At my second daughters’ 9 month well-baby check up, her doctor casually mentioned that she thought it looked my daughter had a lip tie and should go to a pediatric dentist to get it checked out. I nodded and said “oh, ok” and went about the rest of the day. I had no idea what a lip tie was but I was about to get a complete lesson in why the first year of breastfeeding my first daughter was the way it was.
After some initial research online, I started realizing that a lot of the classic signs of a child having lip and tongue ties were describing my daughter almost perfectly. Turns out a lip tie is when the frenulum restricts the upper lip to the gums which can make creating the seal necessary for nursing difficult. It is also the companion to the tongue tie, where the frenulum under the tongue restricts the tongue and it’s movement. It can impact breastfeeding as an infant but, depending on its severity, can impact speech, dental health, cause snoring and breathing issues in children, and is a common root cause of the need for braces later in life.
Some of the symptoms that breastfeeding moms will notice include:
- Nipple pain
- Nipples looking pinched or creased after nursing
- Low milk supply due to ineffective milk transfer
- Plugged ducts
- Recurring thrush
- Poor latch of baby, not being able to hold a pacifier in on their own
- Clicking sound when baby is nursing
- Inadequate weight gain or weight loss
- Gas and reflux
- Fussiness and arching away from the breast
- Difficulty maintaining a latch or breast slipping
- Fatigue after a few minutes of nursing or frequent falling asleep at the breast
- Needing to use a nipple shield
Is this how it’s supposed to be?
In my daughters first year, I couldn’t understand why so many women loved breastfeeding. I stuck with it for practical reasons primarily (formula is expensive and we were a one income family at the time, plus I believed breast milk is the healthiest option) and, yes, it did have it’s nice moments of looking down at my little girl or feeling her “raccoon” hand as I called it when her hand would wonder around my neck and face. However, in general, I didn’t enjoy 30 minute nursing sessions every 2 hours and her constant need to be held and barely managing to shower more than once every 2-3 days.
I dealt with almost all of the symptoms between my two girls. In the hospital with my first, within the first 24 hours my daughter was proving difficult to nurse. I had the lactation consultant in and out of my room the whole time plus the usual rotation of nurses trying every trick they could think of including a lot of manhandling of my breasts to try to make it happen.
I was a member of a couple of breastfeeding support groups on Facebook and regularly commented about various concerns on forums. I recall hearing about tongue ties but it seemed liked the defining characteristics were being able to clearly see the piece of flesh attaching the tongue to the bottom of the mouth and the child being able to stick her tongue out. I even checked my daughter but she could put her tongue out past her lips and she had a posterior tongue tie that you cannot see unless you lift the tongue.
I suppose one of the reasons I didn’t have some of the symptoms was because I used the nipple shield. Embarrassed by it, I didn’t often mention it but when I did, I would get a lot of comments on how it was horrible and that I needed to wean her from it as soon as possible. The thing was, I couldn’t. She couldn’t. She wouldn’t be able to attach without its assistance. I didn’t know it at the time, but I would end up using a nipple shield until that child was 1 month shy of her 2nd birthday.
To revise or not to revise?
Going to the dentist office with both girls for our consultation made it clear that both girls did, in fact, have lip and posterior tongue ties. I couldn’t keep myself from crying. It quickly turned to anger – I had come across so many people in my time nursing and was a current member of an in-person monthly meeting yet not one person could recognize the true issue going on. A procedure that ended up taking a few minutes could, should have been noticed that first day in the hospital in 2011. It could have been corrected that day.
In an attempt to avoid some of the long term effects that may come out of their ties we opted to revise both the lip and tongue ties of our then 10 month old and the tongue tie of our then 4 year old. In was not a fun day in our household. I felt bad about leading our 4 year old in there since she actually liked going to the dentist. It was not fun holding down our daughters to have a laser cut away the thin pieces of flesh and they both cried a lot.
In a way, it was beneficial having an older child along with the infant going through the feeling process. Since she could understand what I was asking her to do, it helped us know how the healing process was going. After a few days of getting her to do her tongue exercises regularly she was on the mend. Almost immediately, I could hear an improvement in the her clarity of her speech. She no longer breathes through her mouth as much as she did before which should help her palette form better as she continues to grow.
The 10 month old, on the other hand, did not go so smoothly. There were a lot of tears for baby and mom during the healing process. One of my fears was appearing to come true as she developed a nursing aversion and I had to pump to bottle feed her. A little over a week, it seemed like the pain had finally subsided and I am glad that I did not give up on offering her the option to nurse.
The first time she nursed again made me tear up. Her latch was much stronger, she nursed for a shorter amount of time and seemed satisfied, plus there was no more pain.
Unfortunately, she looks at me like I grew an extra head if I don’t use a nipple shield so at 22 months (even after my going back to work for almost a year now) we nurse at least once a day with the shield. I have no idea how much longer she’ll go but I do know that it will be her call when to stop and that I was able to do all I could to be able to give her breast milk for as long as she needed. It has been a blessing when she’s been sick and it’s the only thing she’ll ingest.
Where is my time machine?
I wish I had known better what questions to ask but I didn’t. I wish I had spoken up more, researched more, or gotten other opinions. I thought this was just the way it was. I wonder how many other mothers end up giving up on their breastfeeding goals because the stress was too much. It still pains me how little a lot of people in the medical profession and even those in the lactation consultant arena know about this – 2 lactation consultants and a handful of lactation group leaders from 2 different cities missed it.
Since going through all of this, there are certain keywords that make me perk up when I see them in breastfeeding support forums that may indicate lip or tongue ties and am getting better about speaking up and making sure they are informed about what it may mean. At least one family friend had a child born with a tongue tie and I am happy that she able to have in corrected very early on and they just reached the one year mark of breastfeeding. I was sure to thank the doctor that noticed the lip tie and let her know to keep looking for it and educating other doctors on what to look for.
Ties are more common than you may think and they have always been around. Unfortunately with the rise bottle feeding, the knowledge about them fell by the wayside. Hopefully you can now recognize a when a mom may be dealing with a lip or tongue tie and speak up and let them know they are not alone and it doesn’t mean they have to push through the pain or stop breastfeeding before they are ready to. Many insurances cover at least a portion of the procedure and the Dayton area is lucky enough to have at least 3 pediatric dentists that can identify and treat ties.
Have you or someone you know dealt with lip or tongue tie with their babies?