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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

small tongue, clicky lartch and reflux!

31 replies

narmada · 10/11/2010 19:45

Have had more than my fair share of help on here but have a new question....

went to BF cafe today and saw BF counsellor who noted my DS 3 weeks has a v small tongue (and slightly recessed chin) which he never ever pokes out and which can't extend over the gum. He has a clicky latch, more so on one side than the other. he is swallowing lots of air feeding which is making him uncomfy, and this seems to compound the reflux he has also been diagnosed with and which he is now on meds for :(

is there anything i can do to help improve the latch to take acccount of his tiny recessed tongue?? his frenulum does not look tight and no-one (many have looked) can see a tongue tie.

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Original poster

narmada · 10/11/2010 19:47

errr, i could try and spell properly in my thread title, couldn't i?? i meant latch of course. typing one handed....

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foxytoxin · 10/11/2010 19:54

It sounds like he is TT. there are different types of TT. I think you ought to get it assessed again by someone who may know more about what they are talking about.

this link and related pages may be helpful

and this one: scroll down to attachment exaggerated attachment

Original poster

narmada · 10/11/2010 20:13

thanks foxy, will have it looked at then. One of the hospitals is reasonably near us.

I have never had sore nipples or any pain but I guess that doesn't mean anything ...

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TruthSweet · 10/11/2010 21:48

It could be a bubble palate/very high arched palate. These can cause clicking noises with out any pain. They do grow out of it (making the noises rather than the palate shape).

Talk to a bfc or phone NCT/LLL/ABM/BfN helplines for advice.

Original poster

narmada · 11/11/2010 09:57

thanks truth we have an appt with a lact. consultant on monday so hopefully she will be able to shed some light on things. she is also the local tongue tie clipper so if it does turn out to be that he might get some relief....

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Original poster

narmada · 15/11/2010 13:37

truth and foxy you were unbelievably both right, posterior tongue tie and a high arched palate. Poor little bugger.

The question now is whether I get him clipped. He is already fairly unhappy/ a fussy feeder with the reflux and I am a bit worried that inflicting more (short term) suffering on him might make things worse, especially if nursing afterwards is uncomfortable for him. I don't want to do anything to make feeding more unpleasant for him than it already is. Oh good grief, why can't anything be straightforward????????? arrrrrrghhhhhhh.

The LC offered to do the TT then and there or refer us to a clinic at King's to have it done. I just don't know what to do.

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xMrsSx · 15/11/2010 14:26

My DS had a posterior TT (missed at the hospital) which I thought might be effecting his latch/efficiency of feeding though I wasnt sure, and the mw thought not. We got referred and he had the snip at 8 days old(took about a min and he wasnt even crying afterwards), and he fed no probs immediately after. Over the last few days his feeding has got better and better and much quicker/less fussy. I obviously don't know if this is down to the TT or not but just wanted you to hear a positive story about the snip, and of course all babies are different.

He has now passed his birthweight (put on 10oz in the last 4 days) and I can't help feeling like Mrs SmuggyMcsmuggness!

There is light at the end of the tunnel narmada and good luck with whatever you decide. I'm sure there will be someone more qualified along in soon to give you some proper advice.

TruthSweet · 15/11/2010 14:41

Whether you do or don't have the tongue tie done then there will be clicking until around 4-5 months (that is usually but who knows with babies ) as that is due to the high palate (quite often high palates form along side with TT in utero).

On the tongue tie front you may need to get it snipped later due to speech issues (a possibility NOT a given) so perhaps having it done at such a young age is better (older toddlers/babies need a GA for a TT snip).

The TT snip may make for easier feeding as then the tongue is free to make a peristaltic motion (wave like) rather than the uneven tongue motion of a TT baby. Have you tried getting him to suck your finger to feel how he suckles? If there is not even contact/pressure on the finger with his tongue, then that may be how he is swallowing so much air whilst feeding.

Original poster

narmada · 15/11/2010 15:04

the LC said the tongue motion was uneven - sort of one-sided too - and not forming a complete seal. I think we should get it done - home or hospital is now the question. do you know whether posterior ones bleed more/ are more painful than anterior ones, truth? am i being daft and should i just let the LC do it on the kitchen table??! She has been trained by a surgeon with a special interest in posterior TT....

xmrsx well done you, sounds like you have reason to be smug - 10 oz in 4 days .

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TruthSweet · 15/11/2010 15:59

I've no real experience with TT but all three of my DDs have a bubble palate/high palate.

I'd have a look at this presentation for some really in-depth information (evidence based not opinion based) on whether to have a frenectomy/frenotomy/z-plasty (all will be explained in the presentation). You may wish to skip slides 40-42 and 92 as they show operation/stitches if you are squeamish.

I hope this helps with making your decision.

TruthSweet · 15/11/2010 16:16

Sorry I linked you straight to the presentation - there are explanatory notes here and also this presentation but be warned it does contain autopsy slides (16-19 & 26) so it's understandable if you wish to just read the notes for these.

Original poster

narmada · 15/11/2010 16:57

truth, wow, that is really interesting, thanks. particularly interesting to see TT can be linked to 'gastric distress'. So could be making reflux situation worse.

given the reflux and how squirmy/ wriggly DS is i think maybe we will get him clipped in the hospital. i have visions of him moving violently and them lacerating a blood vessel or something! bu mabe i am over-worrying....

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TruthSweet · 15/11/2010 18:00

In the 'good old days' apparently mws grew a little finger nail really long so they could 'snick' a TT as soon as baby was born.

If it makes you feel more comfortable with the procedure then do it at the hospital. The only thing would be if the next appointment was weeks rather than days away then in all honesty I think I'd have it done by the LC.

foxytoxin · 15/11/2010 19:37

In my limited opinion, get is sorted asap.

Going by the information I have read on the Brian Palmer website already linked by Truthsweet, it can solve a lot of problems which have not yet manifested themselves.

Plus the older a baby is, the more mature the tissue becomes and more traumatic (to the tissue) the operation will be.

Maybe ask the LC if you do it now if Cup feeding would help? The LC will have a broader and more in depth knowledge and access to knowledge than use people like myself on a message board.

Original poster

narmada · 15/11/2010 19:39

yes i agree - if it's weeks away, then the LC can do it. think the clinic is weekly tho so we might get seen soon......hopefully.

funny about the fingernail thing - laughed when i saw that in the presentation notes too!

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foxytoxin · 15/11/2010 19:44

besides speech, later on TT can cause problems with teeth formation (permanent teeth), chronic acid reflux in adulthood and the associated problems (like bad breath) and not so severe but still crucial, french kissing and even licking an ice cream.

(all gleaned from the Brian Palmer site btw).

I'd get it done sooner rather than later and maybe to ease your worries, in hospital.

Original poster

narmada · 15/11/2010 21:50

Yes agree. Sooner the better I think.

Maybe it will do something to calm him down more generally. At the moment, we are having nearly 3 hours of almost inconsolable screaming in the evenings, to add to the general unsettled-ness in the day. He fusses during this time - but it doesn't seem to be the normal fussiness/ cluster feeding as he won't go on the breast - just thrashes around shaking his head from side to side over the nipple, the only thing that will soothe him is sucking on my little finger - but he is still absolutely wide awake and frantic-looking. It is driving me absolutely NUTS and I feel so bad that I don't know what's bothering him.

Sorry - off-topic rant. But the whole thing is just doing my head in at the moment.

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foxytoxin · 16/11/2010 04:59

poor you and poor baby. I think the two things are connected. babies have a strong suckling reflex and this is getting in the way of him doing so. it will be much better for both of you when it is sorted.

Original poster

narmada · 16/11/2010 13:37

thanks foxy.

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TruthSweet · 16/11/2010 18:24

I'm sure this is old news to you but just in case:-

Have you tried Nurturing aka Laid back nursing? It works by using baby's feeding reflexes to aid the baby latching on for them selves as sometimes trying to feed in a traditional upright position can make their feeding reflexes work against latching them on. The 'worrying' of the nipple like a terrier can help prepare the nipple for feeding in the BN position. It may not help but it could be worth a try?

Also have you tried daisy chain massage (rub lots of little circles in a big circle about 2-3" out from the tummy button) or bicycling baby's legs to see if that eases the gas pains?

Original poster

narmada · 16/11/2010 20:01

Truth, thanks - we tried the bio nurturing but couldn't get the hang of it at all. He carried on thrashing like a terrier, and didn't seem able to latch. The LC kept saying 'oh, he'll shake his head 5 or 6 times and then he'll latch, but.....nope! Thanks for the idea tho.

I will try the tummy rubbing. The gas mainly comes up the other way - massive burps and I can see his tummy deflate :(

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TruthSweet · 16/11/2010 20:46

Your poor little DS I wish I had a magic wand and could stop his pain. DD1 had bad reflux as a baby and I hated seeing her cry when there was nothing I could do to ease the pain. We even gave Medised once she was over 6 months to ease the pain but it wasn't really effective [note: this was when Medised was for over 6m not over 6 YEARS like it is now we weren't drugging her for fun!]

Original poster

narmada · 16/11/2010 21:34

Ahhh, thanks Truth. That's really nice of you. DS has today been prescribed a new med for the reflux - Omeprazole - thankfully we have a fairly clued up GP, so I am hoping that is the magic bullet, along with the tongue tie division...Did you use anything for your DD in the end?

You don't have to explain about Medised , it was still available when my DD was about 6 months and she had it on occasion. Likewise it did nothing for the reflux pain at all (She had it too). And I don't think it even made her sleep from what I can remember.

DP is currently doing the pacing shift trying to get DS off, and I have to admit to being sat here with a large glass of wine to drown my sorrows.

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TruthSweet · 16/11/2010 22:15

I've had omeprazole (had gall stones/pancreatitis mis-diagnosed as heartburn - nice) and boy do they minimise the old stomach acid

DD1 had domperidone which speeds up the transit of milk/food through the gut so it's not in their tummy for long (hopefully moving it on to the guts before they're sick again). That worked wonders and she actually stopped losing weight and started gaining.

splatt · 18/11/2010 09:11

`Very interesting this thread. DD only reached birth weight yesterday at 4 weeks. BF counsellor came out to house for an hour. She felt DDs tongue was quite short and so making feeding hard work. We're trying nipple shields to give her more to latch on to. What am I looking for to check she doesn't have a posterior tongue tie?

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