This week, we are diving deep into a topic that many new families encounter: lip and tongue ties.
It is an incredibly hot topic right now. We hear about it constantly, leading many to wonder if it is an overdiagnosed issue. However, in our clinical experience, we are seeing a significant number of babies truly affected by these ties.
Let’s unravel exactly what lip and tongue ties are, how you, as a breastfeeding person, can identify the signs, and the crucial role integrated postpartum lactation support plays in navigating this challenge.
Understanding the Anatomy: What Are Ties?
To understand a tie, we first have to look at a frenulum. This is a small muscle that anchors various parts of our anatomy. When a baby is growing during the first trimester of pregnancy, the body develops along the midline. Sometimes, these frenulums form too short or too tight, resulting in a midline defect that can inhibit function.
A lip tie occurs when the frenulum that attaches the upper lip to the gum line is too tight, preventing the lip from flaking or flipping up like a suction cup during feeding.
A tongue tie involves the frenulum underneath the tongue that attaches it to the base of the jaw. If this anchor is too restrictive, it limits the tongue’s crucial range of motion.
Anterior vs. Posterior Tongue Ties
Historically, providers only recognized anterior tongue ties. This is the classic, easily visible tie where the frenulum attaches very close to the tip of the tongue. When the baby cries or lifts their tongue, the tie is obvious.
However, there are degrees of tongue ties, including posterior tongue ties, which are much harder to diagnose. These are not always visible. Unfortunately, some providers still do not believe posterior ties exist, which is non-sense. They absolutely do exist, and ignoring them disregards the very real pain a mother or birthing person is experiencing during breastfeeding.
Decoding the Signals: Is it Latch or Anatomy?
We frequently hear the phrase “breastfeeding should not be painful,” and that is the absolute truth. However, it is reasonable to expect some initial tenderness during the first five to seven days as established lactation begins and your body adjusts. Normal adjustment might look like tenderness during the first 15 to 30 seconds of a latch that then gets better as the baby nurses.
Abnormal pain, however, is a clear indicator that something is not right. Comprehensive postpartum lactation support is vital for differentiating between a positioning issue and an anatomical barrier.
Here are major signs that you should seek the expertise of a Certified Lactation Consultant (IBCLC) to assess for a lip or tongue tie:
The Signs for the Baby
A successful latch requires a baby to open widely, extend their tongue over the gum line, and use the lip and tongue to create a vacuum. A tied baby cannot execute these mechanics.
- Biting or Chewing: If the baby cannot extend the tongue past the gum line, they will use their gums to hold on, resulting in intense biting or chewing pain.
- A “Clicked” Latch: If you hear clicking sounds as the baby nurses, it indicates they are constantly losing the suction.
- Poor Weight Gain: When anatomical restrictions are present, the baby gains weight very slowly because they are unable to transfer milk efficiently from the breast.
The Signs for the Breastfeeding Person
- Persistent Pain: Pain that lasts throughout the feeding.
- Damaged Nipples: The presence of cracks, blisters, or bleeding is never normal and requires immediate attention.
- Recurrent Mastitis: Ineffective milk transfer is a significant cause of common challenges like plugged ducts and engorgement, which frequently progress to mastitis.
The Real Dangers of Unaddressed Ties
Some may think that dealing with ties is just about managing initial discomfort, but unaddressed anatomical issues can severely compromise a lactation journey.
Beyond intense, disproportionate pain, ties frequently lead to:
- Compromised Low Milk Supply: If the baby cannot empty the breast well, it signals your body to decrease production.
- A Very Short Breastfeeding Career: Tolerating the pain of cracked and bleeding nipples while continuously trying to nurse is incredibly difficult, often leading parents to default to formula when they truly wanted to breastfeed.
How SCV Birth Center Provides Integrated Postpartum Lactation Support
We believe that comprehensive care should not require you to bounce between multiple providers to find answers. We offer integrated postpartum lactation support under the same roof where your baby was born, creating a vital continuity of care.
We hear you when you say “everyone says the latch looks fine, but it still hurts.” We are here to listen and help.
Our protocol ensures your baby is assessed for ties at multiple stages during those critical first weeks:
- At Birth: We perform an initial assessment immediately after delivery.
- Home Visit: We re-assess during the 24 to 36 hour postpartum home visit.
- Office Visits: Assessment is part of your one-week and established lactation follow-ups.
Navigating Releases and Tools with Guidance
If our assessments indicate a problematic tie, we refer you to trusted specialists (like pediatric ENTs or pediatric dentists) trained specifically in releasing these restrictions using a laser or blade.
It is important to know that results are not always instant. While some birthing people find immediate relief after a release, others must work patiently with our IBCLCs as the baby relearns how to use their tongue to suck correctly.
Furthermore, integrated support is crucial when tools are necessary. We occasionally utilize nipple shields to manage intense pain and protect damaged nipples in tied babies (for instance, when a release cannot be scheduled immediately). However, a nipple shield should never be a primary solution. We use it under the expert guidance of an IBCLC, always accompanied by a clear plan to transition off the shield once the underlying anatomical issue is addressed.
Don’t dismiss your pain as normal or accept that “not making milk runs in the family.” You deserve a positive, empowering breastfeeding experience.
SCV Birth Center is serving families in Santa Clarita, Antelope Valley, and surrounding areas. (661) 254-3000