Guest post by Jenny
Because my son was poked and prodded in the hospital so many times, I was reluctant to get his tongue and lip tie repaired. I had low milk supply, he had reflux, it was awful.
I decided to pay the $500 and have it fixed with a cold laser. I regret it to this day. He had already been put through so much pain in the hospital, but I was reassured that the laser correction would solve all our problems. It didn’t 😦 He still had a bad latch, my supply didn’t improve, and he still had reflux.
I regret putting him through that pain for nothing. Next time, I will wait.
Jenny is a first time mom who tried for 6 years to get pregnant. Her son was hospitalized at 2 weeks old for salmonella meningitis. Tongue and lip tie was not diagnosed until he was 4 months of age.
Guest Post by Laura Langham
My son and I struggled with breastfeeding from the get-go. I heard about lip and tongue ties and I suspected he had one from the very beginning, but a fellow mom assured me he didn’t.
We became dependent on a nipple shield, though I never wanted to use it in the first place. I was so desperate to make our nursing relationship last that I kept with it. After about 6-7 months, my son stopped practically gaining weight and even lost a few oz. I had a nagging feeling inside me that it was the tie I had suspected all along.
I took him to his pediatrician and he told me that my son had normal frenulum and insisted so much that I was doing something wrong and starving my child that he reported us to the local child protective services. Their investigation concluded that his claims were unfounded and that we were taking good care of our son, but it led me to some amazing IBCLCs that referred me to an ENT. The ENT’s visit finally came and the doctor confirmed what I had insisted was the problem all along—a tongue and upper lip tie.
Within 2 weeks, we had them both cut through electrocautery, and within 2 weeks, my son had started gaining more than adequate weight. The months of breastfeeding through the ties (and with the nipple shield) did a number to my milk supply because proper suction was never established, but his nursing got so much stronger and more frequent after having his ties taken care of.
About The Author:
Laura Langham is a mother to two amazing children, with one on the way, wife to her awesome husband and a friend to anyone in need.
It’s been 5 months now since my daughters had laser frenectomies for their upper lip ties. Many people have been asking me for an update on how they are doing now.
My 3yr old is in corrective speech and has improved a TON. Her teeth have not gotten closer together as some experienced but there is now the potential for her adult teeth to come in together while pre-frenectomy- the skin to the lip was far too thick between the teeth for that to be a possibility.
My now 1yr old (was 8 months old when she had the procedure done) is doing great! It never again hurt to nurse her for long periods of time like it used to and her teeth have grown in together in a way that wouldn’t have been possible before with the degree of her lip tie.
Here are some photos of how they look now.
For more info on upper lip ties and laser frenectomy- Check HERE
This is an account of our experience finding out about my daughter’s upper lip tie (with the focus on my youngest) and some Q&A on Frenectomy’s. This post also is a guest post on Ask The Lactation Consultant.
When my youngest daughter was 8 months old I discovered, through my 2 year old’s speech therapist, that both my younger two daughters had upper lip ties. This area of the mouth is called the frenulum labii superioris and it is an area I had never heard of being an issue. I was well versed in tongue ties, having known plenty of people whose infants had them- some of which pursued having it clipped while others worked with a lactation consultant to have the latch corrected and left the tie intact. This issue with a lip tie was new to me, though, and it got the wheels in my mind churning about breastfeeding.
Grace was already 8 months old at this point and she was growing and thriving on an exclusively breastfed diet (with a few solids beginning to be thrown in the mix now). Nursing was not excruciating and if her latch was shallow, it was not shallow enough to cause any real pain for me or prevent her from receiving a sufficient supply of milk. Yet, I could not help but think about how whenever she nursed for an extended period of time, there was pain. I would get sharp pains after ten minutes of nursing on one side. I always excused it as her latch getting lazy as she drifted to sleep and I changed sides frequently to be comfortable. I studied for a couple weeks and spent many hours on the phone with dentists, ENT’s, and other pediatric specialists. In the end, We chose to have a laser frenectomy done to release her lip. Since having had the procedure done, many parents have contacted me asking why I chose to have the procedure done, where I went, why I went there, how it was done, and an array of other questions. Here is some of the info I gathered in my time on lip ties and the frenectomy procedure.
What is a Lip Tie?
A lip tie is when the lip is attached to the gums. This can really range in severity and there are degree’s that define how severe of a lip tie it is. It is really common for people to have some kind of lip tie but only when it is severe or causing medical issues (or for older, consenting aged people, perhaps cosmetic issues that they want corrected) does it need to be corrected. What problems can it cause? Problems are mostly seen by the breastfeeding mom. A severe upper lip tie can cause a shallow latch, the inability to flail lip out adequately (incorrect latch), slow growth (due to poor nursing), and pain for the mom while nursing. In addition to this, it can cause a severe gap between the front teeth when the tie comes down between them, tooth decay in the front teeth, speech difficulties from the limited mobility of the upper lip, and problems with it tearing and causing pain in rough play or accidents.
What is a Frenectomy?
A frenectomy is the procedure done to correct a lip or tongue tie. Many of you may already be familiar with it from tongue ties but for an upper lip tie it can be a bit more than the “snip” we think of for the tongue tie, especially for the most severe degree where it goes into the palate of the gums. There are two ways a frenectomy can be performed and for young children, most dentists are more comfortable with the scalpel method. When using a scalpel, the procedure is commonly performed in a hospital and the child undergoes anesthesia. The tie is cut out and stitches are used to mend the area back together. Then there is the laser frenectomy (this is what my daughters had done). For the laser procedure the child is just numbed in the area, no anesthesia. The procedure can be done right in the doctors office in under 10 minutes. It is a less painful procedure and easier to recover from and does not leave behind the scar tissue that the scalpel version can cause.
Where Do you go for a Laser Frenectomy?
This is the hard part. Many doctors are not practiced at using a laser on a small, awake child and fear its safety level. I started reading the articles by Dr. Kotlow in Albany, NY who has been doing laser frenectomy on children from infancy through their teen years with no complications and decided I felt confident that it could be safely done. While there are other practices all around the country that perform the laser procedure for young kids, they need to be searched for. His office is very friendly and they are willing to give advice and recommend doctors they know from around the country if his office is out of reach.
Do all Upper Lip Ties need to be corrected?
No. Many people have some degree of a lip tie and it does not cause any problems. The only time it is a concern is when it is causing breastfeeding difficulties or, later on if it is causing other issues. If a newborn has an upper lip tie but mom is experiencing no breastfeeding difficulties and they are growing well, there is no reason to rush out for medical intervention. A frenectomy can be performed at any age so it is fine to wait and just see how it plays out for the child and leave it be if it causes no problems for them. Also, if an infant is experiencing breastfeeding issues, it is always recommended to try working out their latch with an IBCLC first, as it is never pleasant for the parents or baby to go through medical procedures if it is not necessary.
My daughters had the frenectomy performed a month ago and are doing incredibly well. The first week following was harder and they were uncomfortable but healing went well and they were able to eat (and nurse) fantastically. Since having the frenectomy done, I have not experienced pain or discomfort while nursing Grace even once (and I have left her on to nurse in her sleep for long periods of time). Her lip flails out while nursing when it never could before and while it was never horribly uncomfortable to nurse her before, it is 100 times more comfortable to nurse her now. Please note, this info is based on my own research and experience as a mother who has been through this procedure with my children, and I am not a medical professional
On Wednesday we brought Ariel and Grace to Albany NY to see Dr. Kotlow for laser Frenectomy surgeries. They did so well for the 4 hour drive up. Grace got a little annoyed by the end but over all, they did fantastic the entire way up. They had their car DVD players all hooked up and it turned off at every bump in the road, which meant we never got through a single show we brought, but the girls never complained about that at all. They ate snacks and played with toys and watched their fragmented movies. Grace needed to be nursed a few times with me leaning over her carseat (I know, not the safest thing ever but it’s life and stopping on major high ways every time she wanted a little to eat was not an option. Grace hit a point whee she really wanted to be held and stopping was not an option so she ended up settling for my hand on her cheek and fell asleep for me that way.
We arrived in Albany an hour early and had some lunch at a little cafe in the plaza across the street from Kotlow’s office. The girls were thrilled to be out of their carseats and using their legs! They were DONE with being in the car (little did they know they still had anther 4 hour drive home to do).
We arrived at Dr. Kotlow’s office and were thrilled to find he had a nice little play area for the kids for a tiny waiting room. There was a stationary Merry-go-round, a pacman machine, a kids eye level fish tank built into the wall, a fun house mirror and no one there seemed to mind the kids just running back and forth and all around while we were waiting.
Dr. Kotlow himself came to the waiting room and called us back to a little consultation room where he examined each of the girls, discussed some of what to expect and played us a video that fills in a lot of the details on laser frenectomy’s. Then it was time to roll! We found out during our consultation that Grace need both her lip and her tongue done. I was surprised she needed her tongue clipped because she does extend it out of the mouth some and it is not like the photos I’ve seen but he felt it was still tight enough that it should be done. So we consented, because I am not going back out there in 2yrs when she is having speech issues and we realize it should be clipped!
Grace went first and I think I went into shock from that experience. Ive never handed my baby over like that. Not in the hospital did she ever leave my sight. Not at the pediatrician office does she ever get handed over and go anywhere without me. Never. Close family members are the only people who get her without me right there with them. I felt sick to my stomach knowing she was down there, being held down and lasered, and crying. And then knowing Ariel would be next.
Grace was brought back and I think I just walked through a haze of motions then. I took her, the doctor told me he though she needed a diaper change. That just confused me but I went into diaper changing mode (she had peed but was fine) right there and noticed her gums bleeding. It really took me a minute to snap out of it and really get into reaction mode. Yeah, I don’t know why. I’m annoyed at myself for that one! Then I nursed her and calmed her and she fell asleep on me. While I was nursing Grace Ariel was taken by the doctor. I barely saw her go.
I had a moment of panic when he took her because I didnt see him come and didn’t even get to say anything to her on her way out. Now it was Jason pacing the room and waiting and staring at his watch over and over. I caught site of the doctor at the desk minutes later and said to Jason Ariel was back and he zoomed out and got her and swept her into his arms, where she curled into him. She had certainly cried and had that quiver to her breathing but was not still actively crying. After a minute of resting into her daddy she showed us the little green dragon toy the doctor had given her.
Grace was still sleeping on me until the doctor came in and showed me how to pull her lip and tongue back each day. That was a very shocking and painful way for the girl to be woken up and she gave the doctor the worst glare a 9 month old can find, once she calmed down and stopped screaming. That broke my heart to have her woken that way, though, it was def necessary for me to see how I need to care for the wounds as they heal to keep them from reattaching in the healing process.
Anyways, to make a long story short- We booked our butts out of there and began our long journey home. Our very very long journey home. The drive back to Southern NJ from Albany NY felt 3 times longer than our trip up there had been. The girls were not nearly as happy and were very tired of the car. On a positive note, they both napped for half the drive home but when they were up I had to get creative to keep them entertained and at times, just give up, and realize that they were done being happy.
Now it’s been a few days and the girls are still a little swollen and very sore. They are fine when they are eating and playing but when it’s time for me to apply the vit E oil to their mouths and separate the area to keep it from healing back together, they are very unhappy little campers. On top of that, Ariel is now down with a little upper respiratory something or other. So, a lot of this is why the blog has been a bit slow. Prior to the surgery I was obsessing about the surgery and since it we have been recovering and just dealing. I hope to get up some new posts very soon! Thank you for your patience while we delt with this family madness.
For More Information on Upper Lip Ties or on Dr. Kotlow’s office, CLICK HERE
As always, my life is never calm. There is never a day where there is not something to worry about. My kids are constantly keeping me on my toes and worried. This week I had another health issue thrown my way, a lovely, humbling reminder that I am not on top of my game as I sometimes think I am. Ariel has an upper lip tie (frenulum labii superioris). In discovering Ariel’s lip tie, I checked Eve and Grace and found Grace has one as well. oh the joys. So my research begins.
I’ve found so much conflicting information on lip ties and frenectomies (the laser procedure to correct it). Ive read everything from those who say it often corrects itself and that if it is to be removed, shouldn’t be done until after adult teeth are in and gap has been treated with braces to those who say the earlier the better because it grows thicker with age and makes deeper scars, causes more health issues and makes correction harder. I have gone from “she needs surgery asap” to “she doesn’t need it until her teen years, if even” back to “the earlier the better”… and that’s just in the last 12 hours.
We have been dealing with Ariel having speech issues and she is even being evaluated for speech tomorrow but we strongly believe that between the gap and her teeth and the limited mobility of her upper lip, the lip tie is responsible for her speech issues and that her frustrations with not being understood is responsible for her behavior and extreme tantrums.
I’ve been reading stories from other moms who have been through this like This Moms and This bloggers post, as well as all the articles by Dr. Kotlow. I am 100% decided that if my kids do need surgery, it will be done by laser and not under gen anesthesia with scalpels and stitches and lifelong lasting scar tissue. On Monday I will spend a lot of the day on the phone with doctor offices and my insurance company, finding out everything I need to know to make a final decision on it all.
Dr. Kotlow, in NY (3 1/2 hours away from me) even has wrote me this weekend to discuss Ariel and Grace some, even though it isn’t a day with office hours and we will be in touch more on Monday. I’m still open to all info, experiences and advice.
Hopefully I will be able to follow u in the near future with great news, whether the solution is to wait it out or get surgery immediately.