Tongue tie and bottle feeding

[ENMS]

I'm just looking for any stories of tongue tie and bottle feeding.  My DS had a TT which got clipped at 10 days, but they couldn't clip all of it without putting him under GA and now it seems like it's growing back.

Feeds are annoying, he bobs on and off all the time. It always takes 2-3 sitting, me walking around the house, opening the TV to distract him. He does not look in pain, he is fully medicated for his reflux (Nexium AND Zantac) and is not having allergic reactions since he has not had solid food for 3 weeks and is drinking Nutramigen AA.. He is not even spitting up at all these days so really I highly doubt that reflux is the issue here.

I've made an appointment with the pediatric dentist that clipped it (because it was severe / complicated TT, the doctors could not do anything for me but referred me to that dentist who clipped it with a laser), but it's only July 11th and I'm getting impatient a little

I think that might be causing the issue, but when I search on google, I mostly find symptoms of TT for breastfed babies, not much about bottle fed babies.

Thanks! 

[flutie]

What kind of bottle is he using Elise?  We find that DS does so much better with a standard (we use dr. Browns) than a wide neck.

[Lolly]

My two are both quite significantly tongue tied - they couldn't BF but we had no problems with bottle feeding. The only times they refused to feed, were distracted or did the bobbing on and off was if their reflux was bad or I was trying to feed them and they really just weren't hungry.

Laura

[ENMS]

We also use Dr. Brown's standard.

I really do think his reflux is well controlled at the moment.  Usually, when he's not hungry, he will just seal his lips so I can't get the bottle in his mouth at all.  I was actually wondering if this was maybe learned behavior, he's always had so much issues feeding, maybe that's the way he's learned to do it

Laura, could he possibly be needing to feed every 4.5 of 5h then? Because I feed him after his naps, we've got more of an EASY going now, and so it's most days a good 4h between feeds (sometimes more).  He's still waking at night though which might be an issue here, I'm trying to wean the NF by reducing the oz but it's looooooong.  We keep having setbacks because he gets sick or has a reflux flare up.

[Lolly]

Babies do start going 4 hours+ but that when they are having solids too. I would keep to 4 hours max at the moment until you get somewhere with solids - I can't go that long between food .

How are things today?

Laura

[Fiver]

The tongue tie could still be an issue.  We have friend whose son had such a bad tie that he had virtually no available movement of his tongue and couldn't breast or bottle feed.

[ENMS]

Things were ok today, again, not a big fuss, but feeds are still no fun, he'll take 2-3 oz and then start fussing, except for the BT feed though which makes me think hunger might have something to do with it   Or he's really tired at BT these days because we're dropping the CN so it could be that he's really just falling asleep on the bottle - I've caught him with his eyes closed a few times lately!!!! I really don't think it's reflux, I could be wrong of course, but he's such a happy baby this week-end, usually if he has a flare up he'll have trouble feeding and will be fussy during the  day.

The feeling I got was that he was having trouble maintaining his latch on the bottle, but I could be wrong of course. He's definitely restricted in his tongue movement, but I wouldn't say that he doesn't have movement with his tongue. Maybe feeding is really tiring for him because he needs to make lots of efforts

[Rizo]

What about going down a teat size? I found when DS moved from 3 to 4 hour feeding he wanting to go up a size but after awhile and when he got used to eating 4hours apart he was struggling with the faster teat. He was doing similar behavior to your DS, bobbing on and off, seeming like he wanted the bottle but then hardly drinking. I just recently moved him back a size and he is fine now.

As a side note he also has tongue tie and I'm sure it causes more feeding issues than Drs will ever admit to. I could n't breastfeed either of my boys and I'm sure this is the reason, and even when we moved to bottles we have had more (little) problems than most people I know who's children aren't tongue tied...

[ENMS]

What about going down a teat size?

I actually tried the opposite, I tried to go up a teat size... he's been on level 3 since he was 3 months old, so I don't think going back to level 2 would help, though I'm willing to try it and see.

With level 4, the good news is that I get him to take more milk more quickly, so by the time he starts to fuss, he's already had an oz more or so.

As a side note he also has tongue tie and I'm sure it causes more feeding issues than Drs will ever admit to. I could n't breastfeed either of my boys and I'm sure this is the reason, and even when we moved to bottles we have had more (little) problems than most people I know who's children aren't tongue tied...

yep honestly I think so too.  even when his reflux is completely controlled, feeds are still no fun, and I can't think of anything else that could cause this.  we'll see in 2 weeks when we meet the pediatric dentist, she's a big-time expert in tongue ties here, so hopefully she'll be helpful and have some good insights for us.

[Fiver]

Good luck

[Rizo]

What about going down a teat size?

I actually tried the opposite, I tried to go up a teat size... he's been on level 3 since he was 3 months old, so I don't think going back to level 2 would help, though I'm willing to try it and see.

With level 4, the good news is that I get him to take more milk more quickly, so by the time he starts to fuss, he's already had an oz more or so.
Maybe still worth a try, but I kno what you mean about the more oz!

yep honestly I think so too.  even when his reflux is completely controlled, feeds are still no fun, and I can't think of anything else that could cause this.  we'll see in 2 weeks when we meet the pediatric dentist, she's a big-time expert in tongue ties here, so hopefully she'll be helpful and have some good insights for us.

Good luck, wish we had something like that over here. In NZ they are very reluctant to do anything about TT, neither of my DS's have had any treatment

[Rizo]

Haha sorry for weird reply, don't know what happened with the quote bit

[ENMS]

We got a call yesterday that there was a cancellation this morning so we went in to see the pediatric dentist (one of the experts in TT here).

She said it's still tied pretty bad. It can cause bottle feeding issues and it can definitely cause reflux. But of course she can't promise anything. We can clip it, there's no guarantee it will improve things however.

So I said yes and she clipped it again.  It was no fun  - she had to anesthesize him first with a needle, and then she clipped it with a laser. DS DID NOT like it to put it mildly, he was furious. But when it was over I picked him up and he calmed immediately, even smiled at the dentist. I think more of it was the frustration of being held and someone playing in his mouth, more than pain. But it will hurt him over the next couple of days so I'll need to give him Tylenol to ease the pain.

Hopefully that helps.

[flutie]

I hope the clip makes things easier for your ds...eating should be an enjoyable thing.

[Fiver]

Am glad you got in early.  The effects of TT can often actually be confused with reflux so you may find there's an improvement there too.  Did the dentist give you any exercises to keep the tongue from adhering?  Depending on how far back it was, it can sometimes do that.

[ENMS]

She told me to just apply pressure with my finger every day but I looked up online and found some exercices which I will definitely do many times per day - I'd like to avoid getting it clipped for a third time

She also said we were right on time - he has 2 teeth in the bottom but none on top, and because she had to anesthesize his tongue, if he had teeth above and below it would've been a risk of him biting on his tongue hard since he didn't feel anything.

[Fiver]

Good news.  Wish I'd known about the exercises as I'm fairly sure DD's TT has fused up to a degree.

[ENMS]

I did some exercises the first time but started late and did it for a week or two - guess it was not enough   will keep doing it once a dasy for while this time!

[ENMS]

Did any of you get a TT clipped at a later age like my DS? He's 6.5 months. Apparently the most important exercise is to have him suck on my finger and then I slowly pull it out to stretch the tongue. But he won't suck on my finger! He just wants to chew it and play with it. I've tried playing around in his mouth but I can't seem to stretch his tongue...  I do the other exercises but I'm really struggling with this one.

[flutie]

I remember he has some food intolerances, but what if you put something sweet on your finger like pureed pear or something.  Would he be more apt to suck??

[ENMS]

He's currently eating apples, so when I give them to him today, I'll try it! I also keep sticking my tongue out to show him, he seems really interested and curious but so far he hasn't tried to do it himself!

[Fiver]

Would he suck on a slice of apple perhaps rather than you putting in on your finger?  My DD was "only" 9w when hers was done (too long - ouch!)

[ENMS]

yeah it didn't work putting it on my finger, I think tomorrow I'll try removin the bottle towards the end of his feed, and giving it back a few times

I'm terrified of having it grow back again. I kept poking my finger in there today, poor thing, but I am taking this seriously

[Fiver]

Totally understandable that you're concerned.  I wish I'd known back in February 2011 what I know now about the exercises (like you need to do them!) as things may have been a lot easier with DD than they were, although having the division done in the first place made such a HUGE difference that I just felt grateful it had been done.

Keep on keeping on

[ENMS]

I just wanted to update you all.  DS drinks much much better now.  When he drinks, I actually feel the bottle being pulled more towards him, like his suction is much better. So definitely a major improvement with clipping the TT again. Unfortunately, he will not let me near his mouth to do his exercices anymore. I'm trying to persevere but without DH it is getting impossible to do on my own! He's a strong little man  

In addition to that, we have found a bottle that he prefers, initially got it because it is good for refluxers as they are more upright, but I suspect that the y-cut nipple, in addition to the straw thing, gives him the perfect flow and he's really loving it.

http://www.podee.com/

So with the combination of these two things (the TT first so I know it really did make a difference and it's not just a coincidence), my little man has gone from drinking 27-28 oz per day, to 37-42 oz per day. And he is much happier (guess he's not always hungry anymore!).  

[Fiver]

Hooray!  What good news, Elise!  So glad it's made the difference.  Pesky TTs!

[ENMS]

Hi again!

I just wanted to come back and do a little update. Before I had the appointment with the dentist in June, I had called another specialist in the big city, a GP who specializes in TT. She gave us a call after her vacation in July and we decided to go even if we had already seen the dentist and done the clipping. When we got there, she gave us the 'speech', how clipping a TT was not proven to help anything other than BF, how it was probably not what was causing him problem, etc. Then she examined him. You could see disbelief in her face as she examined him. She needed to use a special tool to see under his tongue because she couldn't do it with just her fingers. Immediately she said that we could try clipping it, but she couldn't guarantee results. She said 35% chance that it could help him. DH and I discussed it and ended up deciding to do it. Although he was feeding better, he was still having major problems with reflux and digesting solid foods. She did say there was a link between these and TT but nothing was proven.

We went back this week for a follow up appointment and she told us that when she examined him, she could not believe what she saw.  She was beyond shocked, she said she clipped over 300 TT and never saw one that was this tight  She didn't want to tell us at the first appointment, as she did not want to bias us and she wanted it to be our decision.

She said he basically had no movement at all with his tongue. Nothing. She just repeated over and over 'tight, tight, tight'. It was a posterior TT of course so not many doctors here specialize in that.

She clipped it with scissors, with just local orajel application and some tylenol beforehand. It was definitely less painful for DS than the local anesthesia + laser clipping. He recuperated much faster and much easier. A few minutes after he was already laughing and did not seem bothered at all. Thankfully DH was there with me this time so I did not watch up close, I just could not stand to watch this one more time 

So far, so good. He's doing well, and has been eating solids for 7 days now which is his longest stretch even without starting to refuse to eat.  Fingers crossed that it continues.

[Fiver]

Oh Elise, I'm so glad you've had such a positive experience with this doctor (in the end!!)  I really hope this is the end to his struggles and everything improves greatly from here on in

[ENMS]

Thanks Amanda. I just really feel the need to share because TT is always viewed as a BF problem, but it can be more than that, but I could never find any info on other stuff you know? The more everyone knows, the more likely that the next person in my shoes can be helped

[Fiver]

You've already seen the FAQ we've put together on TT (http://babywhispererforums.com/index.php?topic=233789.0) - some of those links talk about issues with solid food and bottles as well as BF, although in infancy it does tend to be more of a BF issue as often LOs can bottle feed more easily as they have adequate tongue mobility for that, but not to milk the breast.

TT then comes up as an issue in childhood if there are speech issues.

I do think it's a shame that anyone, whether BF or bottle feeding, has to fight so hard to get diagnosis and treatment for such a simply remedied issue.

Good for you for pushing through

[ENMS]

Yes I've seen the FAQ.  Great idea:)

And I agree about getting treatment and diagnosis. My GP knows nothing about TT, and the paed was not knowledgeable either. I asked many times whether the TT could be causing issues and they all said no. Granted, DS is an extreme case and not all TT are as bad as his, but still.

Thankfully I could get info and support here  , IRL nobody knew anything about TT.