How a Lip or Tongue Tie Can Make Breastfeeding Difficult

Breastfeeding came naturally for me with my first child. But when my second child was born, while I thought I knew what I was supposed to do, it just would not click. For the first night, I was feeding my newborn nearly every half hour while my husband inhaled energy drinks to monitor me so I wouldn’t fall asleep holding our baby. For days, we continued like that, somehow managing to also care for our 13-month old son. Snacks and Netflix were life while my nipples chafed, my baby cried, and my breasts ached from manually expressing my milk. I cried and beat myself up because it felt like I was failing my child—until one of my midnight Google searches for “breastfeeding difficulties” linked to an article on lip and tongue ties.

So what are lip and tongue ties?

Lip ties are when the frenulum (a piece of tissue behind your upper lip) is too stiff or thick, and it can make breastfeeding difficult by preventing the upper lip from moving freely. Tongue ties are more common and occur when the frenulum is too short or tight, or when it’s attached to the tip of the tongue instead of further back.

“A thicker, shorter, or tighter band is as common as 3-10 percent of babies and can restrict the baby’s ability to latch and suck properly,” said Dr. Lauren Demosthenes, Senior Medical Director at Babyscripts. “It is also a genetic situation, with boys being three times more likely than girls to have this.”

Source: Tracey Shaw | Pexels

How can tongue and lip ties be identified and why do they need to be “fixed”?

“Typically, the first person to identify a ‘tongue-tied’ baby is either a lactation specialist or a pediatric caregiver,” Dr. Demosthenes said. “The band may stretch and loosen on its own with no need for a procedure at all.”

But that isn’t always the case. My lactation consultant, gynecologist, and the pediatrician at the hospital said my baby and I were both perfect besides a moderate case of jaundice, so I was the first one to notice the issue.

Doctors usually catch a tongue/lip tie if they see the baby struggling to gain weight, and mothers may express concern when they notice pain while breastfeeding or due to engorgement, blocked ducts, and possibly mastitis. In my experience, I noticed that my breasts were still very full even after a half hour of nursing. I strongly believe that if it weren’t for my experience breastfeeding a child a year prior, I might’ve thought my difficulties were normal and not expressed extra milk to feed him.

Source: Icaro Mendes | Pexels

What happens if the doctor recommends a procedure?

According to the Mayo Clinic, some doctors and lactation consultants recommend correcting tongue and/or lip ties immediately while others recommend waiting because it may resolve on its own. However, in some cases, unresolved ties can cause difficulty breastfeeding or even speech difficulties down the line. When the child is a newborn, surgery can be done without anesthesia, and the baby can breastfeed right after the doctor snips the tongue and/or lip tie. Afterward, most doctors recommend simple exercises to stretch and enhance tongue and lip movement so the area doesn’t scar.

“Since there are very few nerve endings in this area, it can be done with minimal discomfort to your baby, who can nurse and be comforted immediately after the procedure,” Dr. Demosthenes said. “In some more difficult cases, your baby may need to have this surgically corrected with anesthesia—in this situation, your pediatrician may ask a physician who specializes in ears, nose, and throat to do the procedure,” she said.

We chose the simple procedure. My son cried for a minute or so, then was immediately soothed as we were now able to breastfeed successfully just minutes afterwards. For us, it was definitely worth it, but you should always discuss any questions or concerns with your doctor or a specialized ENT physician.