Tongue-tied

New mothers are often told, “breastfeeding is best”. However, sometimes the milk just doesn’t flow and more mothers believe that tongue-tie might be to blame. But what is it and what does it mean for mothers and babies?

Jodi Field was naturally overjoyed when a healthy baby girl was placed in her arms. However, she was soon feeling overwhelmed as she struggled to breastfeed her newborn.

Baby Brianna just couldn’t latch on. Nurses checked her over, gave her the all-clear and told Jodi to keep trying.

“I had her on the breast for six hours and it wasn’t working, yet the nurses told me to keep trying,” she says.

Jodi persevered at home but Brianna kept slipping off and suffered from wind. She had no option but to express her milk and feed her with a bottle.

“Essentially I expressed until my fatigue outweighed the benefits of breast milk,” she says.

“I felt like a complete failure. I was in tears because I couldn’t breastfeed my baby.”

Jodi’s story is similar to that of the hundreds of women who seek Jackie Wheeler’s help. The Manawatu Lactation Consultant sees mothers and babies from all around the central North Island.

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“I see so many tongue-tied babies. Undiagnosed tongue-tie can lead to the mother battling on with sore nipples, mastitis, and an unhappy baby.”

Tongue-tie (ankyloglossia), is when the fraenum linguae is short, tight and often fan-shaped and the tongue is bound down to the floor of the mouth. It alters how babies latch on to the breast and affects sucking mechanics, making it harder to get milk from the breast, resulting in poor weight gain and contributing to a lower milk supply.

Babies’ symptoms are both many and varied, including choking on milk, dribbling milk out of their mouth while feeding, making clicking noises while sucking and reflux or colic.

Mothers can experience sore breasts, bleeding nipples, thrush, staph infections, mastisis, and reduced milk supply.

Jackie sees a lot of mothers struggling with these issues. Mothers often believe it’s the cracked nipples or mastisis that is affecting breastfeeding, however, Jackie says these symptoms are often just masking the underlying cause, which is a tongue-tied baby.

She sees about 25 mothers and babies a week who have been referred to her because the baby has a possible tongue-tie. Most of these mothers are opting to have the tongue released.

Jackie believes the so called “rise” in tongue-tie is thanks to better diagnosis.

Ministry of Health figures reveal that the number of tongue-tie diagnosis has increased by more than 500 in the last five years. And the 2,137 diagnosed in the 2016 financial year is likely to still be short of the actual number as many cases are diagnosed in the community setting.

Medical experts differ on whether tongue-tie should be released. Some say it is an over-diagnosed and over-treated fad as some babies can breastfeed successfully with a tongue-tie and some tongue-tied babies show no real benefit from the surgical release.

But Jackie believes it makes a big difference to mothers and babies struggling with breastfeeding.

This is backed up by an American study investigating the impact of surgical tongue-tie release on breastfeeding impairment. The rate of mothers who choose to breastfeed in the United States has been rising during the last 20 years but so too has the number or mothers who fail to breastfeed their babies. There seems to be a similar trend in
New Zealand.

The benefits of breastfeeding have been well publicised in recent years, which has likely encouraged more women to breastfeed their babies. The longer a baby is breastfed the more maternal benefits there are and less chance baby has of contracting a number of health conditions.

“There’s a lot of pressure to breastfeed, we all know it’s the best and there are mothers who want to but can’t
and it’s hard. You feel like a failure,” says Jodi.

The study led by Doctor Bobby Ghaheri MD, claims the United States could save $13 billion a year if mothers followed recommendations to exclusively breastfeed for six months.

However, studies such as this are like a double-edged sword for mothers who want to breastfeed but for whatever reason cannot.

Jodi says she felt a lot of pressure to breastfeed despite her ongoing difficulties.

“I felt it was my biggest failure as a human being, not to be able to breastfeed.”

It wasn’t until Brianna was six-weeks-old that they were referred to a dentist and she was diagnosed with tongue-tie.

At that time, Jodi didn’t know anything about the condition. After doing her research and taking medical advice, she chose to get Brianna’s tongue-tie released.

Recent findings suggest that surgical release of tongue-tie results in significant improvement in breastfeeding outcomes.

The authors of the US study also noticed babies had more stamina to feed on the breast when the tongue motion drives the milk extraction rather than other muscles compensating.

With the use of anaesthetics, Jackie says the pain for babies is minimal and compares the procedure to that of a heel prick test.

“The expectation is a lot worse than the procedure. A lot of people ask: “is that it?”

However, it’s not always as simple as snipping the tie to improve breastfeeding.

Babies who have been struggling to feed are often already on the bottle when Jackie sees them, so it can be hard getting them back on to the breast successfully, which was the case for Jodi.

“Because it took so long to detect the tongue-tie it was too late to rectify attempts at breastfeeding,” she says.

Jodi was all too aware of the difficulties that tongue-tie could cause when her second daughter Sophie was born. Despite reassurances from medical staff, she again had difficulty breastfeeding. Sophie was diagnosed with a tongue-tie when she was two-weeks-old and had the snip a week later.

Unfortunately, Jodi didn’t manage to successfully breastfeed Sophie either as she simply ran out of energy, trying to care for a newborn and a toddler. She believes there needs to be more support for mothers after a baby has had their tie cut.

Jackie feels for mothers who are frustrated because they don’t know the root of the problem and feel guilty because they aren’t able to breastfeed.

The most important thing is that you’re meeting your baby’s needs, no matter how you choose to feed.

“It’s not fair to judge a mother because you don’t know what they’ve been through,” she says.

Read the research at:
www.drghaheri.com