Resources for Newborns & Infants
It should be a natural thing for infants to latch to the breast. But sometimes it doesn’t work out that way. Birth trauma, torticollis, body asymmetry can cause poor muscle coordination resulting in a poor latch. This is why I recommend first seeing an IBCLC (International Board of Certified Lactation Consutant) lactation specialist FIRST to help with things like positioning, technique to improve the latch. Bodywork by a Cranio-sacryl Therapist, Chiropractor, Occupational Therapist, Physical Therapist among others can help balanced the body, improve the ability to latch and reduce other symptoms.
Sometimes a poor latch is complicated by oral restrictions: tongue-tie, lip-tie or both, referred to as TOTS (tethered oral tissues).
Here are some of the signs that TOTS may be involved, at the breast or bottle:
- Shallow latch
- Long, ineffective feedings
- Short, frequent ineffective feedings
- Falls asleep before feeding is over
- Fussy, moving, pushing away while at the breast
- Clicking smacking sounds, leaking milk, breaking seal
- On and off the breast, no rhythmic suck swallow breath
- Swallowing air, colic/reflux/throws up
- Frequent hiccups
- Poor weight gain even though feeding for long periods of time
- Lips curl under while feeding
- Mouth-breathing, noisy breathing, snoring
- Calloused lips
- Heavy white coating on the tongue
- Excessive gag reflex
Here are some of the breastfeeding signs that TOTS may be involved:
- Sore nipples
- Misshaped nipples after a feeding
- Cracked, bleeding, blanched, blistered nipples
- Plugged ducts, mastitis, thrush
BEFORE YOUR VISIT
It is important that you see an IBCLC to evaluate all aspects of your feeding experience whether breastfeeding or bottlefeeding. They can offer vital information and coaching to enhance your experience. If they have experience with recognizing ties they can recommend you seek an evaluation.
Often a child has muscle restrictions in the face, neck, chest shoulders or back that either are a result of TOTS or a cause of TOTS. The body has an amazing ability to compensate for imbalances, resulting in actions or behaviors as listed in the symptoms of ties. Because of this I recommend the help of an experienced bodyworker to possibly help improve some imbalances. This care can help reduce some of the symptoms and give the body a jumpstart on healing should a frenotomy be performed.
PREPARE FOR YOUR VISIT
The best way to prepare for the procedure is to have the medications that you will need on hand so you can focus on your child following the procedure.
Tylenol - You do not need to give any medication prior to the procedure. Dosage: Using the dropper in the manufacturer's packaging. This can be given every 6-8 hours after the procedure. The concentration of Tylenol should be the 160mg/5mL dosage. Some places may sell a concentrated form at 80mg/0.8mL - this is not the one to use.
- 6-11 pounds - 1.25mL
- 12-17 pounds - 2.5mL
- 18-23 pounds - 3.75mL
- 24-35 pounds - 5mL
- For children 6 months of age or older, you may use ibuprofen instead (or with Tylenol). Please follow the dosing instructions on the package.
You may use whatever works for your family. This includes homeopathic remedies like Arnica or Rescue Remedy, or nothing at all. Because numbing medicine is used during the procedure, and because the laser itself has some analgesic properties, not everyone needs a medication beforehand.
It's important to remember that you need to show your child that not everything that you are going to do to the mouth is associated with pain. Additionally, babies can have disorganized or weak sucking patterns that can benefit from exercises. Starting these exercises from the moment you make your appointment can speed up your recovery after the procedure. The following exercises are simple and can be done to improve suck quality. Aim for 4x/day leading up to the day of your procedure.
Slowly rub the lower gumline from side to side and your baby's tongue will follow your finger. This will help strengthen the lateral movements of the tongue.
Let your child suck on your finger and do a tug-of-war, slowly trying to pull your finger out while they try to suck it back in. This strengthens the tongue itself. This can also be done with a pacifier.
Let your child suck your finger and apply gentle pressure to the palate. Once the baby starts to suck on your finger, just press down with the back of your nail into the tongue. This usually interrupts the sucking motion while the baby pushes back against you. Listen for a seal break and then put your finger back up into the palate to re-stimulate sucking. Repeat as tolerated.
With one index finger inside the baby's cheek, use your thumb outside the cheek to massage the cheeks on either side to help lessen the tension.
AFTER THE VISIT
If frenotomy is performed, use the medicine as discussed during the visit. The wounds made are about the equivalent of biting the inside of your cheek or a pizza burn. Noticable but not severely painful. But its a good idea to stay ahead of the pain rather than control it after it comes. Once the scab is formed, usually 1-2 days, most of the soreness is gone.
The release will allow significantly more movement of the mouth parts. Expect the child to be disturbed by this excessive new sensation. The soreness will be bothersome. Muscles that have never moved before will start moving, so these muscles will get sore (how you feel the next day after starting a new activity). With these factors happening at the same time, plan on the child being extra fussy for a few days. Make time for lots of distracting attention, lots of skin-to-skin contact, take a warm bath with your child. This fussy time WILL pass, so be patient.
Expect to have visits with the IBCLC, bodyworker as recommended to improve the results.
POST OP THERAPY
Doing "homework" is VITAL to prevent the wounds from healing tightly. Nature wants to form any wound into a tight scar. New frenums WILL form! The goal here is for the wounds to heal into long, flexible new tissue. You will be shown how to do the therapy, you will be invited to video record it so you can refer to it later. Please see our Therapy help links on the main resources page.