At four weeks old, my daughter was still struggling to nurse and experiencing weight gain issues. I was hormonal, scared, and downright defeated that we couldn’t figure out what was going on. After seeing our pediatrician and several lactation consultants, I took her to a pediatric dentist, who officially confirmed that the problem was lip- and tongue-ties, which were as severe as they could be.
The dentist recommended a frenectomy, and within 10 minutes the ties were revised, and my husband and I left with instructions on healing and the “stretches” we’d need to do over the next few weeks.
I left the dentist’s office relieved but wondering how this happened and why it took so long for anyone to help me.
Unlike many first-time moms, I was aware of tongue- and lip-ties from breastfeeding and birthing courses I had taken. Frenectomies remove the tissue, or tight frenulum, from beneath the tongue and upper lip and are routine procedures that offer many benefits. Not only do they allow babies to properly latch and establish a strong breastfeeding relationship, but they can also solve potential dental, speech, or feeding issues caused by ties.
Babies need proper mobility in their tongues to achieve a strong latch, which gives them the ability to extract plenty of milk.
The revisions can be performed (typically with scissors) in many hospitals if ties are identified, or you can see a pediatric dentist for a laser procedure. Both options are fast, but the laser method tends to result in less bleeding and faster healing.
In the first few days of nursing my daughter, I experienced lots of pain, bruising, and even bleeding. I was told by nursing staff and friends this was normal and not to worry. But I knew something was wrong and that her latch was not deep enough. Babies need proper mobility in their tongues to achieve a strong latch, which gives them the ability to extract plenty of milk. Two days postpartum, we noticed her jittering, prompting the nurse on duty to find that her blood sugar was low. While it’s not uncommon for newborn babies to struggle with regulating their blood sugar, I know now she was not getting the nutrition she needed from me because of her ties. But after 24 more hours in the hospital, during which we received donor milk and I continued to pump, we left not knowing about my daughter’s ties, because the pediatrician on duty and two hospital lactation consultants did not identify them. They didn’t connect the low blood sugar to feeding issues—they thought it was because my labor was hard on her—and they simply missed the ties (all were only with us for a few minutes, and many pediatricians are not trained to identify ties).
Five days postpartum, we went to our first pediatrician’s appointment. While our doctor was great in many ways, she also did not see the ties in Norah’s mouth. Moreover, my daughter was losing weight. I was crushed. I was trying so hard, letting her nurse whenever she wanted, cluster feeding, using a nipple shield, the whole bit, and I was still failing. I still had not ruled out a tongue-tie but also trusted the doctor’s assessment, starting to doubt whether nursing would work for us at all.
But we did what we could: We went home and kept up our routine. I was extremely committed to breastfeeding, but I dreaded my daughter’s cries, and when my husband woke me up from naps to feed her, I prayed she would latch and get enough to eat. But I had no idea whether she was well fed. She cried a lot and fed for long periods of time; wasn’t this just normal baby stuff? For two weeks, we muddled through this way, until it was time for Norah’s two-week checkup. More bad news. Her weight percentile was dropping. I was exhausted and experiencing intense baby blues—and now on top of this I was so ashamed about my inability to help my daughter gain weight. I decided to find another lactation consultant who would travel to our home.
I still had not ruled out a tongue-tie but also trusted the doctor’s assessment, starting to doubt whether nursing would work for us at all.
The consultant arrived with a scale so we could do a weighted feeding. Within a few seconds of watching Norah nurse and evaluating her mouth, she showed me the ties keeping her from opening her mouth wide enough to get a good latch. I was equal parts frustrated and relieved. I finally had an answer for the slow weight gain and pain during feedings. I scheduled a visit with the pediatric dentist immediately.
I can’t say Norah’s missed ties were anyone’s fault. I should have sought out an IBCLC’s opinion after we were discharged. In fact, next time I will take my baby to be evaluated by a pediatric dentist and private IBCLC his first week of life, no matter how well nursing is going (I’m due in March 2021!). I believe the last lactation consultant found Norah’s ties because she was thorough and trained to do so.
After the frenectomy, we did the (horrible) post-revision stretches. I couldn’t bring myself to do them, and my husband performed them every time (bless him!). There were tears and there were screams and there was trauma, three times per day for three weeks.
Thankfully, the mouth heals quickly. Frenectomies can be difficult on new mothers, and it’s hard to see your baby in discomfort, but it was 100 percent worth it. The changes were not immediate, but after the first week or so, nursing got significantly better and easier—and with no pain for me because Norah was finally able to latch properly.
No one should experience guilt or shame over their baby not getting enough to eat due to lip- or tongue-ties. It was mentally tough to handle, too, because I’d see friends nursing with zero issues. Before we had a diagnosis, I felt responsible for not being able to provide the calories my baby needed. In the end, our breastfeeding journey lasted 16 months, and while nursing isn’t for every mother, I’m incredibly proud of what Norah and I accomplished.
No one should experience guilt or shame over their baby not getting enough to eat due to lip- or tongue-ties
Advocate for yourself and your baby by seeking second and third opinions—you won’t regret the results. I didn’t do this well and plan to change that next time around. And give yourself grace, and more grace, as you blossom into the mother you were made to be.
Want to know some of the signs your baby might be lip or tongue-tied? Find a lactation consultant in your area or check out these resources from La Leche League.