I didn’t know about the secret language of nursing moms until my daughter was born, but soon I was laughing over niplash stories (ouch!) and occasionally NAKing (nursing at keyboard) with the rest of them.
There is one phrase I didn’t hear, though. One phrase which, given the opportunity, would be the one thing I’d tell my pre-parent self. In fact, if I could write a simple note and hurl it back in time, it would say this:
Research Tongue Ties
I mean sure, it’s great to have funny stories about washing my son’s new clothes with the tags (and hangers!) still attached. And leaving the house with mismatched shoes? Definitely snort worthy.
But really, I would have preferred to know that the level of sleep deprivation my son and I were both experiencing was not normal. I wish I’d known that he was waking so often to nurse because he couldn’t fully drain my breast during a feeding, and that eating more frequently was the only way he could compensate.
I wish I’d known he was tongue and lip tied.
When I shared our story’s happy ending and followed up with this post on how to identify tongue and lip ties at home, I never imagined that it would reach as many moms as it has. Fortunately, word is getting out with your help, and I receive a steady stream of messages from moms who’ve had an “aha moment’ that helped them on their breastfeeding journey. THANK YOU for that. Seriously.
This post is for those of you who have written to ask about pain-management after the procedure. As I’ve said before, I’m not an expert on this, but I will share what worked for me. If you’ve had the procedure done, please share anything you found helpful in the comments!
Before we get to that, though, let’s discuss two often-asked questions:
Do Babies Feel Pain?
It seems silly to even wonder about this, doesn’t it? And yet it’s what medical professionals used to believe, which is why they performed procedures like open heart surgery without anesthesia or pain killers. (source 1, source 2) Newer research contradicts this, and so does common sense, but occasionally I still hear it said.
When I considered whether or not to have both of my sons’ tongue and lip ties revised, I was very concerned about the discomfort it would cause my boys. Fortunately, the frenulum – or the skin that attaches the lip or tongue to the mouth – has very few nerve endings. The nerve endings of newborns are particularly underdeveloped – a fact I took comfort in when I had my second son’s ties revised just weeks after he was born. (Source: Personal conversations with Dr. Kotlow, a leading expert on tongue and lip ties, and conversations with several lactation consultants)
After weighing the risks and benefits, I felt certain that both my boys would benefit from a revision. Looking back, it made a huge difference both times, and I’m so glad I did. If I had the choice to make again, I’d definitely do it. Of course, I’d use the natural pain management techniques I’ve listed below, too.
Why Not Conventional Pain Relievers?
Though there is still a lot of research to be done, some evidence suggests that tongue ties may be more common in babies who have the MTHFR genetic mutation. It’s fairly common – some estimates say up to 50-60% of the U.S. population has some form of it. (source) Individuals with MTHFR mutations may have low levels of glutathione, a master antioxidant that is essential for cellular redox homeostasis, detoxification, immune function, oxygen transport, protection of DNA and other processes. (source 1, source 2)
Acetaminaphin – aka Tylenol – depletes glutathione from the body. (source) Given the range of illnesses in which low glutathione levels may play a role – ADD, autism, colitis, Chrohn’s, depression and eczema for example – my personal approach is to avoid Tylenol unless a person’s MTHFR status is known. (source 1, source 2, source 3, source 4, source 5, source 6, source 7,)
So what about ibuprofen? have not been able to find much information on it’s use in individuals with MTHFR, but some people I have spoken with think it’s a better option. However, the benefits still need to be weighed against the risks.
According to Dr. Claire McCarthy, “Researchers from Riley Hospital for Children in Indianapolis looked at medical records of children admitted to the hospital, and found that of those who had kidney damage, a significant number had been taking non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen (Aleve). Some of the kidney damage was serious.
This isn’t news to doctors; we’ve known that along with possible bleeding problems, NSAIDs can damage kidneys. But we think of it as rare and we don’t always mention it to parents. Which is our bad. But since medications like ibuprofen and naproxen are readily available without a prescription, we don’t always get a chance to talk with parents about it either.” (source)
Fortunately, I found that boy of my little ones did very well with a more natural approach after their revisions. Here are some suggestions based on my experience:
Pain Management After Tongue And Lip Tie Surgery
Before The Procedure
Chiropractic and/or CranioSacral Therapy – Because the mobility of the tongue has been compromised, tongue tied children may experience whole body tension. It makes sense if you think about it – if for some reason you had to clench your teeth for an extended period of time you’d soon be feeling tension in your neck and shoulders. A visit to the chiropractor 1-2 days before the procedure may help release some of that tension so that a child goes into the procedure as comfortable as possible. Massage prior to the procedure may be helpful as well.
Rescue Remedy For Kids – About ten minutes prior to the procedure, I gave my youngest son Rescue Remedy For Kids using the dosage instructions on the label. He had been fussing a lot and I was worried that he’d be really upset about the procedure, but he immediately calmed down and went to sleep. Most of the time I notice a difference after giving Rescue Remedy, but it’s not typically that dramatic. However, my experience with the grown-up version is that it does have a calming effect even when it’s not outwardly obvious.
After The Procedure
Within 48 Hours
During this period I used Rescue Remedy with my son seemed uncomfortable. It’s also important to follow-up with chiropractic care and/or CranioSacral therapy if at all possible. According to Mellanie Sheppard, IBCLC, who is the lactation consultant who first educated me about ties, CranioSacral therapy administered by a skilled practitioner seems to consistently improve recovery and overall oral function following the procedure. (source: personal email)
With my older son I was able to follow-up with CranioSacral therapy, but when my younger son was born we found that the closest practitioner was a 5+ hour drive. We opted to see a skilled pediatric chiropractor instead, and saw excellent improvement.
And of course, it’s important to follow-up with a lactation consultant following the procedure. If your LC can’t meet you within 48 hours don’t stress, but do schedule a visit as soon as possible.
During Stretching Exercises
This was actually the part that both of my son’s seemed the most bothered by. With my youngest son I finally realized that it wasn’t so much due to discomfort, but due to the fact that he didn’t like my husbands huge fingers pressing around in his mouth. For that reason, we started waiting until he was asleep to do them. We gave him Rescue Remedy with a dropper as he slept, then waited 10 minutes and did the exercises. He fussed a little but didn’t even wake up most of the time.
Other Suggestions That May Help
A book I’m reading right now – 12 Acupressure Points For Pediatric Sleep & Wellness – says that stimulating the “heart point” on the hands can be helpful for tongue ties. I emailed the author to find out how acupressure could be helpful for a structural issue like ties, and she wrote back and said that it helps the area to relax.
According to Mellanie, whom I mentioned earlier, babies seem to tolerate stretches better when parents dip their fingers in ice water so that they are very cold prior to stretching.
Another tip Mellanie shared with me is to dip your fingers in a little coconut oil before massaging/stretching the area.
Do you have a tip for managing discomfort after a tongue/lip tie release? Please share it below!