I already told you in detail about how Abigail was unable to support her head and the neuropediatrician said she was hypotonic at two months of age. She was hospitalized, underwent several tests and I told you about all this in the post: Hypotonia in babies: my baby won’t support his head.
In this post, I want to give details about the posterior tongue tie and the frenectomy (procedure to “cut” the tongue frenulum) that we did – and how Abigail developed after the procedure. Anyone who wants a summary, but at the same time with details, there is a video at the end.
I briefly mentioned in the other text about two people who spoke about the issue of tongue-tie while we were in the process of carrying out tests on Abigail and investigating her apparent hypotonia.
One of them was the nurse who took us for the electroencephalogram. She mentioned that a friend had a baby who was almost a year old and had a lot of motor delays. After undergoing the frenectomy, the child quickly developed all the milestones expected for his age.
But, besides her, I had a great friend who had already told me a little about the topic years before. When her son needed a frenectomy (about 4, 5 years before Abigail was born), she told me about the topic, exactly suggesting it as a topic for the blog, since it is little known and discussed in Brazil.
What do you mean little known? We are not just talking about tongue tie, but about the posterior tongue tie.
Posterior tongue tie or posterior tongue tie
For you to understand, Abigail passed the tongue test at the maternity ward and, at the first appointment with the pediatrician, I asked her to check it again. And she said everything was fine.
The posterior tongue tie is a brake that holds the tongue at the back, at the bottom and is not always visible and easy to diagnose for those without experience.
My friend told me that her son had several limitations in movement, had difficulty with tummy time (laying on his stomach), cried a lot to stay in the car seat, but, most importantly, he couldn’t breastfeed. right. Furthermore, he had had spasms similar to Abigail’s.
Here in the United States, it is very common for mothers to seek out a breastfeeding consultant and, generally, they are the first to notice something wrong with their tongue. The suspect is referred to the dentist who confirms the diagnosis and makes the release (the cut) – with scissors or with a laser.
Abigail’s frenectomy
As soon as I arrived in the USA, I started researching more about this. I hadn’t been to the pediatrician and I wasn’t breastfeeding anymore, so there was no point in looking for a consultant. So I went straight to the experts.
But first I joined a group of mothers on Facebook who shared experiences and, each time I read the reports, I became more and more convinced that this was Abigail’s case. The icing on the cake was when a mother shared a photo of her baby doing tummy time with her face on the ground and, later, the child supporting her head. It was a “before and after frenectomy”. I “saw” Abigail in this photo!
In the group itself, I found a specialist in a city close to me. The dr. Cockley, from East Berlin Smilesa reference center for laser frenectomy in my region.
I called there and they explained that I would do the evaluation and, if I wanted, I could have the frenectomy on the same day. I confess that I was a bit hesitant because I had already researched and heard that to release a posterior tongue tie it is important to do some body work first.
What is body work? It can be chiropractic, bodywork or craniosacral therapy. The objective is to be able to reach as “deep” as possible to the brake and release it effectively, without leaving residues that could be harmful.
Even though I was reticent, I went. Abigail, who had been with me for almost two months in the hotel day and night without seeing anyone, made a scene when the dentist came to evaluate her. She looked very quickly and, along with the anamnesis, said that there was a good chance of there being a tongue tie, but that she would not release it that day due to Abigail’s nervousness. She suggested, first, two body work sessions with a professional from the clinic; one that day and one the following week before the frenectomy.
It was great because it was exactly what I wanted. And with a body work session, Abigail has already shown some improvements. The following week, she was already a little calmer and the dentist was able to evaluate her better, diagnosed the posterior tongue tie and performed the laser frenectomy. They wrap the child like a cigar and it takes seconds, it’s very fast.
After frenectomy
After the procedure, the dentist advised that I could give Arnica or Tylenol for the pain. I’m allopathic and I went to Tylenol. Another suggestion I saw in the mothers’ group was to freeze “drops” of breast milk or formula to provide local relief.
The worst part is the stretches. It is a “stretching” that we do so that the healing is done so that the new brake, which will form, is adequate and no longer restrictive. So, we literally put our finger on the wound several times a day. It’s painful, but it’s part of it. We have to do it and it’s quick, actually.
Here, for the first two or three days it was worse, but then it soon got better. The dentist advises how to do it, how many stretches should be done and until when.
Leap in motor development after frenectomy
What surprised me most was the visible result on Abigail after the frenectomy. On the same day, leaving the office, she already looked physically different. It felt like she had something tying her up inside and now she was loose.
Over the next 5 days, she started doing several things that she hadn’t done before. He was 4 months and two weeks old and he finally started rolling in both directions, stretching his arms to reach toys, picking up objects and putting them in his mouth, putting his feet in his mouth, making noises and playing with the language. It was impressive.
There is no scientific literature (at least I didn’t find it) and no medical consensus on the link between tongue tie and delayed motor development. However, I saw this correlation with my daughter and read several reports in the group suggesting the same. It has to be A LOT of coincidence.
In fact, because there is not much evidence, pediatricians (not even here in the USA, where the topic seems to be more widespread) take the matter very seriously. Many, many mothers report that pediatricians discouraged frenectomy or that it was all in their heads. Therefore, there are a large number of mothers who undergo the procedure without even consulting their pediatrician first.
As I hadn’t been there yet first appointment with a pediatrician here in the USAI did it without talking to anyone.
In fact, if you know someone in Brazil who already talks about the topic, leave them in the comments and it might help someone.
Lip tie – the bridle on the lip
In addition to the tongue brake, there is the lip brake, which is very common for those with a tongue tie. During the appointment with the dentist, Dr. Cockley said that Abigail had a labrum frenulum, but it was not impairing her lip movement, so she suggested not doing the release.
However, when she was around 9 months old, I noticed that her upper front teeth were becoming very far apart – which could be caused by the lip tie. So, I went back to the office.
The dr. Cockley evaluated it and said yes, it was better to release it. In fact, baby teeth come in separately, it is common and desirable. However, not as much as Abigail’s were. The photo below is bad, but that’s what she took to record, lol. In addition to the separation, you can see a protuberance that was very rigid in the middle of the teeth.
The lip frenectomy also took seconds and the recovery was even better than with the tongue tie. Today, Abigail is over 1 year old and her front teeth are super well positioned.
Symptoms of tongue tie
I will translate here some of the symptoms that Dr Cockley shares as being common in cases of tongue tie:
Baby symptoms
- Difficulty latching on to the breast and maintaining the latch
- frequent “clicking” noises while breastfeeding
- baby becomes exhausted and sleeps before being satisfied
- frequent coughing or choking on milk
- release the breast to breathe
- frequently release the handle
- is dissatisfied even after long periods of breastfeeding
- little weight gain or weight loss
- gas, reflux, colic or hiccups from swallowing too much air
- prolonged periods of breastfeeding
- crying and apparent frustration during breastfeeding
- milk coming out of the corner of the mouth during breastfeeding
- chewing the nipple
The mother may feel:
- severe pain when breastfeeding
- cannot completely empty the breast
- does not produce enough milk or produces too much milk (more than the baby consumes)
- mastitis
- frequently cracked or sore nipples
Conclusion
As I already said in the other post, Abigail improved from “hypotonia” in a number of ways because in addition to her tongue tie, she also has hypermobility, which is the subject of the post hypermobility and delay in the baby’s motor development.
But I decided to bring this subject in detail here because a lot of things I had never heard about and they were crucial for us. I hope it helps.
For those who like videos, I talk about this in the videos below. There is a video from the time of the frenectomy and also after a few months.
