After almost three months of drama it has finally been established that little Charlie-Boy had not just one tongue tie - but two! That means that the frenulum (that little flap of skin that holds your lip and tongue to your mouth) is too short for him to manouver properly. It explains why Charlie has been gulping, biting, and pinching while nursing, even when I have him properly latched.
It wasn't an easy road to this point. We've had differing opinions on the state of Charlie's mouth from just about everyone possible. Midwives, pediatricians, lactation consultants, and even an ENT specialist have weighed in. Finally we ended up going to see a pediatric dentist who specializes in laser frenectomy (the corrective procedure for tongue tie). She took one look in his mouth and declared him to be a level four! Not that I have any idea how many levels there are, but four sounded awfully serious.
The procedure was done right there in the office shortly after his examination. Handing my sweet little pumpkin over to the nurse wasn't exactly an easy thing to do - especially when I thought about what was going to happen next. A frenectomy is basically just the clipping of the frenulum. Ouch! The old school method is to perform the cut with a scissor, but there are some advantages to having it done with a laser instead. The laser instantly cautuerizes the cut, so there is little to no blood when the operation goes smoothly. It's also super accurate, allowing the dentist to correct the under-lip frenulum - a spot that ENT specialists often won't or can't treat with scissors.
The only disadvantage of going with the laser treatment as opposed to a traditional treatment, for us, was the cost. While we do have dental insurance for Charlie the one and only pediatric laser dentist between Austin and Dallas (that I know of) was not in our network. We ended up having to pay almost $900 up front. Hopefully the dental insurance will cover a fair amount, and the dentist said that we could also submit it to our health insurance after that to maybe get a little bit more back.
Whenever experts brought up getting Charlie's tongue tie corrected it was described as a really simple procedure. It would be done quickly, without a lot of blood, and without a long recovery. In our experience, we've found two out of three of those statements to hold true.
It will be done quickly: True
Though listening to my baby scream bloody murder in another room for twenty minutes was kind of awful.
There won't be a lot of blood: True
In fact, there would have been no blood at all with the laser treatment except that our little wiggle worm wasn't completely contained during the procedure and ended up with a knicked gum which bled for several minutes.
The recovery is short: False
This is where I call shennanigans. While he was able to nurse right away, this poor kid has been sore and crabby for days. He might have gotten over it by now if we didn't have to keep aggravating the wound, but we were instructed to do "exercises" on his frenulums for ten days following the procedure. Basically, I have to reach into his tiny little mouth and push on the sore spots to make sure they don't heal back together. I'm supposed to do this twice a day for several minutes each time. So far, I can only get away with about thirty seconds on each spot before he starts choking, biting and crying. After that my heart breaks into a million pieces and I die a little inside. Here's a video of what I'm meant to do:
He's also having a heck of a time navigating his new mouth. He's sucking harder, eating faster, and then spitting up all over me. Sleep is also completely out of the question. He's gone from some hard-earned 4-5 hour stretches to 45 - 90 minute sleeps. I've heard from other mamas that this gets better after about seven days. It's good to know there is a light at the end of the tunnel, but dang! It would have been nice to know what was coming.
To Frenectomy or Not to Frenectomy?
In the end, the health and comfort of Charlie and I as we continue nursing should make all of this worthwhile. There have been times during the tongue tie debate where I was tempted to just let the whole thing go and just put up with the issues we were having. He COULD eat, after all, so correcting the tongue tie wasn't absolutely necessary. Then I thought about my long term goals. I'm hoping to nurse him until at least eighteen months, which would have left fifteen more months of pain, gas, and trouble. That would have been a long time for both of us.
If all goes well, he should be healed up and nursing more efficiently in about seven more days (ten days from the procedure). He'll be able to stick his little tongue out and scoot that upper lip over the booby, forming a much better seal and moving the milk a lot easier. All of that should equal less gas, more sleep, and a pain-free nursing experience for mama. I plan to update this post in about a week to let you all know how it's going.