When breastfeeding hurts: here's the low-down on tongue tie
Breastfeeding can be an emotive topic.
There are those who love it from the first latch of the first baby in those first minutes of life. There are those who find it difficult in the early stages, but get there in time. There are those who decide not to breastfeed or who try and try until they can’t try any more.
There are some who have no pain at all. There are some who have low levels of pain and discomfort. There are some who can’t go on, because the pain is too much to bear.
And then there’s the aftermath. The emotional consequences of choices made, and battles won or lost.
There are mothers who love breastfeeding and want to help others to breastfeed, but whose motives are sometimes misunderstood. There are mothers who don’t breastfeed, and feel judged. There are mothers who try breastfeeding, and feel desperately sad if it doesn’t go as planned.
There are forums and websites and articles, generating constant debate and frequent divisions.
There are claims that breastfeeding is incredibly painful. And claims that breastfeeding should never be painful.
How can it be that women have such varying experiences – surely it’s either one thing or the other?
In fact, it’s not so clear-cut. Certainly, if there isn’t a good latch, there can be pain – new mothers often need help from a lactation consultant, or even just a few days practice to improve the latch.
But there’s something else in the mix too; it’s called tongue tie.
I hadn’t heard of it when my third baby was diagnosed with it three years ago, but I will never forget the pain it caused.
Tongue tie is the common name given to the condition whereby the tissue under a baby’s tongue is too tight, and the baby is therefore less capable of stretching his or her tongue in order to cup the nipple and get at the milk.
This is very tiring for babies who have to work much harder than they should to get the milk, and it can (though not in all cases) be very painful for mothers. Up to one in ten babies are born with tongue tie, so this is very, very common, but not always well understood.
In my own case, I knew that there was definitely something wrong, because I had breastfed my two older children – I had a frame of reference. When they were born, I had experienced some low level pain while breastfeeding, but it had subsided within a few days. With my third baby, the pain became worse by the feed, and I’m certain that had he been my first, I would have stopped breastfeeding altogether. I would have assumed that the pain was normal, and that I was a failure.
But because he was my third, I knew to ask questions and to look for help. I saw lactation consultants in the maternity hospital, and then a wonderful private lactation consultant who referred me to a doctor. He diagnosed tongue tie, and carried out a frenotomy – a very minor procedure that involves snipping the frenulum and thus releasing the tongue tie. My little boy was finally able to stretch his tongue properly and immediately became more efficient at feeding. The pain subsided from the first post-frenotomy feed, and within two weeks, it was completely gone.
Unfortunately, maternity hospitals do not routinely check for tongue tie, and many medical professionals are not trained in how to spot it. This is because bottle-feeding has been more popular than breastfeeding for two generations – tongue tie usually only becomes apparent through breastfeeding. So in many cases, hospital staff don’t notice that a baby has tongue tie, and mothers don’t know to ask.
Pain caused by tongue tie is assumed to be “normal” breastfeeding pain, and many women suffer through, while others, understandably, decide to stop breastfeeding. There are countless women who have faced those two choices, not realising there’s a third – a simple, two-second procedure that fixes everything.
Breastfeeding rates in Ireland are abysmally low. It feels, at least anecdotally, as though much of the focus is on convincing expectant mothers to breastfeed. Perhaps if more of these resources were put into supporting women who have already made the decision to breastfeed and are desperately trying to do so, we’d have better success.
If you think your baby may have tongue tie, you should contact a lactation consultant – you can find a full list on Association of Lactation Consultants in Ireland.
Andrea Mara is a shoe-obsessed, coffee-loving mother of three from Dublin. When she’s not working, or looking after the kids, Elissa, Nia, and Matthew, she’s simultaneously making tomorrow’s school lunches, eating Toblerone and letting off steam on her blog.
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