Breastfeeding

Breastfeeding pain? Is a tongue tie the issue?

Are you still struggling with breastfeeding pain even though you’re several weeks postpartum? Your baby may actually have a tongue tie that you cannot see. There are several different ways a tongue tie can present itself and not all tongue ties need a revision. Here’s is my story and I hope it helps you through your own motherhood journey.

Parenthood is such a mixed bag. You go into it with this blind hope that you know what your doing but quickly discover that actually, you have no idea. None. You’re in new territory now and the lessons learned are only through the hard way. Experience. But hang in there mama! There are people who have been in your shoes before and we know how it feels to be completely at a loss in what to do next.

When you’re struggling with nursing your baby, there is little else that seems to matter. It’s an all-consuming task and can soon become the only thing you think about all day, every day. After all, nourishing your baby is supposed to be rewarding and comforting. So why is breastfeeding so frigging hard sometimes?

When my son was born, I immediately fell in love with his precious, tiny old man face. My doctor even said he looked like an old soul and I still feel that this is true about him. He’s also very much my spirited child. I’d like to say that those first few months were pretty tough on my spouse and I, but really, we struggled on and off for much of our first two years as a family of three. After the initial newborn sleepy phase, Little T was a colicky baby – meaning he would cry inconsolably every single evening for at least a few hours. He was a terrible napper and didn’t sleep that well at night either.

Our pediatrician assumed he had reflux and we tried a few different medications but nothing seemed to make a difference. I also felt really uncertain about the need to put my teeny tiny baby on a medication that he may or may not actually need. He was an extremely distracted nurser, didn’t care for pacifiers and never ended up taking a bottle. (This was partially my own fault as I was overly concerned about nipple confusion and never consistently gave him the bottle option. Which I should have, as I sorely needed the break.)

He very likely did have reflux through and since we didn’t treat him with medication it likely contributed to his frequent nursing strikes and fussing at the breast. After all I went through with my daughter (you can read more about that here), I know now that I should have at least cut out dairy from my diet and he probably would have done much better. But I had no idea, and in my haze of new mom anxiety and utter exhaustion, I can’t remember if anyone ever even mentioned this to me. Still, I felt that maybe something else could be wrong.

When Little T was about 6 weeks old I met with my lactation consultant because I was still having difficulty with breastfeeding and nipple pain. I had inverted nipples, which you can read more about here, and I assumed this was the major contributor. She studied our latch, checked in his mouth and determined that he had a posterior tongue tie. I had never even heard of this. In this type of tongue tie, the baby’s tongue is more firmly attached to the bottom of the mouth. They may have lots of range still and often be able to stick their tongue out of their mouth, but the upwards motion to the roof of the mouth can be limited. This is where prolonged nipple pain can come in as the baby may actually be having a hard time holding your nipple in their mouth. Instead they are constantly adapting by moving their tongue back and forth in order to pull the nipple into the right position.

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The fix for this type of tie is a laser surgery where the tight tissue connection is severed to allow for a greater range of motion. I’m listening to her explain this to me as a hold my sweet, perfect baby boy and thinking to myself: there is no way this is real. I fought back tears, went home (cried anyway) and began further research. At the time, I knew no one who had ever done this or like me, even knew what it was. I didn’t want to do it but was at least considering calling the dentist she referred me to. That is, until my husband shut it down. He wanted absolutely no one going near our baby’s mouth with a laser.

About a week later our pain with latching finally resolved itself and we continued to nurse for quite some time. I now assume this was because of two things. One, my nips finally figured themselves out. And two, my son adapted enough to be able to nurse more efficiently. When he was around two years old we took him to a pediatric dentist and she confirmed as well that he did indeed have a tongue tie. She specialized in pediatric laser surgery. Her advice: “He’ll grow out of it.”

She told us that lip and tongue ties are more common that you would think, but that doesn’t necessarily mean everyone should be having these revision procedures. Even if they are “minimally invasive”, the effects are under-studied and more research needs to be done be ensure that a real benefit is being gained. Especially because many people pay out-of-pocket for it.

Over the past couple of years it appears that more and more people are talking about tongue ties and babies. If you are nursing and experiencing issues with latching, hearing a clicking sound while baby nurses, or suffering through continued, intense nipple pain, then it is very possible that your baby has a tongue tie. Your baby should first be evaluated by an experienced IBCLC. It’s also important to do more research and get second opinions if this is found to be the case. If you want to go through with this procedure, then you’ll need to find a pediatric dentist who specializes in this area.

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From my own research I have found that the potential side effects of tongue tie can include:

  • Breastfeeding pain and latch difficulty
  • Decreased milk supply due to poor sucking ability
  • Poor weight gain
  • Delayed speech and/or difficulty making certain sounds
  • Reflux and/or colic
  • Narrow palates and overcrowded teeth
  • Decreased ability to take a bottle or pacifier

I will note that, both of my children had reflux symptoms as babies. My daughter’s was MUCH more severe, however. My son, the eldest, is now four and has been in speech therapy since two years old. My daughter is one and a half and will start her speech therapy next month. She is addicted to her pacifiers still and took a bottle just fine as a baby. The dentist told us she ALSO has a tongue tie, by the way.

So do I think all this is related? Well, no. Definitely not the reflux aspect. I remember reading some comments in a Facebook reflux group about this as well. Many mothers had commented that despite having a tongue tie revision, they had yet to see any improvement in their baby’s reflux symptoms. Reflux can tie into may other underlying issues, but I don’t personally think it serves as a reason alone to undergo a tongue tie revision.

Little T was also a slow weight gainer. I exclusively breastfed and struggled with low supply at times, but I can’t really say that a tongue tie was the true issue. But maybe it was! He started dropping off his growth curve pretty early on and before he reached one year he wasn’t even on the chart anymore. And he still isn’t. So just a side note here, if you’re baby is following his own curve, he’s probably gonna be okay. Even if that curve is considered the .7 percentile. Now if your baby is losing weight, that IS a cause for concern.

As for the speech aspect? That’s entirely possible but pretty difficult to confirm as I’m not getting any laser surgery done on my kids any time soon. It could quite likely be a form of sensory processing disorder, which stems from brain connections and not anatomical anomalies, but we don’t know this yet either.

I really do wish I had all answers for you. If only our infants could tell us what was really going on!! But they can’t. And it’s up to us mamas to make the best choices for them. Do your research and find some sound advice. I’ve realized that Googling every single thing can unfortunately lead to more confusion and self doubt, so try to go with your gut feeling on this one. And don’t blame yourself for these things. We all struggle in some way, but in the end, your baby will always be perfect just the way he is.

If you have questions or something to share about your own experience, please be sure to leave a comment or shoot me an email! I can promise you though, you are doing awesome, mama. Keep up the hard work!

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