Tongue Ties and Feeding your Baby

Tongue Ties and Lip Ties

Breastfeeding is not an easy task or what many people expect. It’s like getting a manual to drive a car, told to get in and drive, without being shown the best way to work all the buttons and levers! Sometimes how the manual is written doesn’t translate into what you are seeing and doing. Those little flailing hands, moving head, and unable to ignore hunger cries, that can escalate into a loud screech you are praying the neighbours don’t notice! The last thing you need is someone else giving you a comment, making you feel as if you are already failing when your new baby has just began their life journey. ‘Breastfeeding is supposed to be natural’. Your friends made it look easy. But most of the time, it’s not what mothers’ anticipate….it’s not reasonable to “relax” and feel calm when you are dealing with a whole whirlwind of moving parts, all the while trying to keep a new little human alive. Talk about pressure!

I know. I’ve been there! And all the prenatal classes, and books/videos, don’t seem to be all that helpful. You can be watching the techniques, and trying to mimic the hold and positioning and yet it still HURTS. It can make your toes curl!

What is going on? All you want is for this pain to be over! You sit in that new nursing rocker, with your new breastfeeding pillow and chant “please, please be like all the books and the videos portrayed”. “ I want to be that smiling mom as I have to feed this little one every couple of hours!”

 

Why would anyone want bruised, cracked, and bleeding nipples?

Doesn’t sound even remotely fun or anything any woman would sign up for willingly. The second sacrifice to our bodies after birth (and thankfully, we forget as we might all just have one child) can be the tissue demise of our poor nipples. Sadly, this occurs more often than anyone talks about.
Automatically we think we aren’t doing it “right”. Something must be wrong with ME.

 

One reason that more and more health care providers are exploring is that babies can be born with a tight frenulum or a tongue tie (ankyloglossia).

This is the fibrous band located under the tongue that can cause the tongue to be tethered. It can be caused by environment (diet such as folic acid) and genetics. It can feel like your infant is chomping or biting the nipple despite you being told the “latch looks good”. The nipple can come out of the babies mouth misshapen. Looking like a squish, pinch, or like the top of a lipstick tube. Some infants don’t grow enough, make a clicking sound, have really long feeds, or feed very often. Frequent feeding can lead to engorgement, blocked ducts, and sore, painful nipples. This ineffective feeding can make moms and babies frustrated. It’s like chewing tough meat. Your baby tries to feed with lots of energy, but then they tire quickly, and still remain hungry. Sometimes if mom has a fast let down (thanks to oxytocin), and an abundant supply, the baby can do “ok” for the first few weeks/months. Then when the milk supply decreases (our bodies regulate after a couple of months), look out! As the nipples can and will be used more often. This can translate from a once comfortable feed…… to pain, and the growth of your baby can decrease. This reduction in weight can be in part to moms not wanting to feed as long or often with pain. In addition some women end up with a condition called Raynaud’s phenomenon (vasospasm) from the nipple being squished. Tongue ties can lead to blocked ducts, and mastitis. Not to mention (as you are already feeling terrible) that damaged nipples also can contribute to yeast (candida).
As for your child, what are some long term consequences of a tongue tie? Some children talk with a lisp, and have speech impediments. Tongue and lip ties can also contribute to dental caries (cavities) and teeth that are crooked (the frenulum pulls the teeth that are developing out of alignment). Other research discusses GERD or acid reflux, gas (colic symptoms) and TMJ (temporomandibular joint disorders) from untreated tongue ties.

So what can be done?

A trained health care provider can revise the tongue or lip frenulum (the restrictive band or web) with a simple procedure. Because there is not a lot of nerves under the tongue, it is not overly painful. The short term crying of the infant comes from being restricted or held tightly which resolves quickly once they are released to parents. This procedure can take seconds and it can cause instant relief. Sometimes it is not a tongue or lip tie restricting the latch, but a trained professional can rule this out. So before you quit, blame yourself, or think you don’t have the right “stuff” to breastfeed…..get a trained professional to give you options. We all know that breast milk is the perfect and most beneficial food for infants (and for Mom’s benefit too), just like we know using a car has many benefits for getting us from A to B. We just need a bit more driver training to really understand all the perks of using the car, and to prevent a car crash. A trained lactation consultant and breastfeeding expert can really help you get to that easy and enjoyable experience. You can feel more confident and know….”You got this girl”.

By: Tara Boyes- Shantz MN, NP, IBCLC www.latchedon.ca

Kumar, J, Kalke, E. (2012) Tongue-tie, breastfeeding difficulties and the role of Frenotomy. Acta
Paediatrica 2012 101, pp. 687-689.
Edmunds, J. Fulbrook, P. And Miles, S. Understanding the Experiences of Mothers who are
Breastfeeding an Infant with Tongue- Tie: A Phenomenological Study. Journal of Human Lactation. 2013
29:190.
Ankyloglossia ( Tongue tie). Dr. Kotlow. Https://kiddsteeth.com/assets/pdfs/articles.
DT Geddes. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and
sucking mechanism as imaged by ultrasound. Https://www.ncbi.nlm.nih.gov>pubmed.
Photos: momjunction.com, breastfeedingusa.org