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  • Cleo Marchese, IBCLC, RLC

Post frenectomy - did it work?

It is very frustrating to new mothers to have a baby still not nurse well after a frenotomy. Sometimes a tongue tie is diagnosed in the hospital and the infant frenulum is 'released' in the nursery. Other times a baby has a frenotomy done later after struggling with breastfeeding for days, weeks or occasionally months. While most of the time improvement is immediate, at others, it is not or improvement is marginal. Some parent’s even consider having their baby’s frenotomy redone at the advice of their pediatrician or other health care professionals. Other mothers frustrated with pumping, slow weight gain or extreme pain during nursing, finally give up breastfeeding. If you are one of the many mothers who are struggling to nurse a tongue-tied baby or infant who is still nursing poorly post-frenotomy there are other things you can try if you are not ready to throw in the towel.

Milk Production is a very important element when trying to help a baby nurse post-frenotomy. The best way to encourage a baby to latched and nurse well is good milk flow. Babies love flow! Make sure your milk production has not fallen behind your infant’s needs. The amount of milk your baby needs change as it grows. The better the milk flow, the easier it is to transition back to the breast or nurse well at the breast. Milk flow is affected by your supply, so the more milk you have the better the flow. While it may be tempting to only use the free pump from your insurance company. Renting a hospital grade pump can bolster your supply better than using a battery/ electric pump. Those pumps are fine for maintaining an existing supply but not great for increasing your current milk supply.

Cranial Sacral Therapy also known as craniosacral therapy is a gentle, noninvasive form of bodywork that focuses on the bones of the head, spinal column and sacrum. Some babies are not just struggling with tongue tie. Some infants have birth trauma from a rapid birth, C-section, forceps or vacuum extraction. I have personally had clients with infants who had a frenulum that was mid-line of the tongue, that were unaware this was considered tongue-tied in most infants. So the presence of a short or midline frenulum does not always mean tongue-tied. Sometimes when babies are having trouble breastfeeding, it is more than one factor contributing to the problem. Craniosacral Therapy works by easing tightness in the baby’s mouth, head and neck to help with successful breastfeeding by waking up under used muscles in neck and face and easing tightness in over used areas that are tight or strained from over compensation.

Finger feeding offers a reward and incentive to continue sucking. It also helps you to 'feel' it when the baby is not using his tongue correctly. For example, some mother’s feel a lot of pain during nursing before and after a frenotomy. One reason is the baby is holding their tongue humped into the back of its mouth and not letting it gently cup breast tissue. So mothers feel a lot of gum hitting their breast during nursing. This is very painful. The constant friction can cause blanching (nipple turning white) and a beveled or lipstick shape to the nipple.

Bottle first method works by giving the baby a method they are familiar with and using food to help them relax and be open to trying the breast. Really hungry babies try new methods of eating poorly.

Whether it is going from the breast to the bottle or vice versa. It always best to try a new feeding method they are not good at by feeding your baby first using a feeding pattern your infant is comfortable with and as the baby approaches satiety, introduce the new method of feeding. Your focus is not on the amount of fluid your baby takes, but on how relaxed your baby is. You don’t want your feed til your child is in a 'milk coma', but your infant should be relaxed and not frantic to eat.

Skin to Skin therapy to encourage self-attachment. Skin to skin therapy is a biological norm that is over looked in modern society. Babies are always over dressed and spend almost no time on their mother’s chest. By allowing them to nestle next to a naked breast or just on your chest, you are triggering instinctual biological patterns that help them smell, lick, crawl to the breast and attempt to latch. Be patient, it may not happen right away.

And don’t get discouraged if it takes hours for them to show interest in

your breast.

Supplementing at the breast using a supplemental nursing system (SNS) or Lact-Aid, uses extra milk flow to coax the baby back to breast with an easy meal. The flow can be gradually decreased over a few days or week and the supplementer can be discontinued. It is best to have the help of a lactation consultant if you want to try an nursing supplementer.

If you are interested in any of these alternative treatments for tongue tie, find an IBCLC in your area. They are the gold standard in lactation care. Many areas have private practice lactation consultants who do home visits. They can work with you one on one in the stress free environment of your home to help problem solve to assess what is really going on. They can also point you to reputable providers in your area such as CST therapists, speech therapists or even providers to redo the frenotomy if it is truly necessary. They can also teach you many different techniques to improve latching and breastfeeding, including the few mentioned above to help your baby back to breast. When looking for a lactation consultant make sure she has experience with tongue-tied babies and post frenotomy care.

#tonguetie #frenotomy #breastfeedingpain #nursing #givingupbreastfeeding #breastfeedingaids


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