Guest Post: From a Mommy Dentist: The challenge of breastfeeding tongue-tied babies

Today I’m going to share, with permission, a post that Dr. Kristen Berning wrote for her dental practice’s blog. As the admin for Tongue and Lip Tie Minnesota Facebook group, I see story after story after story from moms that have many of the same themes that Dr. Berning’s does. In the last year, there has been some very forceful pushback from Lactation professionals, pediatricians, dentists, etc. against addressing tongue ties. Quite frankly, some of the discussions I’ve seen via blogs or social media are very negative about moms who are looking for help on this issue. I’m hoping to share other stories from moms over the next few weeks to help get the word out about what it’s like to be the parent who has to advocate for help. If you have your own story you’d like me to share, email me at veronica@babylovemn.com.

Like many new moms, I thought breastfeeding would come naturally.

When my third baby, Ted, was born, I already had 2 years cumulative experience breastfeeding my other children.   I planned to exclusively breastfed Ted for at least 12 months.

When Ted was just one day old in the hospital, I knew something was different with breastfeeding.  I felt he was “chewing” instead of “sucking.”  The lactation consultants worked with me on encouraging a deeper latch:

tongue tied baby

  • I was told to use my finger to encourage him to stick his tongue out further.  But he couldn’t stick his tongue out very far.
  • I would wait for a wide opening before letting him latch.  But he didn’t open very wide.
  • I was told to use a nipple shield.  But that made the pain even worse since he was still “chewing,” and the plastic was pinching me where I had open cuts.
  • When his latch was shallow, I was told to break suction and try again to relatch.  But the latch-on was the worst part and I didn’t want to restart the feeding.  I just wanted to get it over with.  The toe-curling pain brought me to tears and I dreaded the next feeding.

I had cracked and bleeding nipples.  The lanolin and gel soothies weren’t helping enough.  I attended the breastfeeding support group when he was 3 weeks old and discussed the pain with the lactation consultants.   I was sitting near a sweet mom named Jessi.  Jessi suggested Ted might have a tongue-tie, as she experienced it with her daughter and had it clipped by an ENT physician.   The lactation consultants took a look at his tongue, but were not sure.  At Ted’s 3-week well child appointment, his pediatrician was also not sure.

I made a phone call and the ENT could not see Ted until the next week.

The next night, I felt shooting pains in my chest in between feedings.  With one arm clutched across my chest, and the other arm used to search Google, I read that it might be thrush- a yeast infection of the nipple and breast.  I looked inside Ted’s mouth and saw small white patches in his cheeks.  I went to the pediatrician’s night clinic to confirm the diagnosis of thrush.  Then I drove to the pharmacy in tears, to get our prescriptions.   The pain, the frustration, the thrush diagnosis—were pushing me over the edge.   But I didn’t want to stop breastfeeding.

I called the ENT doctor’s office the next morning, and politely but desperately asked if there was any way they could see us sooner due to the severe pain I was having.  They squeezed me in that day.

At our appointment, I explained to the doctor how I knew Ted’s latch was drastically different than my first 2 babies.   We discussed the procedure, I signed a consent form, and the nurses prepped the room for the frenotomy procedure.  Three-week-old Ted’s little body was placed onto the operating table, he was stabilized by a couple nurses, and the ENT clipped Ted’s lingual frenum with a surgical scissors.  Ted was immediately returned to me to breastfeed.  His latch was instantly better: deeper and less painful.  I was so relieved to have improvement.  My cracked nipples healed over the next week.

It took some time until the thrush was completely managed, but the frenotomy saved our breastfeeding relationship and I exclusively breastfed Ted for 13 months.

_____

Fast forward to when my 4th child, Clara, was born.  She latched on fairly well in the hospital and gained weight well.   I thought we were in the clear.

However, a few months passed and the initial soreness from breastfeeding was not going away.  Her latch was shallow, but not as bad as Ted’s.  She popped on and off the breast frequently and was gassy.  I had sore nipples and cracking again.  I was dreading each feeding as her latch rubbed on the open cracks causing awful, toe-curling pain.  I pumped several feedings (which also hurt) so my husband could bottle feed her and I could take a break from her poor latch.  I tried different nursing positions, used prescription APNO (Jack Newman’s all purpose nipple ointment), and did everything I knew to improve her shallow latch.  I also dealt with clogged ducts and developed mastitis, and was in the doctor’s office again, in tears.

upper lip tie, laser revision, laser frenectomy

I noticed Clara’s upper lip was often tucked in while nursing, and it did not flange.  In our local private Facebook group for breastfeeding mothers, a mom named Tricia mentioned difficulties breastfeeding due to a lip tie.  I had become aware of tongue-ties after my experience with Ted, but I was unsure how lip ties affected breastfeeding   I needed to find out more…

I learned that when a lip tie was present, a posterior tongue-tie was usually present.  A medical practitioner may be familiar with anterior tongue ties, however, posterior tongue-ties are not as visible to the untrained eye.  Clara also had a posterior tongue tie.

Lip and Tongue Tie Revision

I engaged myself in learning about lip ties and tongue-ties as I had experienced so much of this myself with minimal local support.  Let me emphasize, I really appreciate and respect my local lactation consultants and pediatricians.  They are wonderful people!   They just were not (at that time) familiar enough with lip ties and posterior tongue-ties.

Lip and Tongue Tie Revision, Laser Revision

I learned there were dentists revising infant lip and tongue-ties with lasers.  I was using a laser  almost daily in our Dubuque, Iowa dental practice and had done many laser frenectomies on older children and adults.  Dr. Mindy Hochgesang became my mentor and allowed me to observe the lip and tongue tie revision procedure.

As a passionate supporter of breastfeeding, this opened the door for me to “pay it forward.”  It was mom-to-mom support that sent me on this journey.  I could now give both mom-to-mom support and provider-to-mom support for breastfeeding dyads struggling with tongue and lip ties themselves.

My daughter Clara was my first infant patient.   I revised her lip tie and posterior tongue-tie, we did post-frenotomy care, we both healed, and now we have a great breastfeeding relationship.

 

laser dentist, Iowa laser dentist, lip tie, tongue tie

Dr. Kristen Berning provides support for breastfeeding moms who are dealing with lip and tongue ties.  She uses a laser to perform lip and tongue tie revision, including posterior tongue ties.  Her office is located at 4200 Asbury Road, Dubuque, IA 52002 and serves the Cedar Rapids & Dubuque, IA, Galena, IL and Madison, WI areas.  To schedule a consultation or ask questions about laser lip and tongue tie revision with Dr. Kristen Berning please call 563-556-2711 or contact us online.

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

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