Tongue Tied?

I know it’s been a while since I posted. Jasper has gotten worse to the point that I can rarely put him down at all. He has stopped liking being in the Moby wrap (usually get about 5 minutes before he grunts and groans and turns red, most likely “pushing” due to gas), hates his bouncy chair and will only occasionally tolerate being put in his swing. He also will not sleep unless it’s on one of our chests, so that pretty much rules out me getting ANYTHING done.

This also accounts for why I haven’t been able to take any pictures of him from weeks 2-4 (yes, our little guy is now one month old!)

I do have these two though, can you believe how different he looks already?

The Dark Lord

Jasper or Satan?

Jasper or Satan?

All kidding aside, it has been an incredibly trying two weeks. I’ve cried more times than I can count, sometimes out of frustration and feeling sorry for myself, other times out of sadness that Jasper is in SO much discomfort. He basically only has about 2 ten minute periods a day when he is awake and NOT crying.

The rest of the time he is either eating or “sleeping”. I say “sleeping” in quotation marks because he squirms, grunts, cries, arches and screams in his sleep.  So even his sleep doesn’t give us any respite from his unhappiness.

The news isn’t all bad though, here are some positives: His growth is fabulous. He is gaining a tad over an oz. a day. At his one month well visit he was 10lbs 6 oz and 20.5 inches.  He also has started social smiling! One smile has the effect of washing away at LEAST half a day’s misery. (Too bad he doesn’t do it more often.)

He is still on Zantac, though I’m tempted to take him off. It’s been over a week and he is certainly NOT better. The pedi said we could up his dose, but I haven’t yet.. I just don’t feel comfortable doing that if it doesn’t seem to be working at all.

Plus, my observations tell me his problems are not upper GI (reflux) but lower GI (intestinal gas). He seems to groan, grunt, push as if constipated and a fart or two will come out, but clearly there is more gas trapped in there which is what is making him so uncomfortable.

The pedi said there isn’t much more that he can do for us and gave us the name of a Pediatric Gastro-enterologist. I’m not sure we want to go down that route as I’m not willing for him to have any invasive procedures or tests. I would let them test his poop for any signs of bacteria or infection, so that may be something we will look into.

In the meantime, I finally coordinated all the necessary referrals to have a meeting with a Lactation Consultant two days ago.

The results were very interesting!

I had thought the bulk of our discussion would center around my diet (should i go back on dairy or not, clearly it hasn’t helped at all – what else could be causing the fussiness?) but instead, towards the end of our meeting she did a physical exam of Jasper’s mouth… and guess what? Turns out he’s tongue tied!

His upper lip is completely tied (and explains why I’ve never been able to get him to flange it correctly during nursing) and his tongue is 4th degree tied (also called “posterior tongue tie” or “simple presentation”). This means that it’s tied farther back that the “classic” presentation which is quite obvious just by looking because the baby’s tongue is actually heart shaped.

Tongue tie doens’t just hurt the mom’s nipples (mine are actually fine) it also causes fussiness during feeding and colic symptoms due to a difficulty in coordinated breathing and swallowing, particularly with the posterior tie which is counter-intuitive because it is the less “drastic” of all of the presentations. It also causes the baby to tire out and fall asleep before getting all the milk it needs. This makes perfect sense to me because Jasper has always done that, but lately (probably because his nutritional needs are higher now) he needs to eat, falls alseep and wakes up hungry no more than 30 minutes later. He also has been needing to eat every two hours rather than three for the past two days. With the double feedings and the two hours, he is almost CONSTANTLY at the breast.

There is an excellent article called “Congenital Tongue Tie and it’s Impact on Breastfeeding” by Elizabeth Coryllos, MD, MSs, FAAP, FACS, FRCSc, IBCLC; Catherine Watson Genna, BS, IBCLC and Alexander C. Salloum, MD, MA that explains all of this in-depth and it is a very interesting read if you suspect your little one may suffer from any degree of tongue-tie.

Fortunately for us, Dr. Coryllos, perhaps the foremost expert on tongue-ties and breastfeeding and the lead author of that article lives only 1.5 hours away from us, so I’m making an appointment for Jasper to see her ASAP – hopefully this week.

In the meantime, I  started eating dairy and soy again.  In the almost three weeks I was off them, Jasper got worse and not better, so I figured it was time to stop torturing myself! Plus I feel pretty confident that the problem is mechanical in the way he is eating. If it were dietary, I would expect him to be fussy AFTER he eats. But Jasper is fussy WHILE he eats (and after too).

The L.C. also encouraged me to take him to a chiropractor and cited this Danish Study that showed chiropractic manipulation to help colic babies more than drugs.  We had already taken him to cranial sacral therapy once, so we are going to take him back for at least 3 more treatments, as this study showed that was the number of manipulations needed to see improvement.

I’ll keep you posted on these new developments.. wish us luck!!

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nancy says:

Im here to tell you that 35 yrs later it does get better and no you wont kill yourself!! At 5 wks 21 days old my son slept 6 hrs in a row!! I thought he was dead. Drs back then gave me seda drops for him to relax him so he could sleep. It would last about 2 hrs, but that was wonderful for me as i was a single mom and working. you might try carnation good start formula.it worked good on my grandson.He had major birth defects, part of it being tongue tied,and digestive,he was port fed for 6 mos. hes great now but does have speach problems which we will be addressing since he is older. try to lay him down on his tummy with a crib blanket rolled up under him so his hinny sticks up,helps the air get out and the tummy feel better. Good luck youll make it ,i did im65 and hes 36!!!

Maria says:

The photo with the fangs rings true! My babe is 2 and it still hurts to nurse. She has a dairy allergy and a lip tie. It can be painful for them while they eat Bc the milk can irritate their mouth. I eat a more dairy now, but had almost none for about 2 years. We give her slippery elm to calm her gi track and it works great. We also used boiron homeopathic gas drops and loved them. We also do a lot of bone broth soups and probiotics.

Jessica says:

I’ve worked with a lot of moms and babies and have come to sort of specialize in tongue tie. One thing that I wanted to mention (I will admit that I’ve not read every previous comment to see if this was already mentioned) is that if he’s tongue tied, he may not be able to get enough hindmilk from your breast. Foremilk imbalance causes a baby to eat constantly and be extremely gassy. Here are some links about it.

http://www.llli.org/FAQ/foremilk.html

http://www.pollywogbaby.com/breastfeeding/finishthefirstbreast.html

You’ll see that the articles talk about finishing the first breast first, but when a baby’s tongue is ineffective and/or gets tired, he may not be able to fully finish a breast.

Amy says:

My 8 week old has been going through the exact same thing. Prevacid finally worked for us…

Lisa says:

The tounge tie snip is fine the child cries more cause they need to be held down. It will be fine.

ariana says:

Lisa, I’m going Thursday to see Dr. Corrylos. If she recommends it, yes I will have it snipped even though it pains me to think of doing anything that will cause him discomfort. From what I’ve read, they get thicker and have more nerves as the child gets older and needs to be done under general anesthesia later on.. so it seems to me to be better to do early, but again I’ll follow the dr.’s recommendations as long as they make sense!

Lisa says:

See thats the thing Ayden has a gap berween his 2 front teeth (he is 16 months ) and when I went a few weeks ago to get my aby Evan’s tounge snipped (he is 6 weeks) I asked the lady about it and she said to speak to a dentis when he is older….. I dont knw what to do from here
are you getting Jaspers snipped??

ariana says:

Hi Lisa, yes, if you can find someone to do it, you get it snipped. The upper tie is called a “labial” tie (lip) and can cause a really big space between the teeth (and other dental problems I believe) if not taken care of.

Lisa says:

Ariana firstly congratulations he is just adorable, I just wanted to ask do you mean the front of his upper lip is tied? cause my son has this too and I was wondering what to do? do you get it snipped? he also hd the “tounge tie” and we had that snipped all my 3 kids have had tounge ties, but I had never heard of the lip one…..

Jules says:

Ariana–There was grunting and groaning (and he did that high-pitched squealing in that adorable video you posted last week) but for the most part it was screaming. For hours. He was beat red, too, but that is to be expected from constant screaming. ;) Put it this way: it was so bad no one wanted to visit me. :( I take it he is not vomiting? If not, there is also silent reflux–which is twice the bitch because the baby gains weight and looks normal.

Emily says:

hang in there. hopefully you get some more information this week. one day soon you will look back on this time as a distant memory and you will, for a brief moment, forget it enough to consider having a second :)

i have been thinking of you (and i don’t even know you). try to find respite from the crying where you can so you yourself don’t end up beyond exhausted. the tummy sleeping is a good idea. you can especially do it for naps if you are awake.

keep the faith, mama! xo

Jennifer says:

feel guilty, that is.

Jennifer says:

OMG, those pictures are hilarious. If Jasper ever sees them, he will fell so guilty.

You are such a good mom! So well informed. I think you guys are about to turn a corner, so hang in there. What does that cute new poster say? Keep Calm and Carry On.

ariana says:

Christine and Chantal, I have both the happiest baby on the block book AND dvd. They are brilliant! We use those techniques on Jasper all the time, though some don’t work for us… the turning on his side thing doesn’t, and he doesn’t suck on the pacifier well (probably due to his tongue tie issues) but we do swaddle him at night and the shushing is great. But really, the one thing that calms him down more than anything is bouncing on the bouncy ball!

Leah, you are right to cherish the quiet moments.. they will be few and far between, but hopefully not as hard to come by as they are for me ;)

Leah says:

Oye! I have three months to go before I give birth and you are getting me a crash coarse in what may happen. I love it though! This morning itw as so peaceful in the house I didnt want to get up and I thought “I need to cherish these quite moments”
The pictures are so funny! Hang in there I hope you find the right combo that will help him get comfortable.

Chantal says:

My brother’s baby boy was severely tongue tied at birth. It seems to be more common than I expected. Good luck, I hope it can be fixed easily!

The book someone mentioned is by Harvey Karp. It saved me too when Annora was being fussy. There’s a video version as well if you don’t have time to read the book, I’ve heard that most libraries have both.

Good luck Ariana! I hope you get all this sorted out very soon!

ariana says:

Jules, it must have been incredibly frightening to watch him lose weight and vomit so much, but I’m so glad they finally figured out what was wrong with Mikey! Quick question, did he seem to grunt and groan and turn red like he was constipated all the time? I’m just trying to figure out if J’s symptoms are reflux or gas..

Hayley, I’ve read that too about babies not realizing that they don’t have to “push” so much to poop. Poor Jasper only goes about once a day or two days but he “tries” all the time!

Rachel, you’re right, his “maximum” allowed does as per the pedi is the same as his weight. So since he was 10lbs 6oz at last appointment it is 1.6mls. I did actually start giving him that much yesterday.. so we’ll see if it helps!

Stephanie, I’ve heard that a bunch about the prevacid.. I guess I’d feel comfortable trying that if I KNEW it were reflux. As much as I hate the idea of him drinking anything radioactive, it would make me feel a lot better knowing if he had a reflux problem or not. It’s great to know though that the GI docs are pretty conservative. I am definitely going to make an appointment, also would like to know about the occult blood. Hopefully we can get some answers if the tongue tie doesn’t turn out to be the issue.

Hi Lindy, we LOVE Jasper’s burp cloths you made! I KNOW Jasper would be much more comfy on his belly, which is why we slept with him on our chests for so long.. but the night before last we tried the positioner blocks to have him sleep on his side, and he slept so much better! And I didn’t think of it until reading your comment, but he WAS a much happier baby yesterday. I had underestimated how fussy an overtired baby can be. The tongue tie doc told me poor Jasper is probably always hungry or overtired.. which explains the incessant unhappiness.

Lindy says:

Hi Arianna! I’m Dawn’ sister. Okay…what I’m going to tell you may not sit well with you and may gather a few scowls from your readers but here it goes:

I am not a big believer in the “back to sleep” program. I have heard that the studies have shown that it has reduced the SIDS rate and I do respect the research but, in my opinion, I feel that part of the success is also due to public awareness of getting all the loose junk (comforters, stuffed animals, etc…) out of the crib. Again, this my opinion.

Although my kids are grown now, they were always put to bed on their tummies because they threw up too much for me to feel safe that they wouldn’t drown in their own puke. Also, back then, the common practice recommended by pediatricians was to have them sleep on their sides or tummies. I ALWAYS made sure that the ONLY thing in the crib was my baby, a light receiving blanket, and a waterproof lap pad under their head (so I didn’t have to clean the crib sheet every day when they puked on it.

I work in the NICU and I can say wholeheartedly that 99.99999% of the babies prefer their tummies and most of them are positioned as so. They are hooked up to monitors so SIDS thing is never an issue.

When Dawn had Noah, she was breastfeeding and laying Noah down to sleep on his back. I don’t think he ever got more than 30 minutes of sleep at a time because, when a baby sleeps on his back, it is very easy for them to “startle” themselves awake. The only way he would sleep is on her (or Walter’s) tummy. He was a miserable baby and cried all the time. I kept telling her to put him down to sleep on his belly but she REFUSED because the “back to sleep” program all but convinces new mothers that their baby is destined to have the fate of SIDS if they put their baby to bed on their belly. Dawn was an absolute wreck! (Dawn may kill me for telling you that but it’s true). My Mom and I were incessantly urging her to just TRY putting Noah down on his tummy. I think Noah was about 4 weeks old when Dawn, out of pure DESPERATION decided to give it a try. Ding…ding…ding!!! He slept…she slept…Walter slept…and things began to turn around. You can ask her about it and she will tell you how loud my Mom and I sang the “I told you so” song. After about 4 weeks, when Noah began to roll over, she realized that he would end up on his belly regardless of how she put him to bed. He didn’t have colic. He was so darn tired from lack of sleep. He was a COMPLETELY different baby after he began to sleep well. Really…ask her about it.

I appreciate the fact that most new Mom’s regard the advice of their pediatrician as “gospel”. I was the SAME way. Heck, I was afraid to give my 1st baby water without consulting my pedi first and I thought my Mom was INSANE for having me mash a real banana as opposed to giving her jar-food bananas. I look back on those days and laugh. If I had a baby today, I wouldn’t think twice about putting him/her to bed on the tummy. I apologize if this comes across as in a bad way. I mean NO harm and I don’t mean to offend those that are in favor of the “back to sleep” program. This is just my opinion. As a Mom, I feel your pain and am trying to offer some advise from personal experience.

Obviously, Jasper is your baby and you want to be the best Mom you can possibly be, but think about testing this out. I don’t know if you are an advocate of pacifiers or if Jasper likes them (occasionally some do not). If you aren’t opposed, plug a paci in, put him on his belly, and see what happens.

Good luck! He’s such a cute baby!

:o)
Lindy

Jules says:

Oh! I forgot to add that we DID see a pediatric G.I. and the above posters are correct–they (or at least mine) was very conservative. W/o him, Mikey would have never been put on the Reglan. As scary as it was to put him on a drug so powerful, it was a life saver for all of us.

Stephanie says:

Oooh – poor little guy! And poor you! I bet he gulps down a lot of air, which probably really contributes to the gas problem. I really hope your consultation goes well.

Two quick comments:

First, for what it’s worth, I agree with the poster above. Zantac didn’t do much for my daughter but Prevacid was miracle for us.

Second, I wouldn’t NOT see a G.I. just because you are worried about invasive tests. In my experience, they tend to be very conservative about ordering anything invasive (endoscopies, etc.) In fact, one time my daughter had pretty severe colitis and the GI doctor told me that they didn’t scope unless a child was bleeding for more than ten days straight. He told us to call him on day 10, and if she was still bleeding, he’d schedule a scope. She bled for nine days. Then it stopped. Didn’t do the scope. Never found out why she was bleeding. Thankfully, it’s never happened again. But the GI doctor can do an external exam, and can test the baby’s poop, and that’s not invasive at all. And while an upper G.I. isn’t a barrel of laughs, but it isn’t painful and it isn’t invasive. The baby drinks a bottle of chalky barium and then the doctor watches onscreen as the barium makes its way down to the tummy. They can see if there are any abnormalities in the esophagus or tummy and watch the way the baby swallows to see if there are problems there. They can also see, in real time, if the baby refluxes. It’s a test that can provide a lot of information in a short amount of time without causing any discomfort. he barium is mildly radioactive (which is what allows them to see it onscreen), but the baby is awake the entire time and you can be right there with him. (With a scope, it’s not only invasive, there’s anesthesia involved.)

If solving the tongue issue doesn’t solve the other problems, you might still want to think about a trip to the G.I. They cannot MAKE you submit the baby to any tests you aren’t comfortable with, but they might be able to help.

Fingers crossed that you can cross allergies off the list!

Rachel says:

I can empathize with what you’re going through– sounds like you’re doing everything in your power to solve it… and though zantac might not be the answer, you might consider upping the dose, esp. if the doctor said you could. I would guess 1 mL for 10 lbs, 2x per day, 1.1 mL when he hits 11 lbs. But I’ve also heard prevcid works for those babies who don’t take to zantac, so ask about that one too…

Christine says:

I love your blog. My baby is 10 months old and had a lot of the same gas/”colic” problems. A book that really did save me was “The Happiest Baby on the block” by Harvey K. (can’t remember the last name). The key is to swaddle him super super tight, white noise (we did a loud shushing) and a binky. There are other steps and the book explains it well. It really did save me. I looked like a crazy person bouncing up and down in my living room but it worked. Also, I know you’ve heard this but it gets so much better. It gets so much easier!!! Stay strong!

Christine

Hayley says:

You know–Noah had lower GI issues, too. And while he wasn’t as upset as Jasper seems to be…everytime he had to go poop (and lets face it…thats A LOT for newborns) he would scrunch and cry and scream and fuss. We finally found information that said that it just takes longer for some babies to coordinate how to work their sphincter muscles to let the poop come out. Don’t know if thats any of the problem, and it certainly sounds like he has more than just that…but it may be part of it?

Also, Noah was tongue tied, heart shaped tongue and everything and we got it clipped and it changed how he ate remarkably. He didn’t cry at all during the “procedure” (literally took 15 seconds), but his mouth did bleed a lot–like all mouths do.

Anyway, all that to say, hang in there. I know its really hard.

Jules says:

I feel your pain. My Mikey did the same thing. He cried nonstop, and I do mean nonstop. One time my dad called me during hour 3 of nonstop wailing and before I slammed the phone down I told him I was ready to send Mikey back to the shadowy depths of Hell from which he came. It wasn’t a good time for me.

Mikey, though, DID have reflux and it was severe. He wasn’t gaining weight and vomiting constantly (in fact, at 2 months he weighed less than his birth weight). Zantac was ok, but didn’t help much. What changed everything was Reglan. The side effects are serious and terrifying, but we had no choice. The difference was immediate. He gained 3 pounds the first 3 days on the medication. He stopped crying and vomiting, and he was a different child. He was on a combination of Zantac and Reglan 4x a day until he was 6 months.

Hang in there–I hope you find out what it is that is bothering Jasper (tongue-tied, reflux, gas) and that a viable solution is around the corner.

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