Stacie Bingham: Birth Support in Kern, Tulare & Kings Counties
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Tongue-Tie in an Older Kid

12/26/2013

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Back in June when we took Ezra to see Dr. Jesse, it was just my husband, Ezra, and I. I had this picture on my phone, and on a whim, I shared it with Dr. Jesse to show the array of palates and tongues we had left at home:
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"You see this here?" he pointed to my (then) 13 year old's picture, "His tongue-tie is pulling his bottom two teeth in." 

Now after my discovery of Ezra's mouth, and then our science project of comparing the other kids via pictures, I was amazed to see Jacob had a tongue-tie. He nursed with ease until the day he quit on his 4th birthday; well, I should say, after his stint in the NICU for 2 weeks, plus a couple of days figuring things out in our own time and space out of the hospital, he nursed with ease. I thought that was it, end of story -- nursing went well, so we didn't need to worry about it now. But I had before noticed in his otherwise lovely mouth of mostly-straight teeth, those two troublesome bottom guys...

In hindsight, a tongue like that could have caused a few issues we noticed earlier but were clueless about. Jacob was late to start solids. I offered him rice cereal at four months (it is important to know rice cereal isn't the best first food for babies, I was following mainstream guidelines and assuming since it was marketed for babies, it was best for babies; for more info about that, read here). He gagged so I figured he wasn't ready (again, I was uninformed and looking at the calendar and not the baby when determining if he was ready for food). I would wait a couple weeks and try again; same response with additional behaviors such as coughing, tongue thrust, clamping his mouth shut, and turning his head away. After a few more attempts, I lost interest and let my little sister (then 12 years old) eat it all. When Jacob was 9 months old (and still had no real solids experience) we were eating at our favourite Mexican restaurant. Jacob was large -- 9 pounds, 8 ounces at birth, 20 pounds at 4 months, 30 pounds by a year -- and because of that, we often placed him in the high chair while we dined to keep him at our level and engaged. He never acted interested in food, though. This particular night, he was madly waving his arms and shouting at us, so I offered him a bite of refried beans. Surprisingly, he took the food into his mouth, kept it in, swallowed, and wanted more! We were excited, but it still wasn't full-speed ahead with food -- he didn't really start eating food until about 14 months. 

Tongue-tied babies can often be slow to eat solids or have other food issues, but I just assumed he wasn't ready and I didn't worry due to his size. I do believe Jacob limited himself to foods he could easily eat and swallow and this shaped his preferences -- he is still a picky eater, and I fully attribute that to his anatomical make-up and how he compensated to ensure he didn't choke or suffer other discomforts while eating.

The second sign of how he was being affected by his tongue was the fact that he had extensive decay on his top teeth, necessitating caps at 18 months old. Having a tongue that doesn't move in a full range can cause decay, as the tongue isn't able to move between the teeth and the lips up at the gumline to sweep food out. Coupled with an upper lip tie (restricted upper lip), pockets can form and food and bacteria can become trapped, thereby causing decay despite the best oral hygiene practices. Again, at the time we thought it was a fluke, genetic thing, especially since he hadn't started solids until later. Now I see it makes sense. In light of his history, I recently scoured all the pictures I have of him to try and find evidence of his tongue-tie as a baby -- this is all I have come up with:
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Ties, like black holes, continue to exert that force on the mouth and the teeth if they aren't resolved or released; case-in-point: my husband's parents spent thousands of dollars on orthodontics for him, to only have his bottom teeth move once the braces came off and stopped holding the teeth in proper alignment. I could further prove this with a picture, but my husband doesn't readily allow me to share the inner workings of his body on the internet :). 

We decided to take yet another trip to see Dr. Jesse and have Jacob's tie revised. We made an overnight trip out of it, with an adventure to the La Brea Tar Pits attached.

Dr. Jesse welcomed our whole entourage into the treatment room. While we waited, he ran in to get the laser and said, wheeling it away, "Someone has a canker sore that's needs zapping!" and left, happy to remove this thorn in a patient's mouth.

Dr. Jesse came back in to greet us, look in the other boys' mouths, and then get Jacob seated in the chair. He visually and digitally assessed Jacob's tongue function, saw there was no upper lip tie, and explained what he felt we should do for optimal restriction release. Jacob received a numbing shot that needed a few minutes to take effect, and we waited and chatted. 

Since I held Ezra during the last procedure, it was Brad's turn to hold Jacob (just kidding -- Jacob is 6" tall and wears a 13 shoe). I did say that, though, and it got a good chuckle. What I intended to state was, since I held Ezra and wasn't able to watch the procedure in real time, I stood close to Dr. Jesse's shoulder to get full view of the lasering. It makes sense, but I wasn't quite prepared, that it took about 5 soild minutes to keep swiping the laser over, and over, and over the frenulum. Dr. Jesse would then readjust, regrip, and reapply the laser; soon I realized I didn't need to watch the whole thing. The other children were curious, and Dr. Jesse's assistant invited them over to both have a turn.    
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After the procedure, Dr. Jesse made sure all the boys (minus Ezra) received popsicles. We took care of the billing ($80), and bid Dr. Jesse farewell. We went in search of lunch and ended up at BJ's Brewhouse. Jacob ordered pizza and ate like a champ, mostly...but as he neared the end of his pizza, his eating got slower. Finally he pushed the last bit away and said he was done. I looked at him an realized he was white as a sheet! That's when it hit me:  I should have given him ibuprofen before walking out of Dr. Jesse's office! I let the pain come at full-force as the numbing shot and laser affects wore off. I quickly offered him some analgesics and we hit the road toward LA.

We stayed in a hotel, and Jacob and I found a Target to get some provisions (popcorn, hot chocolate, snacks). I threw some Anbesol into the cart, hoping it might help. Jacob threw some popsicles in for good measure. Back at the room, we tried the Anbesol (it stung mightily -- he went and washed it out!), and he decided to keep up with the ibuprofen and popsicles. He had a hard time sleeping that night, but we were away from home, and the distractions were minimal.

The next morning his mouth really hurt, but he was able to drink some hot chocolate with his brothers: 

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We headed off for the day and had a great time at the tar pits. Jacob did experience pain intermittently, and we kept up with the ibuprofen (see a theme here?). For lunch we went to the Cheesecake Kitchen. Jacob ate a hamburger okay, and then the five of us shared three pieces of cheesecake (he had no trouble with that!).

For the next few days, his mouth hurt. Looking back now and reading other adults' accounts of their revisions, I wonder if we could have dissected a bit more what the pain felt like to get to the root of what might have been causing that sensation. As in childbirth, when you throw all the "pain" together in bucket, it is read as PAIN, but when you break down where the sensation is coming from it not only makes it easier to cope with, it helps us to know why it's there. I am sure he was feeling soreness at the site, but was he also feeling tenderness as his tongue moved in ways it never before was able? Was any of that the after-effects of tensing during the procedure, which caused lactic acid build up he was feeling now? Referred pain signals to areas that weren't even affected? All we knew was, he called it pain, and we treated it as such. There is science behind controlling pain for speedier healing, so I am not opposed to doing what works for him. Being that he is the size of a grown man, his frenulum was thicker and required more time to release.

I am trying to get him to write up his experience in his own words, but that may take some bribery on my part, or extra credit on his English teacher's part. But who knows, maybe it'll turn up and you can read how he felt about being tongue-tied and then released?

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Jonas Nathaniel, 11-27-05

12/5/2013

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I just found this in my old email archives and I figured it saved me from starting from scratch on his birth story.

Jonas Nathaniel was born November 27th, 2005 (his due date), at 12:44 am in  the morning. He weighed 8 pounds, 2 ounces, almost 1.5 pounds less than his older brothers who were 9# 8oz, and 9# 9oz, respectively.

Saturday I was having contractions, but they were activity related -- if I stopped the activity, the contractions stopped. At 7 pm,  they began a pattern of about 5 minutes apart. We got to the hospital about  8 pm. When I was checked it was found I was 4-5 centimeters, 100% effaced; I was hoping I would be further along than that.

My mom was already on her way as she had a three-hour-drive.  My doula arrived soon after we got to the hospital. I got into the Jacuzzi tub  and stayed in for an hour. When I got out I was an 8 -- again, I was hoping I would be farther along! I walked around and then labored in a rocking chair. I was breathing through my contractions and things were going pretty well; my nurse said I was one of the calmest laboring moms she had ever seen, which was a  nice compliment.

My mom arrived at about 11 pm. I did not even notice her walk in the room as I was rocking in the chair and had my eyes closed in very deep concentration/distraction. I was surrounded by my doula, my midwife, my husband, and my mom.  The room was dark and quiet.  I vocalized during each contraction in a low ooooooo tone.  I wanted to wait for the urge to push as I had not really experienced that with my other two births.  As I sat in the rocker though, I looked up and caught my midwife's gaze: "Carolyn, I will let you pull him out with a vacuum, you know," dead calm. Everyone laughed, but I didn't think it was funny.  "I'm serious," I said. My doula and my midwife knew this was not really what I wanted in a sane moment -- my oldest was vacuumed out, and I have had long, deep regret about that.  A few minutes later I also looked at Brad and said, "I never want to do this again."

Things started getting pretty intense after my mom arrived. I labored on the toilet for a few minutes, too. At first I was nervous to go to the bathroom as I was in transition and I had a fear that spending too much time in in that small toilet room would make me feel like vomiting (one of my deepest fears!).  I soon realized, like so many women do, it was a calm, cool place where I could relax my muscles and my body. When my midwife checked me and I was a 9 --  wishing I could be farther along yet again! My
midwife said I was a really stretchy 9, and if I wanted I could push. I decided to give it a try. It hurt so  bad! I quickly changed my mind and chose to have a little more time. 

I waited through a few more contractions, getting very desperate as nothing could help me at this point. I started to push again, lying on my back to see if we could get the baby to slide under my pelvic bone. It wasn't really working, and I was having immense pressure at the pubic arch. I decided I wanted to try a different position. My midwife suggested  squatting at the end of the bed, on the floor. I got up and squatted and immediately stood up -- it was too much pressure on my lower abdomen, where all  my pain was coming from.

My midwife had known for some time during labor  that this baby was posterior (face-up) like his brother, Isaac. Since the  squatting hadn't worked, I was left there, standing, as the contraction moved through me, and I started pushing. I remember thinking, "He is probably going to fall on the floor -- I think he is going to be okay," as my body involuntarily worked at getting him born.  My midwife found a foot-hold that popped out of the hospital bed (they have all kinds of doo-dads for helping women have babies -- like the Swiss Army Knife of hospital beds). She had me lift my left  foot off the floor about a foot and a half so I was standing in a lunge  position. I continued to push and I immediately felt the baby turn and drop. "He's  coooooommmmmiiiiinnnnngggg!" I moaned. To check my statement, my midwife crouched under me to see if that was true. She saw his head was right there. "Hurry and  crawl into bed!" she told me, "Before you have another contraction!"  Even with a  baby lodged in my nether regions, and feeling
sensations of an incredibly powerful nature, I hit the foot of the bed on all fours and crawled right through the squat support  bar.

The next contraction I pushed, and after about 5 very hearty pushes,  he was born. I guess I didn't push for too long, maybe a half an hour with all  the weird attempts where I had to stop because of the pain. Once he rotated with the lunge he was born within 5 minutes.

He is a very sweet baby. We are having some nursing issues as he does not want to open his mouth very wide, but we are working through them.

Apparently I hit transition when it's time to push, because that's when I got frantic and panicky!  That was how it was with my last baby, too. I am in a pretty good state until it's time to push.

I am glad it's over! 

It only took me 6 days to decide, yes, I would in fact, do this again -- I didn't know then it would be 7.5 years later.

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Stacie Bingham, LCCE, CD(DONA), CBS(LER)

Calm, comfortable Lamaze education & experienced support for pregnancy, birth, & breastfeeding serving Bakersfield, Delano, Hanford, Porterville, Tehachapi, Tulare, Visalia + the World

​661.446.4532 stacie.bing@gmail.com
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Photos used under Creative Commons from Renaud Camus, jmayer1129, jmayer1129, Rob Briscoe, jmayer1129, jmayer1129, jmayer1129, operation_janet, CJS*64 "Man with a camera", symphony of love, Aravindan Ganesan
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