My third baby was born with a submucosal-type sublingual frenulum ; a condition that began to affect our lactation practically from the first day, causing cracks, painful feedings and poor weight gain.
My extensive experience with breastfeeding her siblings allowed me to quickly identify that something was wrong, and thanks to the intervention of a doctor specialized in breastfeeding, my baby’s frenulum was corrected.
Although no two cases are the same and not all braces need surgery, I would like to share our experience with frenectomy and how this intervention saved our breastfeeding .
Signs that put us on alert
Just a few weeks before my third baby was born, I had ended breastfeeding with his sister; a lactation that was plagued with potholes from the start.
Among the wide range of difficulties that we went through was also a short lingual frenulum not diagnosed in the first months that brought me serious complications.
When a consultant finally diagnosed my daughter’s frenulum , almost five months of pain and cracks had already passed. However, I felt that breastfeeding was beginning to flow after so many tears, so I decided not to intervene with my daughter for fear that a situation that seemed to be on track would get complicated again.
I breastfed my daughter for 13 months, and five months after weaning her brother was born , so I had a very recent memory of breastfeeding dotted with really painful and difficult moments.
I was hoping that this time it would be different, but as soon as I put my baby to my breast I knew that I would have to deal with the same problems again.
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And the fact is that I already had plenty of experience to identify that this stabbing and sustained pain during feeding was not due to poor posture, but again, to a short lingual frenulum of my baby.
But in addition to the cracks and mastitis that immediately manifested themselves, my baby presented other additional symptoms such as tiredness after extremely long feedings in which he was barely able to express milk, clicking with his tongue while nursing and a stagnant weight that began to worry the pediatrician.
Frenectomy, the best solution in our case
If one thing was clear to me, it was that I did not want to relive the ordeal that breastfeeding my daughter meant for me for a long time, so we quickly put ourselves in the hands of a pediatrician specialized in breastfeeding and a reference in the subject of braces.
With great empathy and professionalism, he explained to us how the lingual frenulum that my son had was affecting our breastfeeding , and he told us about possible solutions in this regard.
On the one hand, there was the option of waiting , but always under the consent and supervision of his primary pediatrician, since my baby’s weight gain was not optimal. And it is that as the baby grows, so does his tongue and his mouth , so on many occasions the problem ends up being solved over time, as happened to me with my daughter.
On the other hand, it was important to manage the issue of pain during feeding, and therefore it was essential to have the advice of an expert to help me find the best position to breastfeed my baby.
Finally, there was the option of performing a frenectomy ; a procedure that involves cutting the frenulum with a scalpel or scissors (conventional surgery) or with a laser.
After thinking about it a lot , and since the situation not only did not improve but the pain was getting worse at times, I decided to submit my baby to a frenectomy.
What does the operation consist of and how is the baby prepared?
There are four types of lingual braces :
- Type 1 and 2 is called ‘anterior frenulum’ , and consists of a ‘thread’ that holds the tongue in its front part, preventing it from moving freely.
- Type 4 frenulum is called a ‘submucosal frenulum ‘. The frenulum is not visible to the naked eye, but is hidden under a layer of mucous tissue that completely restricts the mobility of the tongue.
- Type 3 frenulum is a combination of type 2 and 4 frenulum, because although there is a submucosal anchorage, a frenulum can also be observed on the back of the tongue.
When the frenulum is simple (types 1 and 2) it can be cut in the pediatrician’s office, but in my son’s case it was a grade 4 submucosal frenulum , so the intervention had to be done in the operating room with a scalpel.
The operation was carried out when he was five weeks old and it was a quick procedure (it barely lasted five minutes) and was performed under mild sedation.
They explained to us that in the vast majority of cases there is no bleeding during or after the intervention, since there are few blood vessels in the lingual frenulum.
In our case everything went perfectly. My baby did not bleed a drop and did not complain or show irritation after the intervention.
The frenectomy saved our lactation
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When my baby came out of the operating room , the doctor recommended that I put him to my chest , and at that precise moment I felt an indescribable relief. I noticed how his tongue moved in restrictions, and how he grabbed the entire areola gently and without difficulty.
However, he explained to me that as the days went by he would notice more improvement , and I couldn’t believe that breastfeeding could be even better than what I was experiencing at that moment!
As the days went by, not only did my cracks heal and I stopped having pain, but I also noticed that the feedings were spaced out because my baby was satiated . Little by little I also noticed that my milk production increased, and that my little boy began to gain positions in the percentile table.
Rehabilitation after frenectomy
But it is important to mention that the operation does not solve the problem , and it is essential and fundamental to continue for a few months with tongue rehabilitation exercises.
These exercises help prevent adhesions in the healing process, as the frenulum can redevelop even worse than before. For this reason, rehabilitation is more important, if possible, than the intervention itself.
Therefore, and as a summary, in our specific case I have to say that the frenectomy was the best decision we could make , because thanks to it we enjoyed breastfeeding for another year.
However, it is important to bear in mind that it is not always a good idea to operate the short lingual frenulum, so the decision must be made in consensus with a good professional specialized in the subject, and always evaluating the pros and cons of this intervention practiced. to the baby.
Photos | Cover (iStock), Photo 1 (RODNAE Productions in Pexels), Photo 2 (Photo by Marcin Jozwiak in Pexels)