How important is the perfect latch? Related to TT

[ilovetosleep]

Sorry if this is really long.

DS 2 had his tt snipped at 10 days old. He's now just over 4 weeks and I suspect it has grown back slightly/wasn't cut far enough back.

I am considering having it recut as I am concerned about food and speech difficulties in the future. But in terms of long term/ extended BF I am wondering whether not having it cut will have an effect eg, on supply.

The latch is clearly not spot on, he doesn't have a very wide gape and slips back off so that by the end of the feed he is often just sucking on my nipple, maybe a bit more. It doesn't hurt any more, sometimes I get a tugging sensation which is usually remedied by reattaching. I have a fast let down and this, combined with what I guess is a tiring latch for him, means he is asleep/finished within 5 mins despite there clearly being more milk available (just not so easily accessible). He sometimes takes a second side. He feeds 2-3 hrly during the day and 3-4 hourly in the night. He's putting on heaps of weight so no worries there.

Will this feeding pattern effect my supply in the long term? I suppose what I'm worried about is that he is getting all the fast flowing let down milk which is enabling him to put on weight, without having to do a lot of work, and its not encouraging him to learn to suck very ferociously. Is milk supply determined by the actual sucking/stimulation of the breast or the amount of milk that leaves the breast per feed? Also I have read that fore milk is more calorific in terms of sugar but less fatty, so that could explain his early weight gain but that might taper off if my body doesn't get the signal to produce any hind milk? Does it work like that?

I've considered expressing after each feed but don't want to increase supply unnecessarily if there isn't a problem, and I basically don't have time with an older toddler to run around after too. Plus expressing is utterly miserable and I had really hoped to be able to trust my body this time around!

If its relevant, I fed DS1 til 2yrs with no supply issues, although I did express once daily for the first 6 months (for no real reason as he would never take a bottle despite all our efforts!) He was also a very quick feeder (never more than 5 mins each side unless asleep!)

Sorry for ramble. Its all become a bit of an obsession and I'd be devastated to have to give up BF. I really want to feed as long as I did for DS1.

Re TT, I'd rather not get it cut as I have to travel very far, on my own, to get it done, its a long journey and quite disruptive, plus I am also terrified that the cut will disrupt feeding when at the moment we're doing ok. I've read horror stories where babies never feed again after the cut.

Do you sense I have anxiety issues?! Please let me know what you think about it all. I guess my main question is, does a 'bad' latch lead to supply issues if there is currently good milk transfer and no pain for me.

Thanks so much.

Bump... Sorry it's so long!

I can give you my experience - I BF DD with a posterior TT until she was 16 weeks (when we finally got it cut).

I didn't have pain at the start but as she got bigger and whenever she went through a growth spurt I had awful pain and cracked nipples from her feeding harder/longer. Basically she was clamping down to compensate for the poor latch and that caused the cracking. So... don't assume you won't have pain in future (sorry).

I never had supply problems - but I exclusively expressed for the first 3 weeks (DD was prem and tube fed) so my supply was well established by mega hospital pump rather than by her latch iyswim. So may not apply so much to you.

I did have to feed her very frequently - for example at 4 months just before the snip, I was feeding her 5-6 times a day and probably 2-3 at night - whereas non TT babies of the same age were on 4 times a day and 1 or 2 at night. This may not bother you but it is restrictive esp if you have an older DC.

In terms of weight gain, DD seemed to gain weight fine before the snip (was following the 25th centile line) BUT once we had the snip she started to jump centiles and by 9 months she ended up at the 75th centile! so with hindsight I do think the tie was having an effect on weight gain.

Other effects of the TT were 1) she was very windy and this caused her discomfort and awful sleeping; 2) she really struggled to feed when at all tired - got very upset and frustrated; 3) It was very hard to feed in public as I needed an exact position and pillow support to keep her on properly.

Honestly my advice would be to get it re-cut, by someone who can check properly for a deep posterior tie. It's a one off hassle as against the likelihood of feeding being much harder for you (and for your DS) longer term. And there's the possible long term side effects on teeth, speech etc to consider.

I can also give you my experience with ds. He was 100% anterior tt, spotted at birth but not snipped due to anti-snipping midwife. Born at 91st centile and piled on the weight after birth. Feeding was agony and we eventually got tt cut privately at 4wks. Pain didn't really subside until 11wks or so; not sure if tie reformed or, as I suspect, his mouth just grew bigger and latch better.

Ds always latched shallowly and looked like he was nipple feeding; cue hours of traumatic feeding latching and relatching ds to try and get it 'right'. He was also an efficient feeder, no more than 5-10mins each side. Fed 2 hourly until 10mo, night feeds 1-3 times per night. We fed until 15mo when he pretty much self weaned. Supply was never an issue for me; I have very fast letdown and over supply. Spluttering/jet spraying were common events!

BUT somewhere between 4-7 months ds dropped down to 2nd centile and now I've had dd (3wks) I do wonder whether he wasn't actually getting the rich hind milk he'd have to work harder for. He was cleared for any underlying issues and is slowly climbing back up the centiles now.

He's now 2.8yo and speech is brilliant; weaning however was a nightmare. We've had lots of problems with his ability to manoeuvre food around his mouth. Lots of screaming as he couldn't/wouldn't spit food out or swallow it (we had to remove it). BLW but didn't eat much until 1yo really. May have been related to tt (I've always wondered).

Hope some of that essay is helpful! Dd has a small posterior tt but I think it is affecting feeding and will hopefully be getting it cut soon. Can anyone check for you? I'd keep a close eye on weight gain but if you're not in pain then maybe watch and wait for now?
Good luck

DS1 had a tongue tie cut at 3 weeks. He still has some visible tie now (3 years) though eating, speech etc all fine. He never had a perfect latch, always quite shallow and clicky, but it wasn't painful for me - he fed frequently and although he dropped from 75th at birth to under the 25th by 4 months he has remained around there.

Given you have breastfed so long before, I think supply is less of an issue. Once he gets a bigger he will probably start feeding both sides which will help with supply too

DS had his TT snipped three times and it still reattached. He has always been a nipple feeder. He feeds quickly 5 -10 mins and we are still going two years on.

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Thanks for all the replies, sorry i've been a while

I've decided to get it recut. It's nice to read of similar situations and it does seem like it would be very much worth our while to get it re snipped. I don't want to just assume that because his weight gain has been ok so far (although not been weighed since 2 weeks so who knows...) that everything will be ok with regards to solids and speech.

So we are making the journey next week to have it looked at again.

Thanks so much for the detailed replies.