When the lactation consultant told me Cali was tongue tied, I felt a guilty surge of relief. There was an actual, physiological reason for our breastfeeding troubles. Unfortunately, that relief was short-lived. Diagnosing tongue tie was the easy part. Between insurance issues and overbooked schedules, finding a provider was a Herculean task that took us an exasperating two weeks to complete. In the meantime, I had to cope with breastfeeding a tongue tied baby.
If your baby was diagnosed with tongue tie, you face the difficult choice between a frenotomy and coping with your child’s unique anatomy. Either way, breastfeeding a tongue tied baby can be frustrating and feel next to impossible. In this post, I’ll share some of the techniques I used to successfully breastfeed a tongue tied baby.
5 Helpful Tips for Successfully Breastfeeding a Tongue Tied Baby
This post may contain affiliate links. If you make a purchase from one of the links I will make a small commission at no charge to you. I only recommend what I trust. Blunders in Babyland does not diagnose, treat, or give out any professional advice for any medical conditions.
Complications with Breastfeeding a Tongue Tied Baby
Chances are, you’ve already done your fair share of research on tongue tie, or ankyloglossia (you can bet I had to google that one). Essentially, the little flap of skin under your baby’s tongue is too short to allow a full range of motion necessary for efficient breastfeeding. 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 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. For the Babywise mom, this is a nightmare.
- 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 baby creates a vacuum with his lips, rather than 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
5 Tips for Breastfeeding a Tongue Tied Baby
1: Use a Nipple Shield
Before we continue, I should let you know that this tip comes with a couple caveats: use the nipple shield 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 nipple 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, it’s a good temporary fix if the pain has become too much to handle.
Related Post: How to Increase Your Milk Supply Fast
2: Use of Plenty of Nipple Butter
The sad truth with tongue tie is that eventually you do become used to the pain. After Cali’s procedure, I found myself subconsciously cringing every time she latched, and then feeling shocked at how painless it was. I had gotten so used to the discomfort that I barely noticed it anymore. Having said that, every time her mouth slips back to its old tricks, I definitely do notice it now!
Even if you can bear the pain, do yourself a favor and invest in some quality nipple butter. Early in motherhood, I used lanolin. It certainly got the job done. However, lanolin feels tacky and seemed to take a couple applications to work. After Cali’s frenotomy, I switched to Mother Love Nipple Cream.
Oh. My. Gosh.
I wish I could have written my past self a note and saved myself a lot of trouble. This stuff hydrates very quickly and feels refreshing from the second you apply it. Plus, it’s organic.
Just an FYI, although nipple cream doesn’t need to be wiped off before a feed, it’s a good idea to sterilize your nipples after every session to avoid bacteria. The jury is still out on whether or not to use mild soap. Whichever care method you opt for, be sure to wear a nursing pad. The pad will prevent any oil-based stains on your shirt and provide a dry environment for your nipples to heal.
PIN IT FOR LATER!
3: Supplement with the Bottle
There’s no shame in feeding your baby with a bottle. As a Babywise mom, I immediately rejected the idea of feeding Cali every 1.5-2 hours, which the lactation consultant and my pediatrician suggested. This would put us so far back from any kind of productive schedule. Even if you’re not in to Babywise, feeding every 1.5-2 hours can slowly make you lose your mind.
To counteract this, I topped Cali off with expressed milk every other feed. Suckling from a bottle is much easier than breastfeeding, and Cali was able to get an additional ounce or so without becoming exhausted. After our feeding, I pumped what was left in my breasts (usually a combination of foremilk and hindmilk), and bagged it up for the next feeding. This emptied my breasts, maintained my supply, and reduced the risk of developing mastitis.
4: Feed, Wake, Feed, Sleep
When your baby has tongue tie, sometimes you need to compromise certain principles for the overall picture. Babywise highlights a consistent feed, wake, sleep routine (if you’re a fan of the Baby Whisperer, this is also called an E.A.S.Y. Routine). Eventually, I had to decide between feeding Cali every 1-2 hours or figuring out how to give her a full feeding. Over time, expressing and bottle feeding became too exhausting, so I tinkered with our feeding pattern. I fed her until she came off the breast (around ten minutes), changed her diaper, did 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.
This is a great temporary fix but try not to use it long term. Depending on the length between the initial feeding and the next, and the duration of your baby’s wake cycle, you can run the risk of a developing a foremilk/hindmilk imbalance or creating a nurse/sleep association.
5: Add an Additional Feeding
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. It’s better to schedule in another feeding, rather deal with random ones throughout the day (or night!). I took the Baby Whisperer’s advice and clusterfed at night.
The first feed was at 4pm, and was followed by a short play time. After a catnap, I fed her again at 6pm. This, combined with the dreamfeed, allowed us to squeeze in 8 feedings a day. Cali was 9 weeks when we committed to a clusterfeed. She was 15 weeks when we dropped the clusterfeed. This is much older than the Baby Whisperer recommended, but that’s how long it took Cali to learn how to nurse efficiently enough to drop it.
Bonus tip: See an Speech Pathologist or Oral Therapist
A tongue tie release is not a magic solution. It’s only the first step for breastfeeding a tongue tied baby effectively. Performing the aftercare exercises is essential to a successful frenotomy. These must be completed 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 in their baby’s nursing pattern immediately. In other cases, it can take weeks.
I’m not going to lie, I hated doing the tongue stretches. She 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 knew I could not watch her undergo another frenotomy.
Then there’s the fact that even if you’re 100% committed to this regimen, there’s still a chance the tongue could reattach. Cali’s did twice, but luckily we were able to stretch it before it got out of hand.
My point is this: a frenotomy isn’t for everyone. If you don’t think you can make the time commitment, or withstand the procedure, 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 baby’s age.
This Too Shall Pass
You’re a rockstar for breastfeeding a tongue tied baby. It’s not for the faint of heart and 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 baby’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.
I hope you found these tips helpful. If you’ve already been through the crucible, please feel free to share your experiences down below to help other mommies with breastfeeding a tongue tied baby.