Breastfeeding a tongue-tied baby is difficult. There’s just no way around it. If your baby was diagnosed with tongue tie, you face the difficult choice between a frenotomy and coping with your child’s unique anatomy. It can be tiring and frustrating for your baby and sometimes painful for you. You’re doing everything you can to make sure your little one is fed and happy…but you might feel like you’re losing the battle here.
Believe me, Mama, I get it. I successfully breastfed two children with a tongue-tie and lip tie. One daughter received a frenotomy, while the other I was able to breastfeed in spite of the tongue tie. Along the way, I learned some techniques that saved my sanity and milk supply. I hope these tips help you as well!
How I Kept Breastfeeding a Tongue-Tied Baby: 6 Extremely Helpful Tips
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Use a Nipple Shield
Using a nipple shield comes with a couple caveats: Use it under the direction of a certified lactation consultant and as sparingly as possible.
A nipple shield is a clear, silicon barrier that suctions to the breast. The shield encases your nipple, preventing your baby from gumming it. This is one of the most common causes of pain when breastfeeding a tongue tied baby.
Although this is the first item on my list, it is usually considered the last resort. The main issue with nipple shields is weaning. If introduced too early or used too much, it can cause nipple confusion.
The other downfall is intake and production. The lack of skin-to-skin stimulation can lower milk production over time. You can see why this might be problematic, since milk production can suffer because of the tongue tie.
Still, these shields can alleviate your pain so that you can temporarily continue breastfeeding.
If you’re looking for a good recommendation, I liked the Lansinoh shields. It’s really important to find the right size. The most popular size is 24mm, but make sure you check the manufacturer standards.
RELATED POST: The Best Nipple Shields for Breastfeeding Moms
Use of Plenty of Nipple Butter
Breastfeeding a tongue tied baby is usually accompanied with raw, abused nipples. Even after you’ve opted for a frenectomy, you might experience discomfort for a few weeks (sometimes months) afterwards. Other moms find that the pain is alleviated immediately after the procedure.
In any case, you’re feeling raw, bleeding, or scabbed, invest in some quality nipple butter.
The best nipple butter I’ve found is Motherlove Nipple Cream. It’s organic, lanolin-free, safe for your baby, and incredibly hydrating.
Just remember to sterilize your nipples after every session and use a nursing pad afterward to provide a dry environment for your breasts to heal.
Supplement with the Bottle
There’s no shame in feeding your baby with a bottle. Many tongue-tied babies are unable to latch correctly (and therefore drain your breasts efficiently). Sometimes, supplementing with bottled breastmilk is absolutely necessary.
I hated the idea of nursing every 1.5 hours. It was exhausting for both of us. So, to ensure that my baby was getting enough to drink, I pumped beforehand and topped off our nursing sessions with expressed milk. This allowed us to go 2-2.5 hours between nursings.
This technique also emptied my breasts, maintained my supply, and reduced the risk of developing mastitis.
This technique was especially helpful with my second daughter, whose tongue tie was mild and allowed her a little more motion. I would breastfeed at the beginning of our feeding session, then as my daughter grew tired or my letdown diminished, I’d supplement with the bottle. It gave her a very necessary break.
Feed, Wake, Feed, Sleep
If you’ve been to my blog before and have read my baby sleep posts, you probably know that I love a Feed-Wake-Sleep schedule. This routine was a complete life-saver for me and my daughter. It helped my daughter develop healthy sleep patterns and gave me the freedom I needed to flourish as a new mom.
Having said that, in the height of our little tongue-tie crisis, we had to modify it for survival.
Sneaking two feedings can help spread apart nursing sessions and give your baby the food he needs to thrive. For example, my daughter and I nursed immediately after waking (around ten minutes), I changed her diaper, had a short playtime, and then topped her off with a second feeding. I started our nap ritual directly afterward but would not allow her to follow asleep at my breast.
Just a final note: I believe this technique is a great temporary fix but should not be used long-term. Depending on the length between the initial feeding and the next, and the duration of your little one’s wake cycle, you can run the risk of a developing a foremilk/hindmilk imbalance or creating a nurse/sleep association.
Add an Additional Feeding
As you’re probably already finding out, breastfeeding a tongue tied baby requires a little more focus on ensuring caloric intake.
Sometimes your baby just isn’t capable of taking in the necessary ounces in a single feeding. I’ve found that it’s easier to plan for extra feedings, rather than deal with random ones throughout the day (or night!).
One technique I used was cluster-feeding. Cluster feeding is breastfeeding with shorter intervals between feeds. This is usually done in the evening, a couple hours before your bedtime session. (If this sounds a little confusing, The Baby Whisperer Solves All Your Problems has a GREAT tutorial on it).
For example, our first “cluster feed” was at 4pm. After a catnap, I fed her again at 6pm. We implemented these cluster feeds at about 9 weeks and dropped it around 15 weeks.
If your baby is still waking up frequently throughout the night, you might consider adding in a dream feed as well.
Try Daily Tongue Exercises
My firstborn needed a frenectomy. My second daughter did not. We actually improved our breastfeeding experience with daily stretches. This is called “suck training.” The idea is that it helps your little one’s tongue’s range of motion and increase the chance of a better latch.
It worked great for us!
Having said that, if your baby does have a tongue-tie and requires a procedure, you should know that a frenectomy is only the first step.
Performing the aftercare exercises is essential to a successful frenotomy. Most experts recommend completing these exercises 6 times a day with no longer than 6 hours between each session.
In addition, you will need to help your baby improve her sucking skills by practicing a few exercises with her. Some moms notice a difference immediately. In other cases, it can take weeks.
I’m not going to lie, I hated doing the aftercare stretches. My newborn screamed the second I placed her head on my lap and wouldn’t calm down until a few minutes afterward. The only thing that kept me going was the knowledge that if I didn’t complete the exercises effectively, we would run the risk of a revision.
I could not watch her undergo another procedure.
If you don’t think you can make the time commitment, or withstand the procedure, definitely talk to your pediatrician about a referral to a speech pathologist to discuss oral exercises. Over time, it may be possible to stretch the frenulum, depending on the extent of the tongue tie and your infant’s age.
Switch Positions Until You Get a Good Latch
When your baby has a tongue-tie, you really have to search for a breastfeeding position that feels right–for you and for your baby. When the my little one began nursing, and experienced that oh-so-easy initial let-down, any position would work. However, once she got to the fatty, slow-flowing breast milk, a regular cradle hold wouldn’t work. I found that switching positions (sometimes to a football hold, sometimes to a cross-cradle hold), helped her.
I have a (non-scientific) theory about this: my baby seemed tired. She had to work HARD to suckle. So, when I switched positions, perhaps that different angle helped her work different muscles?
Tongue Tie and Breastfeeding: Complications
Chances are, you’ve already done your fair share of research on tongue tie, or ankyloglossia. If you’re new to this whole thing, let me give you the skinny.
Essentially, the little piece of tissue under the tongue is too short. This can restrict tongue from the full range of motion necessary for efficient breastfeeding. The severity of your baby’s tongue-tie can vary. For example, my firstborn’s tongue was nearly to the floor of the mouth. This required a tongue-tie release. However, my second daughter’s lingual frenulum was much longer, and we managed to extend it by daily exercises.
Your baby might have an anterior or posterior tongue tie. My lactation consultant explained that a posterior tongue tie is particularly difficult to diagnose because it is covered by a submucosal membrane. To further complicate things, many tongue tied babies also suffer from a lip tie. Breastfeeding a lip tied baby can cause additional challenges to work through.
If your baby has a tongue tie or lip tie, you’ll probably recognize these challenges:
- Snack Feeding-Tongue-tied babies are frequently labeled “lazy eaters.” Since they are unable to create an effective suction with their tongue, tongue-tied babies struggle to nurse efficiently. The real troubles start after six weeks, when your breast milk supply regulates and any overactive letdown diminishes. By this point, your baby’s muscles are underdeveloped and she’s dependent on your letdown reflex. This causes a startling pattern of 5-10 minute snack feeds. This is exhausting for everybody involved.
- Shallow (Painful) Latch- Many babies with tongue tie have severely inhibited tongue mobility. They are unable to open their mouth wide enough to form a proper latch. They tend to go for the nipple instead, which causes most of the pain for mom as well as milk production issues. When breastfeeding a tongue tied baby, everyone suggests focusing on a deep, correct latch. Given your baby’s limitations, this is harder than it sounds.
- Exhaustion-Tongue tied babies also tire very quickly. When your baby creates a vacuum with his lips, rather than his tongue, he expends double the energy. This results in snack feedings and a cranky, exhausted baby.
Make no mistake, tongue tie is a disability, and there is nothing wrong with adjusting your nursing routine to accommodate your child’s needs.
Related Post: 10 Hidden Tongue Tie Symptoms You Need to Know About
Does My Baby Need a Tongue-Tie Release (Frenotomy)?
Great Question. That depends on you, the severity of your baby’s tongue tie, and your healthcare provider.
For my firstborn, the pediatrician I talked to glanced at the underside of the tongue and immediately dismissed my daughter’s posterior tongue tie. Even after experiencing a host of feeding problems (while breastfeeding and bottle-feeding), no one believed her tongue and lip tie was the cause.
However, a lactation consult immediately knew it was hindering my daughter’s tongue function. We had the frenectomy a few weeks later and we didn’t look back.
My second daughter also had a tongue tie. While her feeding difficulties were very similar to her sister’s, we alleviated the problems simply by daily stretches. No frenectomy necessary!
Here’s a couple questions to ask yourself before you decide to get a frenectomy:
- Does your baby have difficulty sticking their tongue out past their lips? If so, this might indicate a more severe tongue tie. Prime example: my firstborn could not stick her tongue past her lips. My second daughter could occasionally.
- Is your baby experiencing bottle feeding and breastfeeding challenges? Some babies cannot latch onto a bottle nipple without spilling or sucking in a lot of air. This was the case for my firstborn!
- Have you found a provider that you feel comfortable performing the frenectomy? This is a super-simple, ten-minute procedure. And yet I’ve heard some bad stories about providers that botched it. You’ll only want to opt-in for this procedure if you’ve found a provider that feels comfortable doing it.
- Are you willing to commit to the aftercare? Look, the tongue exercises are no joke. That little patch under their tongue heals crazy fast. If you don’t do the aftercare exercises, it will heal, the tissue under their tongue will heal before it has stretched properly. All that pain (your pain, that is) will be for nothing.
Breastfeeding a Tongue Tied Baby is Possible! Don’t Give Up
Breastfeeding a tongue-tied baby is not for the faint of heart. Seriously, Mama, it really shows your commitment!
Try to manage the pain first, either with a nipple shield or nipple butter. Once you’ve eliminated the pain, decide how to effectively compensate for your little one’s unique needs. Tongue tie breastfeeding difficulties can be exhausting at times, but you will get through it. Even a month down the road, this experience will be a distant memory.
Please, if you haven’t already, contact your healthcare professional about the feeding issues you’ve been experiencing. It’s worth the visit! I can only give you my experiences. And trust your mama gut. If your pediatrician seems to dismiss your breastfeeding problems, seek out a lactation consultant.
If you’ve already been through the crucible, please feel free to share your experiences down below to help other babies with tongue-tie.