Tuesday, February 26, 2008

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!


  1. Hang in there Sarah! Ronan was tongue-tied, too, but he didn't exhibit the usual slow-to-gain symptoms. In fact, he was quite efficient with his tight frenulum... the problem was on my end since he couldn't latch on right. Endless cracking, etc. and well, you get the idea. Lactation specialists are life savers, are they not? We had his cut at 6 weeks, which was a little late. We did notice improvement, but more gradual than with a younger baby. The things you wish you knew BEFORE baby, right?! My brother had his clipped at 8 years old and he does have a noticeable speech thingy-- sloppy talk-- but we're all used to it and he learned how to speak just fine! Good luck with the feeding, sleeping, etc. You all look great, by the way!

  2. Frenulum? I never knew that sort of thing existed. I hope that it's not going to be a too painful process to correct it. I wonder if it is what we called "short tonguned"? In that it leaves a child with a lisp?

    Isa tried one of those breast milk pump thingies. Very slow process to get any milk out. She tried a few times then gave up. In the end, she stopped breast feeding when Rémy was approaching 7 months - he just didn't seem interested anymore, and although Isa missed it I think she was glad as one of his teeth was starting to come through. He now has 3 peeping out.

    The other problem was that she could only breastfeed before going to work and then when she came home at about 7pm, so in between I really couldn't help much there. :-j

    Let's hope all goes will with Griffins tongue problem - I think anything that isn't as planned on a newborn is worrying.

  3. Dory--I hadn't realized that Ronan had the same problem as Griffin! But it sounds like both boys' frenulum issue manifested itself in different ways. Was your brother's experience a factor in having Ronan's clipped? I'm glad to hear that it helped.

    We LOVE our lacation consultant!

    Thanks for the compliment!

    John--you're right about how we react to problems with a newborn! Despite all the classes we take, books we read, and friends and experts we talk to, we're just not prepared for what it's like to have a baby, much less one with a problem we've never heard of. (Ed and I are very thankful that Griffin is very healthy and perfect other than the frenulum!)

    Kudos to Isa for nursing for 7 months while she was working! That takes dedication--I'm sure there were a lot of frustrating moments.

  4. My son was also tongue-tied. We actually didn't find out til he was maybe a week old and the midwife cae by for her second or third home visit. He had lost lots of weight and we were having lots of problems nursing. She told us her suspicion, sent us to our lactaction consultant, who confirmed it, and the next day we were at the doctor's having him clipped. Much worse for the parents than the baby!!

    Though some of our nursing problems were my fault, I am convinced that this problem prevented my son from being strong enough soon enough to be able to allow us to nurse the standard full six months or year without having to have breastmilk supplemented with formula. It got better after we had the procedure done, but was never 100%.

    I'm glad we had it done early on. That's one less thing to stand in the way of him becoming trilingual and eating ice cream.

  5. My heart was beating rapidly while reading, especially the part when the doctor cut the membrane ... gosh I'm glad everything went well and Griffin can nurse like champ!!!!!!

    The first 3 months is tough, ... but hang in there ... you've been doing a great job!

  6. I'm really hoping my newest baby nurses easily! Out of five I have nursed, I only had one who never had any problems!

    Glad things are going better!

  7. Sally--Thanks for sharing your son's story. I hope he's well on his way to trilingualism and ice cream cones!

    Santi and Jeanne--Thanks for your encouragement! Jeanne, I hope your new baby will be able to nurse without any problems.

  8. Hi Sarah - I thought I had better introduce myself properly....I found your blog through our mutual buddy John over at Bye Bye England. He had tagged you to complete a meme - sorry I tagged him so there's the link!
    Anyway, like you I am a former French teacher. After 13 wonderful years in the UK system as a French teacher, Head of Modern Languages and finally language Consultant / Inspector I decided to jump ship. We moved to France almost 3 years ago and we have never looked back.

    I now run my own jewellery studio soon to be bead shop & craft centre too....plus at the age of 38 I became a first time Mummy to Manon Lily. Manon was born 10 weeks early, I think I had a rough deal pregnancy wise - I had to spend the 2 months prior to her early birth on permanent bed rest in Montpellier - 2 hours from home! Anyway, I can understand what you are going through at the moment. When she was born she could only take 8ml of milk every 2 hours....I had to pump, what a nightmare! In fact I could write an entire blog on how to pump! :)

    I am so interested in your blog - especially the whole bilingual side. We both speak English (since my husband is English too...) but I speak to Manon in both languages. She is surrounded by French speakers and will go to the French village school.

    I have linked to your blog from mine so I can keep up with Griffin's progress and your news.

    In the meantime - I'm sending you a big welcome hug!
    Kylee xx

  9. Hi Sarah,

    For us parenthood really is like walking into the unknown, added to that we've left it a bit late and wonder why we just didn't go ahead 10 years ago!!!

    Isa has been a brilliant mother, especially as she has a full-time job. She was more frustrated when Rémy decided he didn't want to be breast fed anymore. Mind you... his three teeth played a part in the decision too. LOL



  10. Kylee--Thanks for introducing yourself. How exciting that you were able to parlay your experience as a French teacher into a move to France and opening your own business there!

    It sounds like you had a really rough time with Manon at first, but I'm glad she's doing well now. What a lucky girl--she'll grow up completely bilingual!

    I'll link to your blog as well--I'm eager to hear more about how Manon learns languages.

    John--My husband sometimes feels like he's a little old to be a new dad too--he's worried that he won't have enough energy to chase after a kid! But I'm not worried--he's a fantastic papa already.

  11. Bonjour Sarah!
    I love the Berkeley Parents network website!!!
    It's a lifesaver!!!
    My baby is now 3 months and is gonna be bilingual since I am franch and Dad is american!
    For now he only says agoooo and areuh, but I will share his progresses down the road!
    Good luck to you!

  12. Good for you getting the tongue clipped! You did the right thing. It's such a simple procedure and allows the baby to nurse much more easily. Keep up the good work with nursing! Love the sling!

  13. Wow! Poor little Griffin! I'm glad it was easily taken care of. That's one of those instances where, as a parent, you're glad that they think no more of it once they're distracted and won't ever remember it later!