If you are anything like I was, you assumed that breastfeeding would be a walk in the park. It would be like in the films they make you watch in pre-natal class. The baby would nuzzle on over and latch after divine skin-to-skin and all would be bonding bliss. I believe that this scenario does play out for many fortunate women, but for me it was never to be. You see, all three of my babies had tongue-ties. Which meant the breastfeeding fantasy was never going to be a reality. But by using a bunch of tricks and tips I have been able to get over each false start and successfully breastfeed all three of my Bubbas.
So what is a tongue tie? Also known as ankyloglossia, it occurs when:
“the thin membrane under the baby’s tongue (called the lingual frenulum) restricts the movement of the tongue. In some cases the tongue is not free or mobile enough for the baby to attach properly to the breast. Tongue-tie occurs in 4-11% of newborns and is more common in males.
Some babies with tongue-tie are able to attach to the breast and suck well. However, many have breastfeeding problems, such as nipple damage, poor milk transfer and low weight gains in the baby, and possibly blocked ducts or mastitis due to ineffective milk removal”. – Australian Breastfeeding Association
Leo, my first born actually wasn’t too bad. He was able to latch but it hurt like hell! I nearly fainted a few times from the pain and would see stars when he would latch. After getting the snip at a local GP who is trained in tongue-tie corrections, the pain was gone. Although I did get mastitis a lot with Leo, he was able to breastfeed successfully.
Ari and Rosalina on the other hand were hell. Both had 10/10 or 100% tongue-ties, meaning their tongues were fully restricted with the membrane under the tongue being attached right to the tip of their tongues. Both had their tongue-ties released but neither could latch at all. Ari’s even reattached with scar tissue so had to be re-released (this was in spite of lifting up his little tongue before every feed to try and prevent re-attachment occurring). It took around three months with each of them to finally establish effective breastfeeding.
A lactation consultant explained to me the issue with tongue-ties isn’t just the physical restriction of the tongue, but also the need for the baby to learn how to actually manoeuvre their tongue. The development of the mouth occurs early in the womb. If bubba is tongue-tied they have never been able to practice sucking and licking properly, and therefore need to build the muscle memory plus master technique.
Whilst I’m a massive believer in fed is best, I was determined to breastfeed Ari and Rosalina, to the point of borderline insanity I can now admit. I think being able to feed Leo gave me the determination as I wanted to do it again. I was going through some heavy times losing my mum when Ari was born, so really wanted that connection. Besides, I’m super lazy, and find being a human dairy farm, more convenient compared to bottles.
I am in no means a professional lactation consultant or trained breastfeeding support person, but I still want to share different tricks and techniques that helped me establish feeding tongue-tied babies.
Some of the below was used on just one, both, or all my Bubbas.
1. Tongue-Tie release
If you are dealing with a severe tongue-tie this is obviously the first step. However, depending on your location and support team, not always easy to come by. Tongue-ties have long been a heated topic with many opposing releases. I was actually tongue-tied as a child. My mum begged for it to be snipped when I was an infant, but the thinking at the time was to not release ties. So mum dealt with a terrible breastfeeding experience and a baby who didn’t gain weight, only for mine to be snipped when in primary school as it caused me lots of speech issues. In my experience, demand for the snip, and if the hospital will not organise it for you, find a private practitioner who can do it. After Leo, I flagged my tongue-tie concerns early with Ari and Rosa’s midwives and flagged my impending births with the tongue-tie clinic at my hospital.
2. Lactation Consultants
A great lactation consultant is worth their weight in gold. I was fortunate enough to have access to fantastic ones with Ari and Rosalina. They helped me with technique including how to angle Bubba’s bodies and heads for best latching; ‘best practice’ for breastfeeding such as:
· how to get a let-down to occur before feeding so Bub has an immediate supply
· scheduling of feeds so I wasn’t feeding 24hours a day with no rest
· advice on how to increase milk supply
· emotional support and encouragement
I accessed my consultants through the hospital and then used a GP who specialised in lactation matters, along with midwives at QE2. I also called the Australian Breastfeeding Association several times and they were super helpful.
3. Invest in a great pump
While establishing breastfeeding, you will need to be expressing to keep up supply, plus feed your baby if you aren’t mix feeding. Looking back I have literally spent over six months either attached to a pump, trying to get a baby to latch to me, or feeding a baby expressed milk in a bottle (used a syringe for finger feeding in the first few days, could never get a line to work successfully). Go for a double pump if possible (regret not doing that with Ari, but learnt my lesson once Rosalina came along). If you cannot afford a pump, you can hire them from pharmacies and other community organisations.
4. Nipple Shields
Using nipple shields not only reduced excruciating cracking and bleeding, they also helped my babies latch, particularly Ari. The shields are easier for the baby to get hold of, especially if you have inverted, or slightly inverted nipples just like my left one (over share but it is true). It is a bit of an art using a shield – the trick is to fold it into a bit of a hat shape, hand express some milk into it, pop it on and get baby on quick. They come in different sizes like all nipples do. I only wish they came in other colours than clear, because if I had a dollar for every time I couldn’t find one after it fell off in a dimly lit night feed, I would be a millionaire.
5. Cracked nipples remedies
Even with the best care, with poor latching comes cracked nipples. It is painful and also increases your chances with mastitis, as germs enter your system through the broken skin. Some cracked nipple remedies I recommend include:
· expressing some milk on them and let your girls out to air dry
· go outside topless and get sun on the nipples
· use Lansinoh all day, every day
· use the amazing Rite Aid hydrogel pads. Put them in the fridge before putting on your girls for heavenly relief. Not sponsored, just LOVE THEM!
· use washable breast pads instead of disposable ones. I found the washable ones gentler on the nips.
6. Educate yourself on mastitis
With poor latching you are at a higher risk for mastitis. This is due to not draining the breast properly and feeds plus the above mentioned cracked nipples. Mastitis is HORRENDOUS and I have had it countless of times with various degrees of severity. As soon as you suspect something (usually starts with a hot spot on your boob with blotchy redness) get expressing in a shower, if possible feed your Bubba, where loose clothing and get straight to a GP for antibiotics. The longer you wait the worse it gets. Again, I’m not a medical professional, but in my experience antibiotics is the only thing that works, usually doing a double round of them.
I took all three Bubbas to osteopaths and it made such a difference. The therapists worked on the Babies jaws, neck and mouth muscles, releasing tightness and tension. This allowed them to improve their technique when trying to latch. Makes perfect sense for a tongue-tied baby, as they haven’t had full use of these muscles until a snip. I now think it is worthwhile taking all babies to an osteopath regardless of caesarean or vaginal birth. It is pretty squashy in a mummy’s joey pouch and once engaged I imagine many bubs end up in uncomfortable positions that may result in tightness and restriction of muscles. An osteopath trained for treating infants use super gentle techniques. I even took Ari for his bowel condition and it helped a lot. Many claim to babies sleeping better and being more settled after an osteo session.
8. Emotional and physical wellbeing impacts milk supply
I had an oversupply of milk with my boys, but Rosalina was a different story. My anxiety went through the roof, unwarranted pressure was put on me and my supply dried up. As a result I learnt that without efficient rest, nutrition and all around wellbeing, your supply can actually decrease. I was told to stop worrying about not getting enough domestic duties done and go to bed. I was also given advice on how to limit the breastfeed/bottlefeed/pump cycle to an hour as any longer was depleting me (though I continued to struggle fitting this within an hour for a long time), was given meal replacement shakes to add to my already main meals and snacks to increase my calorie intake, and got a script to increase my supply (all the ‘natural’ solutions of brewers yeast and fenugreek gave me terrible belly pains). I only needed these measures for a few weeks and all worked out in the end, as I’m still feeding nearly 16 months later!
9. Mix Feeding
Rosalina wasn’t gaining weight and was considered ‘failure to thrive’ so we went to mix feeding. I am now a HUGE fan of mix feeding! It seriously was the best solution and allowed me to continue to feed. I worked with my local MACH nurse on working out quotas for formula and how to do top up feeds. Rosa started gaining weight, my anxiety subsided and eventually when she got the hang of feeding I went to exclusive breastfeeding, for no other reason than finding it easier. We started back on the mix feeding regime when Rosa started childcare around 11 months of age and still do a mix of bottles and boob. Please don’t be scared of mix feeding. Not only did it allow Rosa to thrive, it gave me a break and took my self-imposed pressure off.
10. Consider an Upper Lip-tie release
In order to breastfeed effectively, a baby needs to be able to flange in order to create a proper latch. A severe Upper Lip-tie can impact this. Upper Lip-tie releases is more controversial than tongue-ties. Many professionals are anti conducting them as not enough evidence exists on the benefits. I can only talk from my own experience, but a MACH nurse told me to consider getting Rosalina’s lip-tie released. My local hospital doesn’t do them but I found a trained GP who does. It is more full-on procedure than a tongue-tie release but is done the same way. As soon as Rosie had the procedure she was able to latch for the first time and was a turning point in our feeding journey.
11. BONUS TIP: IT TAKES TIME
Ultimately it all comes down to time. With time a baby grows bigger and stronger, making correct latching easier. Time allows mum and bub to work out the whole feeding dance together. I put stupid timeframes on myself during the tough days but now I know I should’ve been more patient and gone with the flow.
So there you have it. I know breastfeeding isn’t for everyone or every bub. I do think we put too much pressure on mums to only breastfeed, and I encourage you to do what is right for you. But if you are wanting to pursue breastfeeding a tongue-tied baby I hope some of these tips and tricks help. I’m more than happy to answer any questions or provide recommendations for Canberra-based support.