When my youngest baby girl was born, we learned that she had a tongue tie. I have never been in as much pain nursing as I was with her. She was born on a Saturday night so we had to wait until Monday to call the tongue-tie specialist we were recommended to and then we were able to get an appointment for Tuesday.
By the time Tuesday arrived, my nipples were cracked and bleeding far worse than I had ever experienced with any other baby. I was beyond miserable. No wonder so many women give up breastfeeding when their baby has a tongue tie! I totally get it!
Mother's Symptoms
Your baby may have a tongue tie if you have any of these symptoms from breast-feeding. A bottle won't tell you if there is pain or an incorrect latch but a breast-feeding mother is acutely aware of it every time she nurses.
- Painful nursing
- Poor latch
- Cracked, creased, and flattened nipples
- Bleeding nipples
- Lipstick shaped nipples
- Poor breast drainage
- Plugged ducts, engorgement, mastitis
- Nipple thrush
- Using a nipple shield
- Feeling like feeding the baby is a full-time job
A Tongue-Tied Baby's Symptoms
I learned about these symptoms after all my baby's had finished breastfeeding but I wanted to share this list with you from "Tongue-Tied" by Richard Baxter in case it would be helpful. I wish I had known this. My babies never took to a pacifier...now maybe I know why. My babies also had other symptoms here...who knew colic could be a sign of a tongue tie?
- Poor latch at breast or bottle
- Falls asleep while feeding
- Slides on and off the nipple when feeding
- Cries often/ fussy often
- Reflux symptoms
- Spits up often
- Clicking or smacking noises when eating
- Gagging or choking when eating
- Gassy burps or toots
- Poor weight gain
- Biting/chewing the nipple
- Pacifier falls out easily or won't stay in
- Milk dribbles out of the mouth when eating.
- Frustration at breast or bottle
- Congested nose
- Milk coming out of the nose
- Short sleeping
- Mouth breathing, snoring, noisy breathing (my middle child still does this)
- More than 20 minutes per feeding required after newborn period
- Eating more frequently than every 2-3 hours
Lip ties and cheek ties can also cause nursing issues even if there isn't a tongue-tie. The ability to stick out the tongue does not rule out a tongue-tie.
Symptoms To Look Out for in Bottle-Fed Babies
- Upper lip tucked under during bottle-feeding
- Clicking sounds during bottle-feeding
- Extended feeding times (longer than 30 minutes)
- Falling asleep during bottle-feeds
- Loss of milk from sides of mouth
- Pseudoleukoplakia (milk tongue)
- Lip or compression blisters and/or two-tone lips
- Excessive jaw excursions and/or cheek dimpling
= Excessive hiccups, gas, or reflux symptoms
- History of poor breastfeeding skills
- Inability to hold a pacifier in, or can only take a flat pacifier
- Collapsing of bottle nipple
- Coughing with thin liquids from an open or straw cup
The Examination
When the tongue tie specialist examined our baby, he laid her down on a board and he stood at the end of the board facing her head and took his gloved hands and reached under the tongue to see how high it would lift. If someone is just looking in your babies mouth and swiping underneath the tongue with their finger to check for a tongue tie, that is not an accurate way to diagnose one. Your baby may still have an undiagnosed tongue tie if they do not lift up the tongue from the bottom of the mouth during their examination.
During the examination, he found a tongue tie, a lip tie, and two cheek ties! I didn't even know cheek ties were a thing! While he was at it, we asked if he would look at our two oldest girls just to see if they had ties that hadn't been caught as babies. It turns out that my oldest had a lip tie and that my middle daughter had a tongue tie that no one had found! Since tongue ties are genetic, we asked him to look at my husband and I too. It turns out my husband also has a tongue tie that was never diagnosed. (This will all come into play in my story later.)
The specialist described a tongue tie like a sail on a sail boat. Some babies have both the mast and the sail (anterior tongue tie) that are both holding the tongue down tighter than it should be. Other babies just have the mast (posterior tongue tie) and if it is too thick and tight, it still limits the ability of the tongue to move correctly. All tongue-ties, both the anterior and posterior ties, have a posterior component that must be released as well. Our middle daughter has a posterior tongue tie which is why no one caught it and so does my husband. If a doctor uses scissors to clip the mast but doesn't also clip the mast, the baby's tongue tie is only half-fixed.
If you have been told that your baby doesn't have a tongue tie but you are still in pain and having issues with breastfeeding, I highly recommend getting an opinion from a specialist in your area...too many tongue ties are never caught because our medical providers are not trained on how to correctly identify a posterior tongue tie.
Releasing The Tongue-Tie
Our tongue tie specialist is one of 6 in the entire United States who specializes in treating tongue ties. He uses a cold laser to cut the tie which is the least painful and the most precise way to release ties without much bleeding. Clipping a tie with scissors only fixes the anterior tongue tie unless it is done a certain way to also release the posterior tongue tie but it requires multiple clips which can be difficult to get accurate after the first clip because of the bleeding caused by clipping with scissors.
My husband watched as he fixed our daughter's ties...I couldn't watch but it only took a few minutes. Then I was able to nurse her which was comforting to her. Nursing felt instantly improved!
Even with cold laser, it is possible to hit a blood vessel in the bottom of the mouth because they are everywhere and every baby has blood vessels in different places so it isn't always possible to avoid them when releasing a tongue tie. The specialist had hit a blood vessel in her mouth so there was a little more blood than there usually is with a cold-laser tongue tie revision.
She was in some pain from the revision about 8 hours later which is normal and we did give her a little bit of baby Tylenol to help manage the pain. We only had to give her Tylenol once as she seemed much improved the next day.
After The Procedure
After a tongue-tie revision, the doctor should always recommend exercises to keep the tongue-tie from reattaching. When you do the exercises, you have to place your fingers and lift up on the tongue and stretch out the area beneath the baby's tongue. The firmer you do it, while being gentle, will eliminate the chances of it reattaching. It is the least fun thing about getting a baby's tongue revised but it is necessary. I didn't do it firmly enough with my baby's tongue so when we went back in for a check-up, the specialist had to re-pop the tie was forming again. Not fun...poor baby...but it was necessary.
To make the tongue-tie exercises less painful for the baby, apply a little coconut oil on your fingers and add a drop of Copiaba Vitality essential oil (FDA approved as GRAS: Generally Regarded As Safe for internal use) to numb the area. This will make the tongue tie exercises easier on both of you.
I would rather have to do the tongue-tie exercises on a baby though then a toddler...I don't know exactly how I am going to do the exercises properly with my 4 year old when I get her tongue-tie revised...and she will remember it. :'(
Symptoms of My Husband & Middle Daughter
My middle daughter who is now 4 is struggling with speech issues and breathing through her mouth at night. Both symptoms of a tongue tie causing issues and we will need to get it fixed sooner rather than later to avoid having to do extra myofascial therapy to help the tongue work properly.
My husband grew up with chronic ear infections. He had tubes 7 times in his ears...and the scars for the tubes plus his military service has made him partially deaf. He also has mild sleep apnea and major dental issues that will take quite a bit of money to fix. If only someone had diagnosed him with a tongue tie earlier in life...now he will have to do myofascial therapy before getting his tongue tie revised and the whole thing is more expensive in an adult because it is harder to fix.
I recommend that every mother, if they are experiencing any issues that could potentially be tied to a tongue tie, to take their child to a tongue-tie specialist to get a second or third opinion and make sure they know how to check for a tongue-tie properly because fixing a tongue-tie when your child is younger may be the best way to prevent more issues as the child grows up.
xo Rachelle <3
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