Tongue Ties

Hi Dr Ryen. I just had my first baby a week ago. The birth went fine, but my midwife said my little boy is tongue tied. We’re breastfeeding, but my nipples are killing me! They’re all chapped and raw. Feeding my baby is supposed to be a special time, but I just dread it anytime he’s hungry. I feel like a failure as a mother already! Also, my mom googled tongue ties and is convinced Aiden’s going to grow up with speech impediments! But I don’t want to get it fixed because the surgery can cause bleeding or mouth injuries. What should I do?!

- Theresa, Jacksonville, FL

Theresa, congratulations on the new baby! Most new moms assume breastfeeding is a natural, easy, peaceful experience, so they’re often devastated when they run into trouble. Breastfeeding difficulty is common. It’ll take some time for you and Aiden to learn how to do it comfortably. 

First of all, discomfort when breastfeeding isn’t normal. A lactation consultant can make a big difference, but most midwives, maternity nurses, and doctors who deliver babies are just as good at sorting out common problems and offering solutions. Don’t let yourself slip through the cracks - help’s available, you just have to persist in seeking it out.

Second, tongue tied babies have tight lingual frenulums. That’s the band of tissue connecting the tongue to the floor of the mouth. When it’s too restrictive, a baby can’t get breast tissue to the back of his mouth - he ends up chomping on the nipple instead of drawing milk off the breast. It quickly causes nipple irritation. Anytime I delivered a baby noticeably and there was painful breastfeeding, I took the kid to the procedure room for a quick snip. The nurse held the baby’s mouth open and I cut the tight portion of the frenulum with a small pair of scissors. Minimal bleeding, minimal crying. Then the baby gets put on the breast again and the result are often dramatic - comfortable, easy feeds. The risks are low and the potential payoff is high. 

Third, ask your doctor for a prescription for all-purpose nipple cream. It has antifungal, antibacterial, and anti-inflammatory components all in one. Apply a thin layer after every feed - no need to wash off prior to the next feed. It’ll make a big difference.

Finally, if all else fails, just bottle feed. Nowadays, babies who grow up on formula are just as healthy as breastfed babies. It can be expensive and there can be a negative stigma associated with it, but if it saves your sanity, it’s worth it. Bonus: your partner can take a turn with nighttime feeds.

Hope that helps, Theresa. Go see your midwife again and see what she suggests.

© D. B. Ryen Incorporated, May 2021.  

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