tongue-tied, literally

Of all the things that can develop abnormally with a baby, isn't it ironic that the one Griffin was born with is one that would almost certainly have impeded his speech? Here we were, wanting him to grow up bilingual, and he showed up with a funky frenulum!

The frenulum is the membrane that attaches your tongue to the bottom of the mouth. It's supposed to be at the middle of the tongue and long enough to allow the tongue to do typical tongue things like lick ice cream cones, make the /t/ sound, and respond to insults with raspberries. Griffin's frenulum, however, was quite short and attached to the tip of his tongue, pulling it back in the middle, making it look like he had a tiny pink heart hiding behind his lips.

This is apparently not too uncommon--the speech therapist next door has seen kids with it, my best friend back home's stepson had it, and a handful of other friends and colleagues know or have kids with short frenulums. Even my husband Ed's grandmother did! (Genetic connection? The doctor says it's likely.)

Most doctors and speech therapists believe that this condition, ankyloglossia, which is also characterized as "tongue-tied," will affect a child's speech down the road. (This was the case with my friend's stepson, who had his frenulum cut as a preschooler after he had been mispronouncing words for years. Ed's grandmother's frenulum was clipped as an adult!) But the more urgent problem for Griffin was that it prevented him from nursing efficiently. (Our doula, who has three decades of experience, said he had the tightest frenulum she'd ever seen.)

How bad was it? The first couple weeks of life, based on his weight, he needed to eat approximately 1.5 ounces (~48 ml) eight times a day. However, when the lactation specialist at the hospital (whom we have been to see SIX times at this point) weighed him, he was getting 2, or 4, or sometimes 12 ml per breast in a ten-minute period. Not enough, in other words, and the feedings seemed interminable to me, back and forth, burp burp burp, fuss fuss fuss, back and forth, burp burp burp, holler holler holler, try again, little boy, try again! More frightening, he was so traumatized by being hungry and not being able to get the sustenance he so desperately needed that he would scream as soon as I brought him to the breast. One night that first week he went 12 hours without eating anything. He had lost a pound--around 10% of his birth weight--three days after he was born.

I felt like I was starving my baby to death.

The lactation specialist and the pediatrician who looked at him in the hospital when he was born both told us that we might need to do something about his frenulum, but that it wasn't urgent and could wait until he had his official two-week pediatrician check-up. So when the home-visit nurse came and weighed him and told us he was losing too much weight and needed to have his frenulum cut that very afternoon, we just didn't know what to do or whom to believe. But we didn't like the idea of rushing to the hospital for a procedure we didn't understand to solve a condition we didn't know much about, especially when the first two professionals to notice it didn't think it needed to be a big deal.

So we compromised: the nurse had me start pumping and feeding him breastmilk in bottles, which worked better because babies can get more milk more quickly from bottles than from breasts. And then we made an appointment with the lactation consultant the very next day! Ever since, we've been doing a combination of nursing and bottle-feeding.

We also did some research so that when we met with the pediatrician and then an ENT doctor we'd have a better idea of what to expect when they examined him. The most helpful information came from the Berkeley Parent Network, which offered testimonials from parents (both pro and con) about having the baby's frenulum clipped. By the time we saw the ENT, we were sure that we wanted it cut--his tongue clearly had a very limited range of motion, and we wanted him to be able to eat as much as he wanted from the source.

The procedure was actually simple and quick and straightforward--and harder on Griffin's parents than on Griffin! We held him and the doctor took scissors--yes, just scissors--and snipped the membrane. Griffin screamed, I popped him on the boob, and he started sucking right away.

He's definitely eating more efficiently now, but nursing still is a little rough (hence the multiple visits to the lactation consultant). His current problem doesn't seem to be related to the frenulum, though: he falls asleep while nursing. Repeatedly. So now we're trying a new tack: he can nurse for as long or short as he wants, and when he falls asleep, I put him down instead of trying to wake him up and force him to eat for the full 30-40 minutes (which often turned into an hour plus the pumping and bottle feeding time). According to his last weight check, he's getting enough to eat this way--but it means he eats as often as every hour! So it's not a perfect system, but he's a healthy boy, and that's what matters right now. Also I only have to pump and bottle feed him once a day! (With the goals of stuffing him full before he goes to bed in hopes that he'll sleep longer at a stretch and also keeping him used to taking milk from a bottle so it won't be a rough transition when I go back to work in mid-March). He's been a real trooper, and we're proud of him, and can't wait to hear his first words in English and in French from a tongue that can move like everybody else's!