What You Need to Know about Breastfeeding with a Tongue Tie or Lip Tie

Breastfeeding is a beautiful and natural process, but sometimes unexpected challenges can arise, particularly when faced with breastfeeding with a tongue tie. In my personal experience, dealing with lip and tongue ties in my newborn made the early days of breastfeeding a struggle.

In this detailed exploration, I’ll share my journey, delve into what tongue ties are, discuss symptoms and treatment options, and provide essential information for parents navigating breastfeeding challenges.

My Experience Breastfeeding with a Tongue Tie and a Lip Tie

My son had trouble from the beginning latching on to breastfeed. When my milk came in three days after he was born, he was really struggling because my breasts were so full. (That can be difficult for any newborn even without ties).

I had a lactation consultant out and she watched us through the feeding and gave us some tips and gave us an A+. I guess because I had studied so much, I must have been compensating for any issues that were happening, because the outward perception was – we were doing great.

By day five, I knew we were having a problem because he was hungry and frustrated but he wouldn’t eat. The LC had mentioned a possible lip tie, but I didn’t know what that was so it didn’t click for me that he had a birth defect. I just thought I wasn’t doing something right. On top of that, my nipples hurt. They were cracked and bleeding. (To read about those first days breastfeeding my son, click here.)

We went in for his check-ups and he wasn’t gaining weight at all, so we started supplementing and went back to the LC. Now that he was a little older she said the tie wasn’t stretching and recommended we have it released. His tongue also looked fine, but as we found out at the pediatric dentist, he had a posterior tongue tie in addition to the lip tie.

When my son was just three weeks old we had both his lip tie and tongue tie revised with a surgery called a frenectomy.

Understanding Tongue Ties and Lip Ties

Tongue ties (ankylogossia) and lip ties are conditions where the frenulum—the small fold of tissue restricting movement—is too tight, impeding normal functioning. A tongue tie affects the tongue’s up-and-down motion crucial for breastfeeding. A lip tie hinders effective latching by restricting the outward flange of the lip.

Tongue Ties, Lip Ties, and Breastfeeding

I didn’t know anything about ties, so hopefully, this will enlighten any of our readers.

Basically, all over our bodies, we have various frenulum, which is a small fold of tissue that prevents an organ in the body from moving too far. This tissue in my son’s upper lip and under his tongue was too restrictive. Both of these issues can cause problems with feeding, especially breastfeeding, (although it can cause issues with bottle feeding as well).

What are Tongue Ties and how do they affect Breastfeeding?

A tongue tie hinders the up-and-down motion of the tongue, which affects breastfeeding in that it is directly linked to low milk supply because there is not enough milk extracted from the breast.

With a posterior tongue-tie, the tongue does not extend over the gum. This causes the tongue to chew (or as I like to call it, “chomp”) on the nipple.

How Do Lip Ties Affect Breastfeeding?

With a lip tie, the baby is unable to latch effectively. This is because the lip is hindered from flanging outward during a feeding. The mouth is unable to open wide and a smaller mouth opening means a shallower latch. All the pain I was feeling was a combination of the tongue chewing on my nipple and my son sliding his latch down just to nurse on the nipple.

When breastfeeding correctly, you want a deep latch that includes the areola as well as the nipple. The lips form a much more effective seal when it is formed with the mucous membrane inside the lip, rather than the dry part of the outward lip. (This latch is correct, and thus pain-free!)

These ties were causing pain for me. They were also beginning to cause me to have a low milk supply because my son wasn’t able to latch properly or extract enough milk. In turn, this caused him to not gain weight and get labeled FTT.

Surgery to Release the Ties

The out-patient surgery, (or surgeries I should say), were very quick. Of course, before the surgery, I was extremely emotional. I was just three weeks postpartum. Plus we had been through all this with his sluggish weight gain and the crazy feeding routine we were following to get him to gain. It was the first time our son had ever been out of sight of either my husband or me.

Our pediatric dentist was recommended to us by my lactation consultant and he was such a kind and reassuring doctor. He was great with our tiny son and with us. When I inevitably started the waterworks, he said gently, “It’ll be OK, Mom.”

So they took my son into the other room and he had the laser surgery to remove both ties. It took less than 15 minutes. Due to the fact it was a laser surgery, there was no bleeding and very little inflammation. We were told we could give him “>numbing agent if needed. The only post-op care he needed, besides the mild pain relief, was very simple. We had to run our fingers over the wounds both under his lip and under his tongue to keep the frenulum from reattaching.

We were also advised not to use coconut oil to aid in achieving a deeper latch because it was such an effective healing agent.

Did Releasing the Tongue and Lip Ties Aid Breastfeeding?

The short answer is, yes. Some people see results right away and for others it takes time. We fell into the latter category. I believe that in those three weeks my son hadn’t been building the muscles he needed to breastfeed, so he had a lot of weaknesses in his mouth and jaw. We saw a speech pathologist to help strengthen these weaknesses. The release of both the lip and tongue tie, coupled with the help of the speech pathologist led to my son’s exclusively breastfeeding before he turned 3 months old.

Is Breastfeeding Worth All The Trouble?

It was very important to both my husband and to me that I breastfeed my son. There are so many incredible benefits to breastfeeding a baby.

Also, lip and tongue ties can lead to other issues besides early feeding struggles, including:

• trouble with feeding an older baby or toddler solids,
• speech challenges, and
• dental problems.

So although breastfeeding was our main catalyst for having the ties released, we wanted to help our son avoid additional challenges later on as well.

For more information about the benefits of breastfeeding, read 15 Amazing Benefits of Breastfeeding.

Tongue Tie Symptoms

• Understanding the symptoms of tongue ties and lip ties is important for early recognition and intervention. If you observe any of these symptoms in your child, talk to your healthcare provider or a specialist in tongue tie diagnosis and treatment.

Early intervention can help improve the breastfeeding experience and prevent potential long-term complications.

Tongue Tie Symptoms in Babies

Common symptoms include:

• Difficulty latching onto the breast
• Frustration or discomfort during feedings
• Poor weight gain

In addition, babies may feed for extended periods of time because they aren’t gaining enough milk.

Tongue Tie Symptoms in Newborns

• Inadequate Weight Gain: Newborns may experience challenges in gaining weight at a healthy rate. The limited range of motion in the tongue can hinder the baby’s ability to extract enough milk while feeding.
• Sleep Difficulties: Tongue tie can contribute to sleep difficulties in newborns. The effort required for feeding due to the restricted tongue movement may leave the baby fatigued, affecting their sleep patterns and overall well-being.
• Clicking Sounds During Feeding: Sometimes there might be a noticeable clicking sound while your newborn is feeding. The inability to form a proper latch may result in the baby breaking suction during feeds, leading to audible clicks.

Tongue Tie Symptoms in Infants

• Difficulty Latching: One of the primary indicators of a tongue tie in infants is difficulty latching onto the breast. Babies may struggle to form a proper latch due to the limited mobility of the tongue. This can lead to frustration for the baby during feeding sessions.
• Fussiness and Irritability: Babies might become fussy or irritable during feeds. The struggle to effectively latch and extract milk can cause distress during what should be a nourishing and comforting experience.
• Prolonged Feeding Sessions: Tongue tie can lead to prolonged feeding sessions as the baby works harder to extract milk. If your baby consistently feeds for an extended duration without apparent satisfaction or weight gain, it could be a sign of a tongue tie affecting feeding efficiency.
• Speech Development Challenges: As infants grow, an effect on speech development may become apparent. Tongue ties can contribute to speech challenges sometimes leading to difficulties later in childhood.
• Refusal of Solid Foods: Introducing solid foods to infants with a tongue tie can be challenging. The limited tongue mobility may result in difficulties in manipulating and swallowing solid food, leading to a reluctance to accept new food.
• Dental Issues: Restricted tongue movement can hinder effective cleaning of the mouth causing oral hygeine . This may contribute to a higher risk of dental problems if not addressed.

Tongue Tie Symptoms in Older Children

• Persistent Speech Articulation Issues: In older children, the impact of a tongue tie on speech articulation may persist. Pronunciation difficulties, especially with certain sounds, can be an ongoing symptom that may require intervention.
• Challenges with Wind and Brass Instruments: For children involved in activities like playing wind or brass instruments, a tongue tie can present challenges. The limited mobility of the tongue may affect the ability to manipulate the instrument effectively.
• Social and Emotional Impact: Children with speech challenges may experience social and emotional challenges. Addressing these symptoms in older children can contribute to improved self-esteem and overall well-being.

Tongue Tie Assessment and Diagnosis

If you suspect your baby has a tongue tie, seeking a professional assessment is essential. A lactation consultant or pediatrician can provide a diagnosis based on a physical examination and an understanding of your baby’s feeding patterns.

• Parental Observation: As a parent, you play a crucial role in observing your baby’s feeding behaviors. Take note of any signs of difficulty latching, prolonged feeds, or frustration during breastfeeding sessions. These observations serve as valuable insights for healthcare professionals.
• Consultation with a Lactation Consultant: Lactation consultants are trained to assess breastfeeding challenges, including the impact of tongue ties. They will observe your baby’s latch, and feeding patterns, and also consider any associated symptoms.
• Pediatrician’s Evaluation: A pediatrician will conduct a comprehensive physical examination which involves assessing the appearance and mobility of the baby’s tongue. The pediatrician will consider factors such as the appearance of the frenulum (the band of tissue beneath the tongue) and any restrictions in movement.
• Feeding History Analysis: Providing details about feeding duration, frequency, and any challenges experienced can assist healthcare professionals in forming a holistic picture of the situation.
• Specialized Tools and Techniques: In some cases, healthcare professionals may use specialized tools or techniques to assess the tongue’s range of motion. This could involve gently lifting the baby’s tongue to evaluate the degree of restriction and the appearance of the frenulum.
• Consideration of Associated Symptoms: A comprehensive assessment involves considering associated symptoms beyond feeding difficulties. Issues such as poor weight gain, clicking sounds during feeds, and maternal nipple pain are taken into account.
• Follow-Up Assessments: In cases where a tongue tie is diagnosed and intervention is recommended, follow-up assessments are crucial. These assessments monitor the progress of any intervention, ensuring that the baby’s tongue mobility improves, and breastfeeding challenges are effectively addressed.

If you suspect your baby may have a tongue tie, don’t hesitate to seek professional help for a thorough assessment and appropriate intervention.

Tongue Tie Treatment Options

Once a tongue tie is diagnosed, determining the most suitable treatment option becomes pivotal for addressing the challenges associated with breastfeeding and potential long-term implications.

Various treatment options exist for tongue ties, ranging from conservative measures to surgical intervention. Tongue tie exercises, recommended by healthcare professionals, can help improve tongue mobility.

In cases where conservative methods are insufficient, a tongue tie release procedure, commonly known as a frenectomy, may be recommended.

• Tongue Tie Exercises: Tongue tie exercises involve gentle stretches and movements aimed at improving the mobility of the baby’s tongue. These exercises can be recommended by healthcare professionals and are often performed by parents as part of the post-diagnosis care routine. Consistent and gentle exercises can contribute to enhanced tongue function over time.
• Laser Frenectomy: Laser frenectomy has become a popular and minimally invasive procedure for releasing tongue ties. Using laser technology, the tight band of tissue (frenulum) beneath the tongue is precisely cut, allowing for improved tongue mobility. This method is known for its reduced bleeding and quicker recovery compared to traditional methods.
• Traditional Frenectomy: Traditional frenectomy involves cutting the frenulum using sterile scissors or a scalpel. While this method is effective, it may result in more bleeding compared to laser frenectomy. The choice between laser and traditional frenectomy depends on factors such as the healthcare provider’s expertise and the specific needs of the baby.
• Post-Operative Care: Regardless of the chosen treatment method, post-operative care is crucial for preventing reattachment and promoting optimal healing. Parents may be instructed to perform gentle stretches or exercises to ensure the tongue tie does not re-form. Adhering to the prescribed care routine is vital for a successful outcome.
• Pain Management for the Baby: After the procedure, some babies may experience mild discomfort. Pediatricians may recommend appropriate pain management options, such as over-the-counter pain relievers suitable for infants. This helps ensure the baby’s comfort during the recovery period.
• Breastfeeding Support: Breastfeeding support is an integral aspect of the treatment process. Lactation consultants play a key role in assisting mothers and babies with re-establishing effective breastfeeding post-procedure. They provide guidance on latch techniques and monitor the baby’s feeding progress.
• Speech Pathology Intervention: In cases where tongue tie impacts speech development, a speech pathologist may be involved in the treatment plan. They can provide exercises and strategies to support the development of speech sounds and oral motor skills as the child grows.
• Reassessments and Follow-Ups: Following the intervention, regular reassessments and follow-up appointments are scheduled to monitor the baby’s progress. These appointments ensure that the tongue tie release has been successful and that the baby’s feeding and oral development continue to improve.
• Parental Education and Support: Educating parents about tongue tie, its treatment options, and the importance of consistent post-operative care is crucial. Providing ongoing support and addressing any concerns or questions parents may have contributes to a positive treatment experience.

The treatment of tongue tie involves a range of options tailored to the specific needs of the baby and the family. From non-invasive exercises to precise surgical procedures, the goal is to enhance tongue mobility, alleviate breastfeeding challenges, and mitigate potential long-term consequences. Collaborating with healthcare professionals and actively participating in the treatment plan ensures the best outcomes for both the baby and mother.

FAQs – Frequently Asked Questions about Tongue Ties, Lip Ties and Breastfeeding:

Conclusion

Remember, you are not alone in this journey! There is a wealth of support and information available to guide you every step of the way.

By recognizing symptoms early, seeking professional guidance, and adopting a systematic approach to treatment and support, parents can navigate this journey successfully.

Resources for Tongue Ties, Lip Ties, and Breastfeeding

1. Tongue and Lip Ties by La Leche League International 
2. Ankylogossia in Children by Cedar Sinai
3. Tongue-tie (Ankylogossia) by Mayo Clinic
4. The Womanly Art of Breastfeeding by La Leche League International 
5. Dr. Jack Newman’s Guide to Breastfeeding by Dr. Jack Newman 
6. Latch: A Handbook for Breastfeeding with Confidence at Every Stage by Robin Kaplan M.Ed.
7. La Leche League International Website
8. Internation Lactaction Consultant Association Website