I realize I've been a terrible blogger lately. The thing is, it isn't from lack of writing. It is just emails, and facebook comments instead. I've been thinking lately that especially on things that I repeat myself on often, it might be nice to store things that I can grab easily and edit, so I'm not having to come up with them from scratch every time. So here's a recent email reply I sent, to a mom with a small baby having a lot of issues who found my email address on a comment somewhere and sent me some questions. Maybe it will be helpful to someone else. :)
Hi L----!
I'm glad that you found my email address! :) This is something I'm super passionate about and I'm happy to help you in any way I can.
A laser revision only takes a few minutes for the actual procedure, but you do have to do mild stretch/massage on the site for a few weeks which can be painful. Different providers have differing protocol, our provider wanted stretching every 4 hours for two weeks. It was definitely the hardest part of the whole thing. We did give her two doses of pain meds, but I was reluctant to give her more when she was seeming to be fine except for stretching. She seemed very uncomfortable for a few days, then it decreased. Probably after the first week, she was only in pain seemingly during the stretches. I would say, don't plan on doing much besides baby holding, nursing, etc for at least the first week if possible. Frozen pizzas and a sling are your friends!
Our provider had us push firmly up on the tongue for a count of three, and the same on the lip. We did it pretty faithfully, not wanting reattachment, but it's my understanding (and you should know this, before you decide how to approach it) that this is such a new thing that we don't really have a lot of information about how effective stretching is in preventing reattachment. The theory seems sound - break up beginning attachment by reopening the area - but we cannot say definitively that it is effective, especially since many people DO struggle with reattachment issues who have tried to do the stretches.
I do not have any regrets except not doing it sooner, and not pursuing bodywork, like cranial sacral therapy, before and after revision. It can really, really help release tension and help the revision be the most effective. As it was, she had slow but steady improvement, and now is a happy 15mo who is very good at nursing! :) But honestly, the more I read about long term health impact of tongue tie, the more I feel like if it's causing ANY issues in infancy, it's really going to be better to try to head off any other issues it may cause down the road. The tie impacts so much more than just breastfeeding!
This post by Dr. Ghaheri, one of the leading tongue tie specialists, is very helpful, I think, in understanding function.
If you join the "
Tongue Tie Babies Support Group" on Facebook, they have a list of providers that people have had good experiences with, as well as helpful files, and you can post there to get more experiences and support. You can also see
the files here. There are also a lot of smaller local groups that may be helpful to you as well in finding local options for chiropractic or cranial sacral therapies. I also have
this blogpost you might find helpful.
Please let me know if I can help you any further - best wishes!
And my reply to her second email, with more questions...
Hi L-----!
Well, it's been a year [since revision], so my memory is a bit foggy, but here are my best guesses.
Yes,
we started stretches 6 hours after the revision, I believe. We lifted
and held for a few (3?) seconds, then released. I rubbed a few times,
since I had read some people recommend that. My provider did not tell me
to, that I can remember.
I gave pain meds that first night, and I think the next afternoon. I didn't use any type of topical gels.
I
can understand that! But honestly, if you're having issues, I really
feel like the sooner the better. It will be a rough few weeks, possibly,
but getting it over with will likely be worth it. I would just say,
make a plan and
have a team.
Figure out where you can get cranial sacral or cranial facial therapy -
the ideal is within 72 hours pre and post revision. (We didn't have an
IBCLC who knew about ties, or any bodywork...I'm just talking about the
ideal now!)
My daughter Ruby could not latch
initially - despite being my fourth baby, so I had plenty of experience!
And when she did figure it out and latch, it was a very shallow, weak
latch, where she basically was just drinking my let down, not able to
create good suction. Due to not having that suction, her seal was really
poor, and she was swallowing a lot of air. That led of course to
painful gas, needing burped often during feedings, very very long
feedings, etc. Her weight gain was fantastic, but I was pumping
initially, in the NICU, and then I was also tandem nursing once we got
home. At about three months, we figured out the issue. I think it was
right at four months that we had the revision.
After
revision, we saw slow but steady improvement. She was able to hold a
pacifier in a few weeks later. She was able to take a bottle a few
months later. I could breastfeed her while walking around without having
her loose her latch! It was amazing.
I hope some of this is helpful to you.
Best wishes, and I'd love to keep in touch and find out how things go for you either way.
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