Nursing Through Tongue and Lip Ties
When most people think of the term “tongue-tie”, they think of someone’s inability to speak or stick their tongue out. But in reality, it basically means the tongue’s motion is restricted, otherwise known as anklyoglossia. With the rise in the United States breastfeeding rates, tongue ties are gaining recognition. More moms are struggling to nurse their precious new babies and don’t understand why, or are easily giving up. I know this because I was one of those moms just nine months ago. I nursed my oldest daughter Isla for nearly 18 months pain-free (other than those first brutal few days postpartum), but when my youngest was born, all my nursing experience went out the window.
After just giving birth to our second daughter Maeve at home and having such a healing birth experience, I intuitively knew something was wrong when I went to put her on my breast to latch her and she just didn’t. A few hours later, my midwives did her newborn exam and immediately noticed that she had both an anterior tongue tie and a lip tie. They mentioned getting them revised if we had issues nursing. I had heard of a tongue tie briefly in a pediatric seminar I had taken in chiropractic school, but didn’t realize the impact a tongue tie could have on a nursing relationship.
Babies with tethered oral tissue will routinely latch poorly, make clicking or smacking sounds while nursing, be frustrated or fall asleep at the breast, experience reflux, or have trouble gaining weight. Meanwhile, mom may be experiencing pain with nursing, flattened nipples post-feed, blistered or cut nipples, incomplete drainage of the breast, clogged ducts, or mastitis. In my experience, this was incredibly frustrating and painful. Once we would get her on the breast with a good latch, she would fall asleep. Tied babies often use their facial muscles to nurse, causing them to become tired quickly and fall asleep at the breast before a full feeding. I had stagnant milk left in my breast at every nursing session; along with bleeding and cracked nipples that allowed for bacteria to come in, it ultimately led to a horrible case of mastitis that later resulted in a breast abscess.
At my one week postpartum visit, my midwife snipped her lip tie and anterior tongue tie with scissors, and then referred me to a local OT that specializes in tethered oral tissues in pre-crawling babies. At around 10 days old, we had her buccal ties, lip, and tongue ties revised with a laser.
After a tie is identified, it is important to know that when the baby is not quite ready for revision, the nursing relationship can actually get worse. I have seen many clients in my practice that had a revision too early, resulting in baby struggling to gain weight or latch properly; I’ve also seen some at risk of dehydration. In addition, it is important to have pre-frenectomy therapy by a bodyworker to help prepare the tissues for the best release possible and to train the muscles how to properly transfer milk from the breast or bottle; usually there are a lot of compensation patterns that need to be broken.
I often tell my clients that nursing a tied baby will likely be the hardest thing they will ever endure. I would rather give birth a million times than struggle through that first 6-8 weeks nursing Maeve again. It is so critical to surround yourself with people who love and support you during your Motherhood Transition. So many times people would ask me, “Why not give up?” or “Why not pump and give her a bottle?” or “ Why continue to struggle when you don’t have to?” However, I knew that continuing nursing my daughter was the best thing for our relationship. I would not still be nursing my sweet girl if it wasn’t for my midwives, doula, OB, breast surgeon, IBCLCs, chiropractor, and the oral motor feeding therapist, Michelle. It takes a group of providers working together to have a successful tie release and nursing relationship. Tongue and lip ties can be diagnosed by a variety of providers, such as midwives, OB/GYNs, chiropractors, OT/PTs, or IBCLCs. A release provider can be an ENT or pediatric dentist. Here is a link for Facebook groups by state to find someone near you! Reach out to your support circle, lean into them when you are struggling, and let them lift you up!
Shaina Hickman, D.C.BIRTHFIT East Cincy @birthfit_eastcincy