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Jessica M. Lang: Tongue-Tied? Snip that Frenulum

In our very imperfect world we love to seek perfection, especially in our children. I remember when my sons were newborns, I gazed in utter amazement at their perfect skin, perfect bodies, perfect peace. 

I distinctly remember the moment I discovered that my son Brady was tongue-tied. It was as if I was listening to ENYA and then all of the sudden the record screeched to a stop. His tongue was connected all the way to the tip.  He had an attached frenulum. This was not perfect. This would require intervention.  I began to get distraught and anxious…I immediately called my mother with the “devastating news”. 

I am being dramatic in retrospect because I now know that it was an easy fix. Stressful, yes.  Painful for Brady, yes, but only for a split second. Apparently it is quite common for a child to be tongue-tied. In fact, midwives used to check for this congenital defect, technically known as Ankylogossia, immediately after birth. They would use a little T-shaped scalpel and the tongue would be instantly freed for easier feeding.

From birth, it seemed that Brady was a nice, easy and gentle nurser.  He didn’t have the bitey newborn latch that my older son had.  I attributed that to being an experienced nursing mother.  However, Brady had more of a “lazy latch“. He  was constantly coming off the breast and having to re-latch.  In between the latch and unlatch I would have to completely dry myself off or he wasn’t able to get any suction.  He also vomited….a lot.  He was not just spitting up, he was losing almost the whole feeding about half-way through nursing.  It was scary to me, but I was told it was just reflux and that some infants have an under-developed upper digestive tract.  I thought he’d grow out of it.

Brady was just over 3 weeks old when I noticed his very tight lingual frenulum (the thin membrane that is under your tongue attaching it to your lower jaw). He was beginning to open his mouth more and smile.  It was the first time I actually even looked at his tongue, honestly, and all of the breastfeeding issues that we were having suddenly made sense

Ankylogossia (tongue-tie) is usually a hereditary congenital defect. I have a close relative who was tongue-tied at birth. Nobody knew about it until he was 2 years old and by that point he had to have an invasive procedure to correct the problem which was causing a speech impairment. Luckily, since I knew about my relatives attached frenulum I called the doctor right away to have an evaluation. Opposing points out some different types of tongue-tie and how they can missed very easily, even by doctors and lactation consultants.

Our pediatrician was so understanding of my emotions surrounding the “snip” and we ultimately decided to go through with the procedure (frenetomy).  He was supportive and explained that the membrane (frenulum) was so thin at this age (4 weeks old) that it would be like trimming a finger nail or pulling off a hang-nail.  It would hurt, but only for a split second and that I should put the baby to the breast immediately after freeing the tongue. 

He also let me know that we might see a white canker like sore under the baby’s tongue for about a week.  A nurse swaddled the baby and held his head straight and they put a little bit of sugar on his tongue to distract him and boom, it was done right after it started.  He cried hard for about a minute and then latched right on to the breast.  His tongue was freed and the frenotomy was a success!

The exorcist vomiting stopped immediately. Apparently, before the frenotomy he was having to suck improperly and it was causing him to choke when let-down began, thus the major throw-ups.  The lazy latch problem got better over a period of about 3 weeks.  Since that time, Brady, has been a champion nurser and loves to stick out his FREED tongue!…and when he does, he looks simply PERFECT, and to me he always will.


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