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Healthy Baby Happy Parents
Feeding
Breast Feeding
There is broad consensus that breast-feeding is best for babies. Remember that it can take up to five days for a mother's milk to fully let down. In the beginning, your baby will be getting a small amount of a very important fluid called colostrum. Because infants void and stool (thick greenish meconium) but do not receive a large amount of milk, they normally lose weight in the first few days. If weight loss becomes excessive, you will be counseled on appropriate management. Piedmont Augusta Hospital has lactation consultants to provide breast-feeding support. Detailed information can be found at the following resource: https://www.uptodate.com/contents/breastfeeding-guide-beyond-the-basics/print
Pumping
Piedmont Augusta Hospital has electric breast pumps available. Breast milk production is optimized when babies are breast fed every three hours. Sometimes it is helpful to pump in lieu of placing your baby on the breast. A lactation consultant will guide you if necessary. If for any reason you are separated from your baby, pumping and collecting milk is a good substitute for breast-feeding.
Bottle Feeding
If you choose to bottle feed, the formulas offered at Piedmont University Hospital provide very good nutrition. The first-line formula chosen for you baby is Similac Advance. If spitting becomes a problem, the formula may be changed to a second-line formula such as Total Comfort. Please share family nutrition history with your baby's doctor.
After discharge, your formula may be changed by your Pediatrician or the WIC program (if eligible). If you would like to use a formula that is brought from home, one different than Piedmont Augusta offers, then tell your nurse.
Tongue Tie
Ankyloglossia
A rare condition that can limit tongue movement is when the tongue has a fibrous cord of tissue connecting the underside of the tongue to the floor of the mouth. The fibrous tissue is called lingual frenulum. When it is located toward the tip of the tongue and is thick, the tongue can be limited in mobility making the infant’s latch on the breast ineffective. In severe cases, the tongue can demonstrate a heart-shape. when the baby is crying. The medical term for this condition is ankyloglossia or anchored tongue. Sometimes the upper lip can have fibrous tissue limiting mobility, too.
The Coryllos ankyloglossia grading scale is a system for noting the type of tongue-tie.
- Type I: The frenulum is thin and elastic and anchors the tip of the tongue to the ridge behind the lower teeth.
- Type II: The frenulum is fine and elastic, and the tongue is anchored 2 – 4 millimeters from the tip to the floor of the mouth close to the ridge behind the lower teeth.
- Type III: The frenulum is thick and stiffened, and anchors the tongue from the middle of the underside to the floor of the mouth.
- Type IV: The frenulum is posterior or not visible, but when touching the area with the fingertips, the examiner can feel tight fibers anchoring the tongue, with or without a thickened, shiny surface on the floor of the mouth.
A thorough evaluation considers not only the Coryllos grade, but also how well the child’s tongue is able to move. The Hazelbaker assessment tool for lingual frenulum function (HATLFF) or a similar tool, can be used to assess tongue function.
If severe while in the hospital, an ENT can be consulted to clip the fibrous tissue under the tongue. Another option is to seek outpatient care by either an ENT or a dentist who specializes in treatment.
For more information, read this article from the December 2023 New York Times: