Triumphant Tuesday: Breastfeeding with Tongue-Tie

Most of us think of tongue-tie as a situation we find ourselves in when we are too excited to speak. In fact, tongue-tie is the non-medical term for a relatively common physical condition that limits a baby's use of it's tongue – and, if left undiagnosed, can be the final nail in the coffin of your breastfeeding relationship. Tongue-tie occurs when the thin piece of skin under the baby's tongue (the lingual frenulum) is abnormally short and may restrict the movement of the tongue tip. This can interfere with the baby's ability to suckle efficiently at the breast, leading to nipple pain and trauma, poor breastmilk intake and a decrease in milk supply over time.

Diagnosis is only the first hurdle however. The decision to release a tongue-tie often depends on a doctor's personal belief about the possible impact on feeding. Currently, doctors are divided in opinion, which leads to a lottery of patchy treatment for breastfeeding mothers.

Emma drew the short straw in this lottery. Here is the story of her struggle to get her son’s tongue-tie taken seriously.

“After two hours of my pushing, my son Samuel, took his first breath. As soon as I saw him I knew I was going to breastfeed no matter what. It's natural, it's normal. Making sure I give Samuel and myself all the "benefits" of breastfeeding was very important to me. There is a strong family history of allergies and asthma that I didn't want Samuel to inherit it. I don't understand when mothers don’t attempt to breastfeed. I think it's sad they won't even give it a go.

Sent to NICU

Samuel in NICU

When Samuel was born, because there was meconium in the amniotic fluid, the pediatrician sent him to the NICU for monitoring and tests to check if he had an infection. Samuel was put on antibiotics as a precaution. As a result, he got thrush which took a while to clear up.

Samuel was born at 6:49pm, yet it wasn't until 3am the following morning he was released from the NICU and was allowed to breastfeed for the first time. I became so anxious about nursing him in the hospital that I couldn't get him to latch and needed the help of a midwife every time I wanted to feed him. That night he fed for an hour, sleep for an hour, then wake screaming for more. As a first-time mom I didn’t know this was normal newborn behaviour. In fact, the midwife told me to give him formula because I couldn't possibly keep up with him as he was so big. As she suggested formula I could feel my face falling. The midwife was polite, but in an overbearing, condescending sort of way. It seemed like she thought formula was much the same as breast milk. Up until that point I had been confident in my ability to feed my son. It felt as though everything had come crashing down. I was in tears. I knew giving formula would negatively impact my milk supply so I didn't. The midwife tried to help me manually express some colostrum, but as you'd expect we didn't get much and I was very stressed out at the time. My son was barely 24 hours old and I was already failing.

Once Samuel fell asleep, the midwife took my observations, and my pulse was through the roof (I think I was on the verge of a panic attack). She asked if I was in pain; I said I was stressed. She then gave me panadol to help me sleep. The next time my baby woke – I was so drugged up that I didn’t hear him.

Baby weight loss

By the time we left the hospital Samuel was had dropped from his birth weight of 4.424kg (9 pounds 12 ounces) down to 4.1kg. On the drive home I was bawling. I had tears streaming down my face. I cried through each feed for the rest of the day.

At his two week check he still hadn't regained his birth weight; in fact he had lost 45g. The only advice the health visitor offered was to top him up with formula. She even asked who my GP was, so she could keep tabs on me. This was my lowest day in a long time. I spent the rest of it in tears. I couldn't even feed my own baby. I had failed at being a mother.

After a phone call to the Australian Breastfeeding Association (ABA) I started to feel little better. I just kept feeding on demand (which was a lot). Samuel also had a handful of formula bottles when I knew he was hungry and I couldn't satisfy him.

At his 10 week check he only weighed 4.6kg. I was devastated. Things were not helped at times when my mother saw Samuel and she would regularly comment on how small he was. Every time I spoke to her she asked if he was still feeding as much.

Investigating the latch

I decided to ask a professional to check his latch, so we saw a lactation consultant at the hospital I gave birth in. I asked her specifically about tongue tie and lip tie and she told me he was fine and he just had a small mouth.

I had a feeling his tongue didn't look normal so later that day I called the ABA helpline and described his tongue. The counsellor told me I had described a tongue-tie perfectly.

I went to see our regular doctor about the tongue-tie. He told me that because Samuel could move his tongue somewhat, he was fine. My instincts told me otherwise. 

Determined not to give up, I saw a THIRD professional; this time, a IBCLC who was able to direct me to a FOURTH professional – a laser dentist.

Samuel was 10 1/2 months when the tie was cut. I returned to work two days a week when he was 6 ½ months and negotiated to pump at work. 

He is now 12 months and we are still breastfeeding. The unhelpful voices are still there: every time I talk to my mother she tells me he will wean in a month or two and she asks me whether I think he still feeds as much as he used to. When I see my doctor (the one who would not treat the tongue-tie) he tells me I should wean Samuel now that he is 1 year old. I have learnt to ignore such negativity. I plan on letting Samuel self wean. Needless to say I am in the market for a new doc; but I can't get a refund on my mother.

I really enjoy breastfeeding my little boy. I often think that, if instead of making me feel bad, the health visitor had suggested an IBCLC, I wouldn't have spent those precious first moments as a new mother worrying about my sons weight gain and feeling like I was a failure. When I look at photos he does look skinny; it breaks my heart to think he was hungry because no one suggested anything helpful, like an IBCLC.”

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