable clicking sound from his inability to form a secure latch. He especially had trouble maintaining a latch during my letdown and he would sputter, choke, and pop off the breast. He would also fall asleep mid feed and as a result he didn’t fully drain the breast. This led to me getting plugged milk ducts (which I massaged away after applying a hot compress and drained completely using a breast pump), and I believe that this is what led him to have a lot of green poops (from not getting enough hindmilk). He was also taking in a lot of air during feedings which resulted in him being gassy, needing to burp and fart a lot, and getting the hiccups. When he had gas (which was often), he would get really fussy and squirm, wiggle, and grunt…even in his sleep. He would also puke a lot, but he also would nurse a lot, so weight gain was not an issue. Finally, at his six week checkup, the midwife noticed that he was tongue tied. Once I started researching the symptoms, it all made sense.

Temporary Relief

If you are waiting for a corrective procedure or trying to decide if you will get one, the following strategies may help to provide some temporary relief.

  • Stretch the Lip Tie – To help with stretching out both Ophelia and Julian’s lip ties, I would put my finger under their upper lips and roll up. I tried to remember to do this before every feeding. To help them latch on, I would have to grab my breast and angle the nipple down, wait until they opened their mouth, and then torpeedo my nipple in there! Once they latched on, I would sneak my finger under their lips to flange it out. By the time they were three months old, I didn’t have any problems with their lip ties anymore.
  • Sitting Up and Leaning Forward to Nurse – Getting a good latch is difficult enough as it is, but when you’re dealing with a lip and/or tongue tie, it’s even more challenging! This seems to help.
  • Burp Often – Because they are taking in a lot of air, it can help to burp during a feeding by either patting their backs or putting them up on your shoulder. I would also try to angle their bodies to make them more upright while nursing. Also, keep burping periodically even long after the feeding.
  • Hold to Sleep – Now, I’m a really light sleeper, so this works well for me, but it can be dangerous, so use this strategy with caution! What I do is prop a big tower of pillows in a U-Shape around me for support. Then I sleep with pillows propped under my arm and my head leaning against a pillow. When we sleep, I hold his upper body upright and about every 3o minutes or so when he gets fussy, I would pat his back, bounce, and rock him until he calmed down. We are six weeks after the procedure and Julian is 3 months old, and I still actually hold him while I sleep every night. I think I’m just used to it now!
  • Belly Band Over the Boobs – You know that thing that you put over your pants when you’re pregnant so that you can leave your pants unbuttoned as your belly grows? Well, I pull that over my breasts because my nipples are just so dang sensitive. It’s a much more comfortable alternative to wearing a bra at night and makes it easier to nurse too.
  • Air Time – Putting breast milk on my nipples and just walking around without a shirt on felt good. (I just had to remember to close my curtains!)

Options Moving Forward

You have several different options depending on your specific situation. You will want to consider the following: the problems you’re having breastfeeding (If it’s not causing any noticeable problems, I would recommend leaving it alone.) the availability of a skilled practitioner in your area or your capability of traveling, your financial situation and insurance coverage, the age of your child (over 6 months is almost too late), and so on. Here is a list of the next possible steps.

  1. Wait and See – If your symptoms are not that bad or if you feel like they may be caused by something else (a poor latch, strong let down, flat nipples, etc.) you might want to take a wait and see approach. Dr. Kotlow however. strongly advises against this for a lip tie because he does not feel that it will get better with time. But with Ophelia and Julian’s lip ties, I saw that they did, although they were not extremely severe. It was really hard to get a good picture, but you can kind of see Julian’s below. It attaches below the gum line and was kind of tight at first, but seemed to stretch out over time. (Sorry about your nose buddy.)
  2. Best Time to Act – Keep in mind that the younger the child, the easier it is to deal with this procedure. Once you go through with the procedure, not only will your child have to physically heal, but he or she will have to learn how reuse his or her tongue based on the release and the new muscle use related to the increased mobility. The best time to get a procedure done is before the child is 3 months old, and really, the younger, the better. Usually, when the child is over 6 months old, the doctor won’t do the procedure in the office, and it will have to be done in the hospital with anesthesia.
  3. Pediatrician’s Opinion – We did not need a referral to get an appointment with a specialist, but you might, and this would be a good place to start to learn about your options. Just keep in mind that some pediatricians are not familiar with tongue or lip ties or worse yet, might not believe in them and make you feel silly for even asking. We took our fourth baby, Julian, to see his pediatrician because we had no idea where to even start. She said, “Yup, that’s a tongue tie!” and suggested that we see an ENT for a frenectomy (also known as a frenulectomy, frenulotomy or frenotomy – which is the removal of a frenulum). When he cries, you can see the heart shape of the tongue and how it is tethered to the floor of his mouth.
  4. ENT – That’s an Ear, Nose, and Throat specialist in case you didn’t know (I didn’t). Some people feel like this is the best place to go for getting a tongue or lip tie procedure. For us, we needed something close that was in our network, and this was the only option. We had to pay $45 for the office visit and we were quoted that the procedure would be $450, but six weeks later, we have yet to get a bill. (Maybe insurance is covering it after all?)
  5. Pediatric Dentist – Some people feel like this is the preferred specialist for this procedure. I think that it all depends on what is most convenient for you. If you can travel and money isn’t an option, then you might have the freedom to research all specialists nationwide and find the best of the best.
  6. Scissor Method – This is the most common way of doing the procedure, and what we did with Julian. Depending on the severity of the tongue tie, a topical and/or local anesthetic may be used, the membrane may be clamped to stomp blood flow, a nurse (and you if you can handle it) will hold the baby down, the nurse will prop up the tongue with q-tips or some other tool, then the doctor will go in with one or two snips, and then he or she will then cauterize it with silver nitrate if there is a lot of bleeding. When Julian had his cut, I was really shocked by the amount of blood, but the doctor assured me it was normal. He breastfed right after the procedure and the bleeding stopped after a few minutes. (His next poop was pretty black from all of the blood he swallowed.) There is a concern with this method that the doctor won’t cut enough (I’m sure it’s scary going into a little baby’s mouth like that with a pair of scissors, especially if they are screaming!) and there won’t be a full release, but we did not have this problem.
  7. Laser Method – Some say that the laser method is superior because it can penetrate through more of the tissue for a more complete release and immediately cauterizes the wound, but it is not easy to find someone who will do this. (It takes a steady hand and a lot of skill.) Here’s a list of nationwide providers that will do the laser method.
  8. Questions to Ask – If you have several options within your area, it might be a good idea to ask some of the following questions to narrow your search such as: 1) How often have you done this procedure? 2) How often do your patients come back for a revision? 3) What is the procedure like? 4) What are your thoughts on the scissor method versus the laser method? 5) What do you recommend for aftercare?

After Care

After the procedure, some say that doing exercises to help the muscles learn what they are supposed to do and to make sure the tongue tie doesn’t reattach and scar tissue doesn’t form is absolutely crucial. I personally felt that my son would strengthen his muscles by nursing and that the wound would be given sufficient time being stretched every time he cried. (I mean, I wish I could soothe him perfectly so that he never cried, but that has yet to happen.) To be honest, I felt like he had been through enough and I could tell he was in pain when I tried to do the exercises, and I just couldn’t bear to put him through any more. I can see how the lip tie would reattach if the lip continued to not to flange out while nursing, but I can’t imagine that the newly detached lip wouldn’t flange out. At any rate, you may want to rub a finger over the wound periodically to ensure that it doesn’t reattach.

Typically, babies feel discomfort for the first 24 hours after the procedure. Older babies and toddlers will typically feel discomfort for the first 48 hours. Breastfeeding and skin to skin are the best first lines of defense. Arnica is a good natural method for pain relief, or there’s acetaminophen (dosage should be given based on the child’s weight not age). Ibuprofen should not be given to children under the age of 2 months and topical numbing ointments containing benzocaine (Orajel/Anbesol) should not be given due to health risks.

After Julian’s procedure, he was in a considerable amount of pain for the first 48 hours. I ended up giving him some acetaminophen every couple of hours for the first two days and then periodically after that as needed. The wound was white for about the first 10 days and then it looked pink again. They say that with a successful tongue tie revision, you should be able to see a diamond shape. It was really hard to look under Julian’s tongue to see if this was the case but I could tell things were better based on our nursing relationship.

The Ideal Diamond Shape After a Tongue Tie Release

The Ideal Diamond Shape After a Tongue Tie Release (Photo credit: Ghahri, 2014)

We are now 6 weeks past our frenectomy date and I feel like I am finally noticing a difference. To be quite honest, he improved ever so gradually, that it was hard to notice on a daily basis, but when I reflect back to the way things were 6 weeks ago, it’s really a night and day difference. The clicking went on for some time until it finally faded away. He still pops off the breast during my let down from time to time, but that could just be due to my really powerful letdown. He is sleeping better and best of all, I am able to nurse laying down! He still wakes up to feed every 2-3 hours, but that is WAY better than every 45 minutes! At first, I really questioned whether or not getting the procedure was worth it (holding him down screaming, the needle under his tongue for the local, and the blood spurting as the doctor cut all we’re absolutely brutal), but now I am definitely glad we did it. I think that maybe we would’ve had a better experience had we found a pediatric dentist who could do the laser procedure, but that just was not an option for us.

Body Work

Some people recommend chiropractic or CrainoSacral Therapy both before and after the procedure to help release the muscles needed to nurse. CranioSacral Therapy (CST) is a gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance. In her article, CranioSacral Therapy: When Can It Help, by Dee Kassing, BS, MLS, IBCLC, she states that,

“If there is misalignment and imbalance of the skull bones, this can affect the function of the palate, tongue, and other structures of the head. This can cause the palate to be too high or uneven, or the facial muscles to be too tight. Imbalance of the structures of the head, as well as trauma from the birth process itself, can cause constant irritation to the nervous system. This constant irritation may also cause hypersensitivity, which can sometimes be the underlying cause for babies who gag and cannot accept anything in the center or back of the mouth.”

We took Julian to get some CST before his tongue tie release when he was about 5 weeks old, and while it didn’t make breastfeeding better per sae, it changed him in both subtle and powerful ways. He always seemed to be just a little bit fussy, and afterwards he was SO CALM. I would definitely recommended CST for every infant after birth (But that’s another post!). I kept meaning to take him for some post CST, but the timing just never worked out. It is definitely something I would recommend to anyone getting a frenectomy. To find someone who does CST, you can call chiropractic offices that specialize in infants and see if they recommend anyone.

Happy Julian

Happy Julian

More Personal Stories

Like I said, all of our children have had either a tongue tie, lip tie, or both. Too bad I didn’t learn about what they were until recently.

  • Ruby – Looking back, we had a very rough start to our breastfeeding relationship, and now I know that it was due to her having a lip tie. She couldn’t get a good latch, she was constantly popping off the breast, she would spit up A LOT, she couldn’t drain the breast and had green poop, she took in a lot of air while nursing because of the constant on and off and as a result she was very gassy and fussy. Now she is five years old and has a noticeable gap between her front teeth. And sure enough, when we lift her upper lip, there’s a lip tie. It doesn’t seem to be too serious, however, and we are hoping that the gap will close when her permanent teeth come in. If not…braces!
  • Elliot – Looking back, I can see that I had a lot of the same problems with Elliot that I have had with Julian. I just had no idea about tongue or lip ties at the time! I nursed Elliot until he was 18 months old, but had to wean him (before either of us were ready) because it was just too painful. Now, he is four years old and has some speech problems. He cannot say the /r/ or /l/ sound and has trouble with the /c/, /g/, and /th/ sounds. We had the ENT look at him when we were there for Julian’s appointment and he said that he definitely had a tongue tie, but that it wasn’t bad enough to warrant surgery. We have decided to just work with him on correctly pronouncing his letter sounds and hope for the best.
  • Ophelia – Our midwife pointed out that she had a lip tie right away even though I had no idea what that even was at the time. Per her advice, I worked on stretching it out as she suggested and flanging her lip out when she nursed, and it never really became a problem. When her baby teeth came in, there was no gap in between her top front teeth.
  • Julian – I noticed that he had a lip tie right away, so I was able to stretch it out and it wasn’t really an issue. I asked our midwife to look at it during our 6 week visit, and she discovered that he was actually tongue tied. And that is when all of this research began. Full circle.

    Julian's Tongue at 4 Years Old

    Julian’s Tongue at 4 Years Old

For more reading on the matter, check out these resources: Breastfeeding a Baby with Tongue-Tie or Lip-Tie (Resources)

January 12, 2015/by Stacey Maaser
https://embracing-motherhood.com/wp-content/uploads/2015/01/Add-subtitle-text-1.png 400 810 Stacey Maaser https://embracing-motherhood.com/wp-content/uploads/2018/01/EM_Logo.png Stacey Maaser2015-01-12 10:47:552024-06-16 06:59:01How to Identify and Deal with Lip Tie and Tongue Tie

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Stacey Maaser

Stacey Maaser author of Embracing Motherhood

Author of Embracing Motherhood

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Hi, I’m Stacey Maaser,

author of Embracing Motherhood! I am a stay at home mother of 5 with 7 years of teaching experience and a Master’s degree in Curriculum and Instruction. I am passionate about teaching my children, feeding them healthy food, learning the truth about things (not just what is popular opinion or counter culture), and sharing what I’ve learned and experienced with others. Thanks for stopping by!

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