After tongue tie treatment some babies resolve instantly and spontaneously. We often hear about these cases online and it can be easy to think that if this doesn’t happen, it hasn’t “worked”.
Toning
Suckling and swallowing requires the use of lots of different muscles. Tied babies however have had to employ compensatory techniques to feed at the breast or bottle.
Indeed Dr Ghaheri says:
“An example I often cite was inspired by Dr. Brian Palmer: If I ask you to train for a marathon for 3 months, but during that 3 month period, your shoes are tied together, you will develop a specific way of running the marathon. You might be able to eventually finish that marathon on race day in that fashion. But if I untie your shoes on the morning of race day and ask you to run that marathon in a normal fashion, your training for 3 months won’t help you much. You would have developed a different skill set and muscle strength to compensate.
Tongue-tied children practice sucking against resistance up to the moment their ties are released. Often, there is significant muscular discoordination and habit that doesn’t allow them to nurse efficiently. I don’t think it’s reasonable to expect a mom and child to nurse normally right after a procedure.”
Expectations
It’s often unrealistic to expect an instant result from frenulotomy, any more than you would if someone separated webbed fingers. How many of us would expect to wake up the next morning and have completely full function and absolutely no soreness or stiffness?
After tongue tie treatment, protruding the tongue may feel unusual. An adult I spoke to said it felt like sensitive piece of jelly, and the sensation of it moving forward was extremely strange; like his tongue was going to fall out. He commented parts of his mouth were hypersensitive when touched by his tongue, which resulted in an extremely “ticklish” sensation.
Muscles may ache or feel stiff after a few feeds and there may be a little discomfort from the wound site. Pain wouldn’t appear to be the sole cause of fussiness, as some babies don’t settle with pain relief. Others don’t express any obvious signs of discomfort and as practitioners it doesn’t appear to be linked to the position or size of the tie.
Some babies don’t seem phased and enjoy the easier transfer of milk, one baby this weekend was smiling within seconds as he drank! Polishing off a bottle in 10 mins than nearly took him an hour. Others look visibly confused or startled, some move backwards and forwards checking out what happens with a deep versus shallow latch. Some seem to become frustrated when hungry, and things just don’t work how they did – particularly if they’re tired.
Worse before they get better?
Since baby may suddenly be able to pull much bigger volumes of milk, some swallow this easily whilst others, perhaps those used to bunching up the back of the tongue may cough and splutter and look horrified.
Sometimes baby can pull the nipple further into the mouth, yet isn’t doing the right action – which can temporarily make things more uncomfortable.
Babies are individuals and just like 10 will respond differently entering a bright chaotic play place (some running with abandon embracing the chaos, whilst some run backwards embracing their caregiver!), some will barely flinch during a heel prick test whilst others cry long and hard – there are no rules.
Ongoing Support
This is why it can be helpful to work with an IBCLC or suchlike who can help provide ongoing support over the coming weeks – keep in touch to ensure things are moving in the right direction. Lactation involves two people and two bodies, we can’t just bring it down to removing frena.