After a 28-hour birth, I’d thought I’d made it through the hard part with my third son. I was an experienced mom, I reasoned, and my second baby had been a dream (I spent his first six months taking pictures of his fat cheeks and wondering why he napped so much). Enter: colic baby—or so I thought. After a lip and tongue tie went undiagnosed by his pediatrician, a lactation consultant finally saved the day by correctly identifying the problem and referring me to a team of specialists that opened my eyes to new techniques and set us on the right path.
At five days old, my son started crying and basically didn’t stop for months. He struggled to breastfeed, which had come quite naturally to my previous babies. He was diagnosed with an ear infection at five days, apparently the youngest the nurses had ever seen one diagnosed. I reluctantly started him on antibiotics and hoped it was the end of the screaming and discomfort. Far from it.
In both tongue ties and lip ties, connective tissue in the mouth is too short and thus restrictive.
The pediatricians encouraged me to stick with breastfeeding. But a few days later, he developed white spots in his mouth, and I had searing breast pain. We’d both developed thrush, basically a yeast infection the mom and baby pass back and forth. (Of course I found out later it was caused by the antibiotic.) Dealing with thrush as a breastfeeding mom is the equivalent of dealing with lice in a house full of school-aged long-haired girls: lots of sterilizing, medicating, and checking (and repeat). It didn’t go away with any of the prescribed treatments, the crying worsened, the pediatrician checks became almost weekly, and I was ready to quit breastfeeding.
I turned, as many moms do, to online chat boards for comfort, anonymous complaining, and advice. When I explained my pain while feeding, the thrush, and even the ear infections, multiple women commented, “Has he been checked for lip/tongue ties?” I replied that the pediatrician had checked at birth, but their responses were surprising: “He has to be checked by a lactation consultant. Pediatricians miss them sometimes.” Some quick Googling had me even more confused, as I’d stumbled on a hot debate in the mommying community: whether or not a baby needs a lip or tongue tie revision.
In both tongue ties and lip ties, connective tissue in the mouth is too short and thus restrictive. In the case of a tongue tie, the frenulum—the bit of tissue that connects the tongue to the floor of the mouth—is too short, and in the case of a lip tie, it’s the connection between the upper lip and the gum line.
Four to 11 percent of babies have lip ties, and the diagnosis rate has risen dramatically in recent years, hence the controversy. An article in ENT Today leads with Western medicine’s stance: “Tongue ties are being blamed on social media for a slew of woes affecting infants—from nipple pain to poor napping to speech issues—but many experts agree that the rise in diagnosis and treatment is being led by consumer demand rather than by hard science.”
Limited research has been done on the subject, but in 2008 an ultrasound study of a breastfeeding baby increased understanding in the field around the mechanics of lip and tongue ties and how they can negatively impact breastfeeding. After the study came out, lactation consultants started referring more children for corrective procedures for lip and tongue ties, but many pediatricians, who are not trained in breastfeeding medicine, still did not. The procedure, called a frenectomy, is a one-minute, anesthesia-free surgery in which the connective tissue is cut.
My son continued to struggle eating, even when I briefly tried formula, and I knew I had to solve his eating dilemma. So I found myself heading down the lip- and tongue-tie road.
There’s also some tension between doctors and lactation consultants, as some pediatricians refer to frenectomies as a “fad” procedure, while lactation consultants are taking a more active role in diagnosing and referring patients who are struggling to breastfeed to specialized dentists who perform frenectomies. The outcome of frenectomies is still unclear: A study released in 2019 says that of 115 babies referred for the procedure, 63 percent did not have the procedure in the end but went on to breastfeed successfully with other interventions, leading the researchers to conclude they didn’t “need” the frenectomy. Meanwhile, lip and tongue ties, if unresolved, can have long-term impacts on eating, speech and development. So, while the frenectomy might feel to some like an “unnecessary” intervention, it may be significant in the long run for more than just breastfeeding. Some parents who do go through with a frenectomy claim their breastfeeding problems almost immediately disappear. Others are pleased with the results a few weeks later. Still others are apprehensive. Frenectomies, for their part, don’t appear to have any long-term negative effects on infants.
The other medicines, pediatricians, and pathways hadn’t answered my question: Why was my baby still crying? My son continued to struggle eating, even when I briefly tried formula, and I knew I had to solve his eating dilemma. So I found myself heading down the lip- and tongue-tie road.
Five months after his birth, I found myself reluctantly breastfeeding in front of a registered lactation consultant, Jamee Diver. A woman examining your nipples and baby’s mouth up close and personal wasn’t my idea of a fun outing, but it was a smart move—I felt heard and validated for the first time, as she showed me with charts, demos, and my own baby’s mouth why he wasn’t able to latch or to consume enough milk. She diagnosed him with four ties: a lip and tongue tie and two buccal ties, in which the upper cheeks are too connected to the gumline. The kid couldn’t eat, I couldn’t sleep—these first five months had been a miserable disaster. When she handed me the list of potential lip tie symptoms, I almost lost it. Thrush: check. Pain while feeding: check. Colic: check. Frequent ear infections: check, check, check. It went on. I texted a picture of it to my mom, in shock that this was all it took.
Within a few weeks of our session, my son had a laser frenectomy, or in other words, I paid $700 to have a special dentist laser a piece of my son’s mouth skin. These “approved” dentists are recommended by lactation consultants based on the availability of the laser procedure, and Facebook groups for each state keep up-to-date lists of providers. I didn’t even recognize myself but had no idea what else to do. I was even scared to tell the pediatrician what had happened, feeling as if I’d strayed from his plan of treatment.
Not only was the lactation consultant’s support invaluable to our breastfeeding efforts, but the specialized dentist included consults with an occupational therapist as part of the pre- and post-frenectomy evaluation.
Before the procedure, the OT—or “baby whisperer,” as she was called—spent time holding the baby, examining his head, neck, jaw, mouth, and muscles. She talked to him in a way that made him light up and complimented him like she would a grown adult. It was fascinating to watch. She explained the interconnectivity between muscle tightness and a baby’s ability to use their mouth to suck milk properly. She’d been at our nationally renowned local children’s hospital for 20 years and now had dedicated her life’s work to helping babies flourish after lip tie surgeries.
Within a few weeks of our session, my son had a laser frenectomy, or in other words, I paid $700 to have a special dentist laser a piece of my son’s mouth skin.
After the procedure, we visited her office, which was a cross between a physical therapist’s office, a doula’s apartment, and a chiropractor’s clinic. She taught me concrete exercises to use with my son and also less concrete concepts, like speaking positivity into his life—no longer could I refer to him as our “colic baby.” I showed up to improve breastfeeding and left feeling like I’d visited a parenting psychologist. My view of him started to morph as I changed the perspective with which I was looking at him. It helped, of course, that our breastfeeding endeavors improved drastically by within three weeks of the procedure, he cried less, and seemed like the full, happy baby I’d expected that first week of his life.
One leader in the field of lip and tongue tie research, Dr. Bobak Ghaheri, published a study revealing that after procedures, milk intake improves by 155 percent. I’m not a scientist, but I know my baby was 155 percent better and screaming 155 percent less of the night as well. While not all studies show improved baby feedings, they also show few to no adverse side effects, making it worth the risk for us and for many parents. This research concludes that, at the very least, the mom suffers less pain while breastfeeding. Our thrush cleared up for good after months of suffering once my son had the procedure, and our pediatrician was stunned by the results and asked me questions about the process with interest.
My son went on to breastfeed for 14 sweet months in total, and I learned that sometimes the traditional path isn’t always the right path.
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