Updated: May 23
Continuing my series on Tongue Ties in Infants, this week I wanted to address a common question about breastfeeding a tongue your tied baby. Many people find tongue ties to be controversial, but many breastfeeding mothers know that breastfeeding with a tongue tie can present some very real challenges. Today we will discuss the ways your baby's tongue tie could impact breastfeeding.
How Breastfeeding Your Baby Works
Before we can understand how tongue tie affects breastfeeding, we need to understand how the Tonge works for the baby to breastfeed. Your baby’s tongue should be resting against the upper palate when their mouth is closed and they should breathe through their nose. When feeding, your baby will use the tongue in a wave like motion to signal milk to eject from the breast. Your baby will use the tongue to compress the breast against the roof of the mouth, use the lips to create a seal, thus, creating suction, coordinating between sucking, swallowing, and breathing (through the nose).
Breastfeeding Your Tongue Tied Baby
When a baby has a tongue tie, properly compressing the breast against the roof of the mouth WHILE maintaining suction AND being able to breathe can be impossible. So the infant begins finding ways to “compensate” or take shortcuts so they can breathe. For some babies this means losing suction so milk drips out and they suck in a lot of air (possibly resulting in reflux and colic), for other babies this means chomping the breast to control milk flow, and for other babies it can mean not latching to a breast (or even bottle) at all. Of course there are a variety of symptoms and combinations of symptoms that can signal tongue tie. But when we understand how the restricted movement impacts feeding, we understand why some breastfeeding challenges are common in breastfed babies with tongue ties.
Common Signs Your Breastfed Baby might have a Tongue Tie
Nipple damage from breastfeeding a tongue tied baby can include:
vasospasm / white nipples
cracked and bleeding nipples
inexplicable nipple pain
Low milk supply / Slow weight gain
If the baby is falling asleep quickly at the breast or struggling to stimulate significant milk transfer from breast to their tummy, they will lack the ability to gain weight, obviously. This lack of milk transfer can also signal the body to stop producing breastmilk. If you have unexplained low milk supply, consider meeting with an IBCLC for an oral function evaluation and plan for supporting your milk supply.
To completely contradict what I just said, sometimes frequent feeding patterns breastfeeding babies exhibit creates a massive oversupply of breastmilk. This could also be from mom pumping frequently to protect the milk supply if she suspects feeding issues, and oversignalling the body to produce breast milk.
Oversupply can lead to mastitis in some mothers. A combination of a strong milk supply and poor milk removal might even result in recurrent mastitis or clogged ducts every few weeks. Oversupply and tongue can also lead to the infant struggling to control milk flow, resulting in nipple damage as explained previously,
In some instances, there may be such an abundant milk supply that the baby “catches” plenty of milk and gains weight well, but never learns how to actually use the mouth muscles to feed properly.
In these babies we will often see sudden weight loss/slowed weight gain when the milk supply regulates around 3-4 months old. Even when these babies maintain weight, they often struggle to start solids or develop speech issues later because of improper oral motor development.
What to do about tongue tie when breastfeeding
If you are struggling with any of these symptoms and suspect your baby might have a tongue tie, breastfeeding help IS available!! While tongue tie release may be a consideration, the first step should be working with a lactation consultant to help get the full picture of yours and your baby's needs and help them begin developing proper oral motor skills before and after tongue tie release.
Check to see if your health insurance is working with The Lactation Network to get you Free Breastfeeding Support Visits. If they are, you can schedule a telehealth lactation consultation with me with no out of pocket cost!
If your insurance is not working with TLN, I have a variety of options for you.
Tricare East families qualify for free telehealth support. Tricare West and Medicaid patients qualify for 15% off their lactation consult.
Everyone else is able to use FSA/HSA funds to cover their consults, and if you check your coverage through TLN and are denied, I’ll offer you a 5% cash discount as a courtesy (but you have to check through TLN first!!! I get notified of all denials and approvals)