Evaluation for tongue/lip tie UPDATE

[polarbearfans]

I have only been talking about it for over a month now, but I finally set up an appointment to have the baby checked for tongue/lip tie. I am not having the revision done today if the pediatric dentist feels it is needed because i cannot talk to my husband, but she is being looked at by someone who is very familiar with posterior tongue ties.

I'm not sure what to expect. The appointment is long, but that is because it includes time for the procedure.

I'm a bit stressed. We have an hour drive and I hate not being able to see the baby. She has been choking more often on her salvia and spitup. I am nervous that the doctor will say she has tongue/lip tie and needs revision but also nervous she will say she doesn't because then I have no idea what our next step is.

Any tips for questions i should ask? I would prefer to avoid revision if possible whether that is through CST or more effort on my part when she is nursing or whatever else helps. Last night she was going crazy stretching her tongue around, so I am wondering if she just needs time to get things figured out.

UPDATE:
I took her to the appointment. She has a class 3 lip tie and class 4 tongue tie. I did not have it lasered. Once I go over everything with my husband, i will call and set up a time. they are booked the next 2 weeks but said they would squeeze us in sooner. Yes, I know we could have had it done today and i was lucky to get an appointment so soon, but I did not get it done. It is going to cost $100 more than if i did it today, but that is ok. My husband knew that going in, and I know it is important to him to be included in this decision. If I hadn't kept researching and pressing for answers, we would have never known and would not have had this corrected until other complications that may have popped up later in life. The baby did not mind the exam at all. She kept sticking out her tongue and playing around.

[origami]

I am biased b/c of my experience with DS2 but IMO I think you should just get it done. My DS2 had a tongue tie, but b/c he was bottle fed it wasn't a big issue with feeding. He gained weight appropriately. So our docs were in the "wait and see if there are other problems" camp. Sure enough 2 years later he had speech issues. He had a frenectomy at 2y and had to be put under anesthesia. It was such a PITA for something that could have been so simple had he done it as an infant. Even after that I had to do tongue exercises with him, and still to this day he is lazy about tongue movements. I had a tongue tie clipped as an infant and (I'm told) it was super fast and NBD - and that was with a scalpel and no anesthesia. So yeah, if I could do it again, I'd have fixed DS2 before he even left the hospital.

[polarbearfans]

Sept 1, 2015 5:07:23 GMT -5 origami said:

I am biased b/c of my experience with DS2 but IMO I think you should just get it done. My DS2 had a tongue tie, but b/c he was bottle fed it wasn't a big issue with feeding. He gained weight appropriately. So our docs were in the "wait and see if there are other problems" camp. Sure enough 2 years later he had speech issues. He had a frenectomy at 2y and had to be put under anesthesia. It was such a PITA for something that could have been so simple had he done it as an infant. Even after that I had to do tongue exercises with him, and still to this day he is lazy about tongue movements. I had a tongue tie clipped as an infant and (I'm told) it was super fast and NBD - and that was with a scalpel and no anesthesia. So yeah, if I could do it again, I'd have fixed DS2 before he even left the hospital.

That is a good point about effects later in life. I wouldn't be able to do it today because my husband doesn't have phone access and I would prefer he be with me. I also would want him to drive.

[anna7602]

I cannot relate to being in a position in which revising the tie is an option to be discussed and delayed. I took an hour-long train ride to Long Island to see a specialist and basically wasn't going back to the city unless something changed.

[starburst]

I was also hesitant about getting DS's tongue and lip ties revised because he was just so little and I didn't want to put him through it. After some frustrating nursing sessions, I decided to go ahead and at least get the tongue tied revised. The procedure was so fast and it really didn't seem to bother him much. The dentist used a water laser. I ended up getting his lip tie done a couple of weeks later. That one did cause a little bleeding, and he was a little fussy afterwards, but was back to normal the next day.

Check with insurance to see if it's covered. The dentist said that if dental insurance won't cover it, sometimes your health insurance will. My dental insurance covered both 100%. I'm glad we got it taken care of now so we don't have to worry about potential speech and oral hygiene issues down the road.

[polarbearfans]

Sept 1, 2015 5:53:30 GMT -5 anna7602 said:

I cannot relate to being in a position in which revising the tie is an option to be discussed and delayed. I took an hour-long train ride to Long Island to see a specialist and basically wasn't going back to the city unless something changed.

I cannot make a non-urgent medical decision for my child without discussing with my husband. She is his child too. If a revision is recommended, I can take her back tomorrow or the day after depending on their schedule. It is no different than me having this consultation later in the week. If my husband cannot come, I will take a friend. I prefer to not be alone.

It costs $100 more by delaying it a day because I have to pay for today's appointment. My husband is on board with my need to have her examined by a pediatric dentist even though the ENT didn't feel there was a problem, but he will want facts before I have a procedure done. I want facts before having it done. Unfortunately with his job, he is unavailable by cell phone today (phones not allowed). I can only reach him in case of emergency.

[anna7602]

Okay, again, I can't relate to "non urgent." If it's so easy to get in to see this specialist again, why not just save yourself the trip today and go when your H can accompany you? Seems like a lot of hassle.

[thebreakfastclub]

I don't understand either.

I guess we would just discus it in advance and decide to go for it if the doctor suggested it. It seems like a huge hassle that you might as well get out of the way.

[auntie]

I agree with anna7602.

If this isn't urgent enough to have the procedure at the initial appointment, reschedule when your DH can be there. The idea of putting your baby through the exam which will annoy the shit out of her and then through the re-exam and procedure on another day seems like something to avoid.

DH traveled a lot when DS was younger. DS is 22, so much of his childhood emergencies happened before smartphones.  There were times when DH had to trust me make the decision without his input.

I used to counsel bfing moms as a peer mentor. I don't know anyone who regretted this procedure, even when their team was not unanimous in their opinion on whether it was truly needed.  

[Brie]

Revision isn't really something to be avoided. If it is tied, it needs to be revised. It's not just a nursing issue. It can affect speech, eating solids, and cause tooth decay if not released. Our OT has stressed this to me on more than one occasion and is so happy we caught P's early and had both his lip and PTT lasered.

[mcfelix]

Well the LC came to my house last night. She watched me latch DS and how she fed. She tried to adjust DS and saw how DS just couldn't stay latched more deeply. She also stuck her finger in DD's mouth to check her suck.

She also looked at my nipples to see if there were signs of trauma, which there are.

After that she looked in her mouth - lifted up both of her lips and lifted up her tongue.

I am calling the dentist today to schedule an appt. she said he will probably want to see me latch, but may just look at her before he clips her.

The LC gave us a lot of good info. She said it is actually better for my to pump instead of attempt to nurse bc DD is an incredibly inefficient nurser right now. She is gaining weight but the LC commented that milk was basically falling out of my boobs since this is my second and my milk came in earlier. I will take DD to the appt by myself if I have to bc I want this done ASAP so we can go back to nursing.

[polarbearfans]

They were able to fit me in today which is why we are going. My husband'a work schedule is full this week which is why I am taking her for the consult alone. He can make it work if she needs it done. At this point there are a lot of maybes. Her ENT and lactation consultant don't see an issue, but neither are familiar with posterior ties, and the ENT said it's debatable whether lip ties need corrected. So from my husbands perspective, there is nothing wrong.

I was asking what to expect because I wasn't familiar with the exam. Now it sounds like it is uncomfortable and that maybe I should cancel until next week.

eta: I just brought up getting it done today if needed and he said that the ENT said she was fine. He puts a lot of trust in doctors, and i question and seek second options if something doesn't seem right. I think the ties are there, which is why I am just going straight to the person who would revise them. I'm cutting out the middle man. He isn't the one breastfeeding and doesn't understand what it is like. He hears the lactation consultant say she has a great latch but he cannot feel her slipping back or how the suck changes. Im doing the best I can for her. It's frustrating because I'm the one who is with her all day and dealing with her reflux, breathing, and nursing issues.

[hbomdiggity]

If your H is already questioning the tie, then wait until his schedule allows him to go to the appointment. That way he can ask the questions, have the docs show him the issues etc.

otherwise it's just going to be you trying to relay the info. And in that case, I agree with Anna that this is something that can be discussed beforehand.

[rxbeth]

That sounds very frustrating. I agree that I would try to wait for an appointment when DH could go.
DS had a very obvious tt (4th degree) and I remember worrying whether revising it was the right thing to do. I don't remember the exam bothering him and the dentist doesn't have parents go back at our office. He came back to me a few minutes later totally fine. He slept through the first set of stretches at the office and nursed well. Stretches were a nightmare after that, though. He's freakishly strong and was biting me through the stretches within a few days. That said, I'm very glad we had it done. He was 6 days old
Good luck

[lolo]

There are a specific set of tests for posterior tongue ties. They often can't be seen visually and can be easy to miss.

Maybe your husband would feel more comfortable if he read about those and confirmed that the ENT didn't do them?

You are your advocate as well as your child's. I understand your husband's hesitations to some extent, but I think you need to be more insistent.

[litasail]

The revision really is not a big deal/risky thing, and it can have SUCH a positive impact moving forward. I would do it today. And I say this as someone who had to have my son's anterior and posterior ties revised in two separate procedures on different days.

[anna7602]

Is your H a medical professional? I don't get the need for a delay. By two weeks post-revision, DS was completely healed and we'd already been to a few CST sessions. This whole situation still strikes me as odd.

[polarbearfans]

Sept 1, 2015 13:14:03 GMT -5 anna7602 said:

Is your H a medical professional? I don't get the need for a delay. By two weeks post-revision, DS was completely healed and we'd already been to a few CST sessions. This whole situation still strikes me as odd.

My husband heard several medical professionals say there was no tongue tie or any problem from a lip tie. That is the problem. He doesn't question doctors as much as I do. He also isn't close enough to the situation to know something isn't right. He cannot breastfeed and feel what I feel. To him I just keep shuffling this baby from one doctor to the next without ever being satisfied. I'm on our 2nd pediatrician and about to be on the 2nd GI. He has been at the various appointments where I have been told no problem with her tongue or lip. He was standing in the kitchen and heard the LC say her latch is great and her intake is great going by her weighed feeds, which they are but my nipples are getting tore up and she has a weak suction most of the time and very sleepy.

It is just frustrating trying to figure out what is going on with babies. Training varies so much with the pediatric doctors. I have pictures and information for him to read on the subject. She will get the revision. It will be discussed as a family first. I'm glad I had today to go over the information and speak to the doctor with no pressures. I have been researching this for over a month but it was nice to ask all my questions and the time to process. I've had every professional we spoke with over the past 7 weeks saying she is fine other than the bad reflux

[polarbearfans]

Sept 1, 2015 13:58:32 GMT -5 @this said:

I'm confused about how your husband apparently blindly trusts doctors too much, but how he wouldn't consent to a necessary and very minor procedure beforehand? Something seems off.

Oh well. I'm glad you're getting it fixed in two weeks.

I'm getting it fixed tomorrow evening. I just got off the phone with my husband. I said they were booked for the next two weeks but would fit us in sooner since she doesn't need the full appointment slot.

To him, this isn't just a minor procedure. He wanted information, he got it, and now she is getting everything done.

[polarbearfans]

Sept 1, 2015 15:35:03 GMT -5 Maud said:

That's great you got another appointment so soon. Hope everything goes well and you start to see an improvement soon.

Thank you. I am hopeful. It has been a long stressful 7 weeks. I've already verified everything with her pediatrician since this is shifting her reflux meds a couple hours, and we are doing a bit of Tylenol. Now I just needs things to fall in place with the LC.

[lolo]

Sept 1, 2015 15:14:42 GMT -5 polarbearfans said:

Sept 1, 2015 13:58:32 GMT -5 @this said:

I'm confused about how your husband apparently blindly trusts doctors too much, but how he wouldn't consent to a necessary and very minor procedure beforehand? Something seems off.

Oh well. I'm glad you're getting it fixed in two weeks.

I'm getting it fixed tomorrow evening. I just got off the phone with my husband. I said they were booked for the next two weeks but would fit us in sooner since she doesn't need the full appointment slot.

To him, this isn't just a minor procedure. He wanted information, he got it, and now she is getting everything done.

Well, I'm glad you are able to get it corrected soon. 

I wonder if there is a way, with future medical decisions, for you to discuss contingencies ahead of time. Like, if the diagnosis is X, we will do Y, but if it's Z, we will wait and see. 

There are A LOT of decisions to make as a parent when it comes to your child's health. Yes, you should both have a say and have the opportunity to voice opinions, but there is also an element of personal responsibility in researching. Sometimes we are surprised by things at pedi appointments, but most of the time, you can read up on it ahead of time, discuss it, and avoid the spur-of-the-moment (in)decision.

[lolo]

Also, if your nipples have trauma, APNO is a fucking god-send.

[lolo]

And finally, LOL that your husband trusts drs SO MUCH but doesn't trust them when they say this is minor.

[polarbearfans]

Sept 1, 2015 16:50:37 GMT -5 lolo said:

And finally, LOL that your husband trusts drs SO MUCH but doesn't trust them when they say this is minor.

Thank you for the tip on the nipple ointment.

The problem was nobody telling him it was a minor quick procedure. He was only being told that it didn't need done.

I have no problem making medical decisions that need immediate or quick action. I've taken her in a few times with no discussion and have made all medication decisions. This did not need immediate action and he didn't want it done today without more information.

[anna7602]

Sept 1, 2015 17:04:39 GMT -5 polarbearfans said:

Sept 1, 2015 16:50:37 GMT -5 lolo said:

And finally, LOL that your husband trusts drs SO MUCH but doesn't trust them when they say this is minor.

Thank you for the tip on the nipple ointment.

The problem was nobody telling him it was a minor quick procedure. He was only being told that it didn't need done.

I have no problem making medical decisions that need immediate or quick action. I've taken her in a few times with no discussion and have made all medication decisions. This did not need immediate action and he didn't want it done today without more information.

I do not live in a universe in which nipple damage does not require immediate action! Anyway, I'm glad you're getting the ties taken care of. Know that you may still have some work to do, such as daily exercises or some kind of therapy, but it's doable. I'm still nursing at 13 months thanks to everything we did to address DS's tongue and lip ties.

[rxbeth]

Wow, a class four tongue tie that you had other people evaluate (including an LC) that didn't get caught? That is absolutely ridiculous. My DS had a class 4 tie and even I could tell that as a layperson. I've only seen a few of your posts but you're dealing with a lot of reflux and GI issues? Getting the ties revised should be a game changer and give you some improvement on that front.

Make sure that they go over the stretches that you need to do so there is no reattachment.

I also recommend the APNO. While I waited the weekend to get my sons tie released, I made sure to get some of that for my poor nipples.

I hope the release helps you out! Let us know.