June 2019 Newsletter: Breastfeeding a Baby with Tongue-Tie

By Applie Wan (BMSG Volunteer)

Stay-at-home mum Applie Wan was eager to start breastfeeding when she gave birth to her baby girl. Things seemed to start off rather smoothly on the day of the birth. However, on the second day, her nipples began to crack and breastfeeding grew increasingly painful. This is the story of how Applie figured out that her daughter was tongue-tied and how it affected their breastfeeding journey.

I am a SAHM of a 22-month-old girl. We first knew of the tongue tie when our paediatrician checked our baby in the early morning after she was born. The doctor asked if I experienced any pain while breastfeeding, to which I replied that my nipples were sore but I thought it was all very normal since it had only been a day since we had started breastfeeding. She suggested that we discuss this further with our postpartum doula and see a paediatric dentist for a proper diagnosis. 

Initially, we felt a little discouraged, as we hadn’t expected our baby to have any issues. Having a tie seemed almost like she wasn’t a perfectly healthy baby. Thankfully, our doula assured us that tongue ties are actually quite common and our baby was doing very well. Coincidentally, her child also had a tongue tie and she was able to tell us in depth how it might potentially affect breastfeeding and what our options were. 

It is best to catch a baby’s lip or tongue tie as early as possible. If you have your doubts, see a paediatrician or a paediatric dentist.

On the second day after delivering my baby, my nipples began to crack and breastfeeding started to become really painful. We worked on baby’s position as much as we could to get baby latching as deeply as she could, but the pain continued to persist as I could feel the raw wound on my nipples every time she nursed. We decided to book an appointment to see a paediatric dentist as soon as possible so that we could make the necessary decisions without delay. However, the earliest appointment we got was four days later. 

By the next day, my breasts started to get engorged. My milk had started to come in and shortly after, I started to get fever and chills. Our postpartum doula helped me to hand express and found out that there was pus, which may have been due to the cracked nipples leading to an infection. In addition, even though I had been nursing baby on demand every two to three hours, I ended up with blocked ducts. I started to dread latching her because of the pain and tried to pump instead to give my nipples a break. However, I didn’t yield much as I was still new to pumping so I bit my tongue and persevered to latch baby, even though I was in tears each time.

As our baby also had jaundice, she was very sleepy and had to be woken up to nurse. I also started to research about tongue ties, and found out that tongue-tied babies can also be very sleepy as it takes a lot of energy for them to extract milk from the breasts. Their milk transfer is not as efficient, hence they may fall asleep while suckling due to the effort they take. It dawned on us that our baby was gaining weight very slowly, she rarely pooped and her skin seemed loose and wrinkled.

A paediatric dentist will be able to properly advise you on whether your baby’s tongue and lip ties are severe and require a revision. Comparing your child’s lip or tongue tie with other children’s or guessing just from observation will not be helpful. See a professional instead.

Finally, the day of our appointment with the dentist arrived. We saw Dr Tabitha Chng on the advice of our paediatrician and she diagnosed that our baby had both tongue and lip ties. She also did a thorough evaluation of our breastfeeding journey. By the end of that evaluation, it was clear that the ties were impacting breastfeeding adversely. She went through all the procedures that we could do to resolve the ties before allowing us to make a decision. At that moment, I knew that we needed to proceed with the release if I wanted to continue breastfeeding exclusively so we went ahead with the release on the day itself. Within ten minutes, the procedure was finished and I was able to latch baby immediately to comfort her.

Surprisingly, I felt the difference the moment she latched on. I could feel more of her tongue moving against my breast when previously, I could only feel the tip of her tongue. She was also able to flange out her upper lips more than before. Even though she took some time to relearn how to latch with her newfound tongue mobility, I was immensely relieved that breastfeeding was no longer painful. 

We engaged a lactation consultant to continue working with us to improve her latch over the next few days, and diligently did the stretching exercises that were crucial in preventing the tongue and lip from reattaching. Within a week, my nipples had healed, our nursing sessions were pain-free and I was able to enjoy bonding with my baby much more. She started to gain more weight also. Baby is now 22 months old and is still breastfeeding. I am proud to have come this far!

After the revision, your baby may need to relearn how to latch. It will be best to work with a lactation consultant during this period.

If you suspect that your baby has a tie, I would definitely recommend that you seek a proper diagnosis from a paediatric dentist trained in tongue and lip ties. The dentist can help to evaluate how the tie is affecting breastfeeding. Some parents decide not to do the procedure as their babies are able to breastfeed without much issue despite the tie, so it is important to consider if the benefits of doing the release would outweigh the risks.

A release is also harder to do when the child is older. For example, the procedure may have to be done under general anaesthesia if the child is already very mobile, and the baby also has to relearn how to latch after the revision. Hence, I strongly believe that seeking help and advice as early as possible is very important.