Re: type 4 submucosal posterior tongue-tie?

[Guest guest]

Nadja,

I have to tell you that this post horrifies me! I would never refer a baby to

anyone who would risk general to release a TT or maxillary frenum. Please do not

hear that as a criticism of you--it is clear you did not expect it and were

upset as well. But, I would be very honest with the doctor and tell him that you

have very serious concerns about this and would like to ask him if he would be

willing to change his practice on this. If not, find someone else to work with.

Secondly, you say the baby was born by cesarean--apparently due to medical

intervention--so I would get that baby for structural work right away. Cesareans

structurally injure babies--it really is that simple. In my practice, I try to

make sure every baby is seen by a chiropractor within 24 hours of the release if

at all possible. Without structural work it is impossible to know what it tongue

restriction and what is birth trauma.

One of the first clues to me that a baby is in serious need of intervention is

the description of a " strong suck " , which is compensatory and not normal. I

wonder if that dentist had any idea how one assesses a sub-mucosal tie. When you

examines him, did you push the tissue back and look for one?

Baby has 9 months in utero and 6 weeks in the world--he clearly has developed

the skills his tongue can manage--compensatory " sucking " and clamping. What a

ridiculous statement.

If you are close to San Diego--I would try to get them to Jim .

Tow, IBCLC, France

>

> Permission to post:

>

> Hx: Baby 7 weeks old, born by emergency cesarean; cord wrapped around neck

twice. Mom had a great, easygoing labor, dilated to 5 cm prior to arriving at

hospital, where labor slowed, she was monitored, fetal heart rate scare, made to

lie down, etc.

> Saw hospital LC's and " everything looked great. "

>

> As soon as mom and babe home on day 5, baby " screamed at breast, " and either

latched briefly and fell asleep, or was frustrated, arched back, refused.

>

> Hospital Breastfeeding Center LC's gave her an SNS. Mom has been pumping, and

is not happy with the SNS's cumbersomeness, and her nipples are somewhat sore.

> She calls me at 6 weeks not wanting to quit, but not wanting to continue with

this kind of stress for baby at breast.

>

> Baby's tongue lifts to midline plane with mouth wide open; no visible lingual

frenulum; possibly a slight speed bump, a webbed look under the tongue. Tongue

is completely horizontal, only tipping up at the anterior tip. Baby's sucking

is choppy; mother reports that it feels like biting, clamping.

>

> I repositioned mom and baby in a biological nurturing, laid-back position,

which she found very comfortable and had never tried before. She reports baby

does best at night, lying-down to nurse.

>

> Tight labial frenum clipped yesterday per my referral to ped surgeon, Dr. #1,

to whom I over the past year have supplied numerous TT articles, and even copies

of Supporting Sucking Skills, ch's 8 & 9.

>

> Mom reports baby did well with the labial frenotomy:

>

> " He acted like nothing ever happened immediately after surgery. I already

noticed that he can open his mouth wider. Dr.#2 (another, ped plastic surgeon

and DDS) examined him prior to the procedure and couldn't find anything under

his tongue, "

>

> (I don't know whether he used a grooved obturator)

>

> " but did confirm that his tongue does not function normally, but that he has a

strong suck. Dr.#2 said to give it some time to allow him to further develop

his skills of using his tongue " .

>

> (what is that supposed to mean??)

>

> " Dr.#1 (the ped I refer to) examined his tongue again in great detail when he

was under "

>

> (they used general--ugh)

>

> " and they could not diagnose a tongue tie, yet the symptoms definitely

indicate such. Dr. 2 said that his upper lip was very tight. He immediately

nursed after the surgery. The latch is much better, but we still need to work on

the breastfeeding. I breastfeed him for a few hours on and off today and he

wasn't able to empty my breasts, but i don't get as sore anymore. "

>

> Mom is very motivated, has an appointment with a CST, and has started with the

post surgery exercises. She says with test weights baby is only getting 1/2 to

1 oz per feed at breast today.

>

> I am encouraging her to use special needs feeder first, breast, then pump;

warned that it may take at least 2-4 weeks, probably more as he is older to

transition back to breast completely.

>

> My question is whether it is worth it to go 2 hours away to Poway or San Diego

for another opinion? Anyone here have experience with the Surgeons on

lowmilksupply.org? Otherwise what would be the best way to help her on my

follow up visit with her?

>

> Thank you so much!

>

> Sincerely,

> Nadja Catano, M.A., IBCLC, RLC

> mom of 8, LLLL

>

[Guest guest]

Thank you, . I did refer mom to CST; she has an appointment this week.

Am I understanding you to say that chiropractic in addition to this or instead

of this in cesarean births are best?

When I examined under baby's tongue, I did a finger sweep, as per Dr. (in

Making More Milk); I did not palpate both sides underneath, as I did see

pictured in Supporting Sucking Skills. I am fairly terrified of the whole oral

assessment, but slowly gaining a bit more confidence.

I saw that West recommended Dr. , but it appeared that underneath

his info was the qualifier " For Military Dependents Only; " can anyone still see

him?

Thank you, again

Nadja Catano, M.A., IBCLC, RLC

mom of 8, LLLL

> >

> > Permission to post:

> >

> > Hx: Baby 7 weeks old, born by emergency cesarean; cord wrapped around neck

twice. Mom had a great, easygoing labor, dilated to 5 cm prior to arriving at

hospital, where labor slowed, she was monitored, fetal heart rate scare, made to

lie down, etc.

> > Saw hospital LC's and " everything looked great. "

> >

> > As soon as mom and babe home on day 5, baby " screamed at breast, " and either

latched briefly and fell asleep, or was frustrated, arched back, refused.

> >

> > Hospital Breastfeeding Center LC's gave her an SNS. Mom has been pumping,

and is not happy with the SNS's cumbersomeness, and her nipples are somewhat

sore.

> > She calls me at 6 weeks not wanting to quit, but not wanting to continue

with this kind of stress for baby at breast.

> >

> > Baby's tongue lifts to midline plane with mouth wide open; no visible

lingual frenulum; possibly a slight speed bump, a webbed look under the tongue.

Tongue is completely horizontal, only tipping up at the anterior tip. Baby's

sucking is choppy; mother reports that it feels like biting, clamping.

> >

> > I repositioned mom and baby in a biological nurturing, laid-back position,

which she found very comfortable and had never tried before. She reports baby

does best at night, lying-down to nurse.

> >

> > Tight labial frenum clipped yesterday per my referral to ped surgeon, Dr.

#1, to whom I over the past year have supplied numerous TT articles, and even

copies of Supporting Sucking Skills, ch's 8 & 9.

> >

> > Mom reports baby did well with the labial frenotomy:

> >

> > " He acted like nothing ever happened immediately after surgery. I already

noticed that he can open his mouth wider. Dr.#2 (another, ped plastic surgeon

and DDS) examined him prior to the procedure and couldn't find anything under

his tongue, "

> >

> > (I don't know whether he used a grooved obturator)

> >

> > " but did confirm that his tongue does not function normally, but that he has

a strong suck. Dr.#2 said to give it some time to allow him to further develop

his skills of using his tongue " .

> >

> > (what is that supposed to mean??)

> >

> > " Dr.#1 (the ped I refer to) examined his tongue again in great detail when

he was under "

> >

> > (they used general--ugh)

> >

> > " and they could not diagnose a tongue tie, yet the symptoms definitely

indicate such. Dr. 2 said that his upper lip was very tight. He immediately

nursed after the surgery. The latch is much better, but we still need to work on

the breastfeeding. I breastfeed him for a few hours on and off today and he

wasn't able to empty my breasts, but i don't get as sore anymore. "

> >

> > Mom is very motivated, has an appointment with a CST, and has started with

the post surgery exercises. She says with test weights baby is only getting 1/2

to 1 oz per feed at breast today.

> >

> > I am encouraging her to use special needs feeder first, breast, then pump;

warned that it may take at least 2-4 weeks, probably more as he is older to

transition back to breast completely.

> >

> > My question is whether it is worth it to go 2 hours away to Poway or San

Diego for another opinion? Anyone here have experience with the Surgeons on

lowmilksupply.org? Otherwise what would be the best way to help her on my

follow up visit with her?

> >

> > Thank you so much!

> >

> > Sincerely,

> > Nadja Catano, M.A., IBCLC, RLC

> > mom of 8, LLLL

> >

>

[Guest guest]

You are right--I forgot that Jim cannot see them, but he has been training other

docs in the area. Shari Silady would be the best person to ask. My preference in

almost all cases is a ped chiropractor, but in some cases a CST has better

skills. You have to know your community, but I find ped chiros have better

training related to birth trauma and breastfeeding in general.

Tow, IBCLC, France

> > >

> > > Permission to post:

> > >

> > > Hx: Baby 7 weeks old, born by emergency cesarean; cord wrapped around neck

twice. Mom had a great, easygoing labor, dilated to 5 cm prior to arriving at

hospital, where labor slowed, she was monitored, fetal heart rate scare, made to

lie down, etc.

> > > Saw hospital LC's and " everything looked great. "

> > >

> > > As soon as mom and babe home on day 5, baby " screamed at breast, " and

either latched briefly and fell asleep, or was frustrated, arched back, refused.

> > >

> > > Hospital Breastfeeding Center LC's gave her an SNS. Mom has been pumping,

and is not happy with the SNS's cumbersomeness, and her nipples are somewhat

sore.

> > > She calls me at 6 weeks not wanting to quit, but not wanting to continue

with this kind of stress for baby at breast.

> > >

> > > Baby's tongue lifts to midline plane with mouth wide open; no visible

lingual frenulum; possibly a slight speed bump, a webbed look under the tongue.

Tongue is completely horizontal, only tipping up at the anterior tip. Baby's

sucking is choppy; mother reports that it feels like biting, clamping.

> > >

> > > I repositioned mom and baby in a biological nurturing, laid-back position,

which she found very comfortable and had never tried before. She reports baby

does best at night, lying-down to nurse.

> > >

> > > Tight labial frenum clipped yesterday per my referral to ped surgeon, Dr.

#1, to whom I over the past year have supplied numerous TT articles, and even

copies of Supporting Sucking Skills, ch's 8 & 9.

> > >

> > > Mom reports baby did well with the labial frenotomy:

> > >

> > > " He acted like nothing ever happened immediately after surgery. I already

noticed that he can open his mouth wider. Dr.#2 (another, ped plastic surgeon

and DDS) examined him prior to the procedure and couldn't find anything under

his tongue, "

> > >

> > > (I don't know whether he used a grooved obturator)

> > >

> > > " but did confirm that his tongue does not function normally, but that he

has a strong suck. Dr.#2 said to give it some time to allow him to further

develop his skills of using his tongue " .

> > >

> > > (what is that supposed to mean??)

> > >

> > > " Dr.#1 (the ped I refer to) examined his tongue again in great detail when

he was under "

> > >

> > > (they used general--ugh)

> > >

> > > " and they could not diagnose a tongue tie, yet the symptoms definitely

indicate such. Dr. 2 said that his upper lip was very tight. He immediately

nursed after the surgery. The latch is much better, but we still need to work on

the breastfeeding. I breastfeed him for a few hours on and off today and he

wasn't able to empty my breasts, but i don't get as sore anymore. "

> > >

> > > Mom is very motivated, has an appointment with a CST, and has started with

the post surgery exercises. She says with test weights baby is only getting 1/2

to 1 oz per feed at breast today.

> > >

> > > I am encouraging her to use special needs feeder first, breast, then pump;

warned that it may take at least 2-4 weeks, probably more as he is older to

transition back to breast completely.

> > >

> > > My question is whether it is worth it to go 2 hours away to Poway or San

Diego for another opinion? Anyone here have experience with the Surgeons on

lowmilksupply.org? Otherwise what would be the best way to help her on my

follow up visit with her?

> > >

> > > Thank you so much!

> > >

> > > Sincerely,

> > > Nadja Catano, M.A., IBCLC, RLC

> > > mom of 8, LLLL

> > >

> >

>

[Guest guest]

I am lucky. I have a chiro who does cst.

Pam

Pam MazzellaDiBosco. IBCLC