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Lip tie procedure - I need your input

Posted by on Apr. 18, 2013 at 3:43 PM
  • 26 Replies
Hey mamas!
Well, what I already knew has been confirmed - ds2, 1 month old, has a significant lip tie. It's very thick and the ent we saw wants to cut it, but under general anesthesia in the OR. He said it definitely has several blood vessels and will bleed a lot, so he needs to do it where he can cauterize it. It will be a 5 minute procedure, so very short general anesthesia, but the main thing is the ability to cauterize.

Because I'm tandem nursing his older brother, my supply is plentiful and ds2 is gaining weight and height crazy fast. I don't bother counting diapers because he goes through PLENTY, LOL. He's starting to hold up his head and has a lot of alert awake time, so I know his nutrition is not being negatively affected. Thus far, the tie hasn't impaired that. His latch is also comfortable, though shallow and weak. He falls off easily and swallows a lot of air. He also has a hard time managing my fast letdown, though ds1 did, too, without a lip tie. He nurses, cries, burps, nurses, cries, burps. It's hard. But I don't know how much of that is from the tie and how much is from the fast letdown. I burp him several times through each nursing session and he always has big man burps and is starting to spit up more. I worry that when my supply regulates, his gain will take a downturn.

So here's the rub - ds2 is 1 month old. I initially wanted the clip done right away, like yesterday, but we will have to schedule it for a few weeks from now since they can't just do it in the office. If we do it before 3 months, they will keep him overnight for observation because of the general. I would, of course, stay with him. If we wait until after 3 months, it's a quick outpatient procedure, but he'll still be sedated. Either way, they'll sedate with gas.

My thought is to see if we can wait until 3 months to avoid staying in the hospital, the upheaval for ds1 (we bedshare, I nurse him to sleep and we've only spent the night apart the night ds2 was born) and exposure to all those germs as well as the significant difference in cost. Or is it worth it or time sensitive enough to just have it done ASAP? If we wait and try to get to 3 months, what should my markers be for pulling the plug and having it done sooner? Weight and diapers, obviously, right? What else? Any other factors I haven't considered?
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by on Apr. 18, 2013 at 3:43 PM
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Replies (1-10):
TTC2Long
by on Apr. 18, 2013 at 5:11 PM
Bump!
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IrishIz
by Silver Member on Apr. 18, 2013 at 5:45 PM
So my first question is why general anesthesia and not sedation? They could do iv sedation and skip general and reduce the risk right there.
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TTC2Long
by on Apr. 18, 2013 at 5:47 PM
They will give him gas just long enough to make him sleepy, then snip, cauterize and done. No iv.

Quoting IrishIz:

So my first question is why general anesthesia and not sedation? They could do iv sedation and skip general and reduce the risk right there.
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mostlymaydays
by Group Mod-Stacy on Apr. 18, 2013 at 5:51 PM
That sounds kind of backwards from what other people experience: usually very young babies get the clip in office while they want to do general for older babies.

If it were me, I'd probably get a second opinion to see if anyone else will do it in-office now. If this were my only option and I wasn't having issues I'd wait for the non-anesthesia option. My kids have had eye surgeries before a year and I really hate exposing them to the risks of anesthesia. But you do what you've got to do, right? Ideally you'd find someone who can do it now without the general. I'd get a second opinion and see what other options might exist.
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TTC2Long
by on Apr. 18, 2013 at 5:56 PM
I know, I was surprised he couldn't do it right then. He said they usually do tongue ties in the office because they are thin and don't have a blood supply. They can do lip ties if they are thin, as well, but his is very thick. Either way, he will be sedated, regardless. What we'll skip by waiting is the overnight hospital stay.

Quoting mostlymaydays:

That sounds kind of backwards from what other people experience: usually very young babies get the clip in office while they want to do general for older babies.



If it were me, I'd probably get a second opinion to see if anyone else will do it in-office now. If this were my only option and I wasn't having issues I'd wait for the non-anesthesia option. My kids have had eye surgeries before a year and I really hate exposing them to the risks of anesthesia. But you do what you've got to do, right? Ideally you'd find someone who can do it now without the general. I'd get a second opinion and see what other options might exist.
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IrishIz
by Silver Member on Apr. 18, 2013 at 6:01 PM
Oh so that's not general anesthesia. Honestly....I'm not sure why they would want to keep him overnight. Schedule him first thing in the am and go home in the afternoon if they want to watch him.

My son had a tie taken care of when he was about 6-8 years. I forget when it happened exactly. We were going to do it in the office but he's autistic and wouldn't sit in the chair right side up...he insisted his head belonged at the feet. The doctor decided....hospital. Lol. His was thick and we did it so that he could get braces and get rid of the gap. I know he was older but bleeding was a non issue.

I think they need to either do it in office or do it with sedation and let him go home if all looks good.


Quoting TTC2Long:

They will give him gas just long enough to make him sleepy, then snip, cauterize and done. No iv.



Quoting IrishIz:

So my first question is why general anesthesia and not sedation? They could do iv sedation and skip general and reduce the risk right there.
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TTC2Long
by on Apr. 18, 2013 at 6:07 PM
The doc used the words general and gas. He said a 24 hour observation period for newborns is recommended by the national anesthesiologist org and some other group. I don't remember.

Quoting IrishIz:

Oh so that's not general anesthesia. Honestly....I'm not sure why they would want to keep him overnight. Schedule him first thing in the am and go home in the afternoon if they want to watch him.



My son had a tie taken care of when he was about 6-8 years. I forget when it happened exactly. We were going to do it in the office but he's autistic and wouldn't sit in the chair right side up...he insisted his head belonged at the feet. The doctor decided....hospital. Lol. His was thick and we did it so that he could get braces and get rid of the gap. I know he was older but bleeding was a non issue.



I think they need to either do it in office or do it with sedation and let him go home if all looks good.




Quoting TTC2Long:

They will give him gas just long enough to make him sleepy, then snip, cauterize and done. No iv.





Quoting IrishIz:

So my first question is why general anesthesia and not sedation? They could do iv sedation and skip general and reduce the risk right there.
Posted on the NEW CafeMom Mobile
mostlymaydays
by Group Mod-Stacy on Apr. 18, 2013 at 6:18 PM
I've heard here about pediatric dentists who cut and cauterize with lasers, just with local anesthetics. I'd investigate all my options. I'm really surprised they want to admit him for overnight observation. That's quite a bill.

Quoting TTC2Long:

I know, I was surprised he couldn't do it right then. He said they usually do tongue ties in the office because they are thin and don't have a blood supply. They can do lip ties if they are thin, as well, but his is very thick. Either way, he will be sedated, regardless. What we'll skip by waiting is the overnight hospital stay.



Quoting mostlymaydays:

That sounds kind of backwards from what other people experience: usually very young babies get the clip in office while they want to do general for older babies.





If it were me, I'd probably get a second opinion to see if anyone else will do it in-office now. If this were my only option and I wasn't having issues I'd wait for the non-anesthesia option. My kids have had eye surgeries before a year and I really hate exposing them to the risks of anesthesia. But you do what you've got to do, right? Ideally you'd find someone who can do it now without the general. I'd get a second opinion and see what other options might exist.
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tabi_cat1023
by Group Mod - Tabitha on Apr. 18, 2013 at 7:49 PM
HMMM I think I would just get it done and over with...and I am used to this being cut with lasers so no real bleeding
GoodyBrook
by on Apr. 18, 2013 at 7:56 PM

Can you find someone who will laser it instead of the cut/cauterize process.  I've heard it's kinder on the child, but don't have personal experience.

I'm in your shoes, too.  I have oversupply and OAL.  Both my sons had lip and tongue ties and poor latches.  BUT they gained great because of my oversupply, and they managed to deal with the OAL without too many problems.

I'm considering not clipping either boy.  I'm enduring the latch, so I can't think of a good reason to cut my child.  Is it necessary in every case?  Cosmetically, I'm not concerned with the space between the upper teeth at all...

(My older son's teeth are not showing any problems, and he's 2 years old.  My youngest is 3 months old).

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