We first noticed there was a problem when breastfeeding just wouldn’t stop being painful. We worked our way through every possible (and real) problem, only to have the pain persist. Poor latch. Poor positioning. Thrush. Sunburn. Vasospasms. Blocked ducts. Over supply. Fast let down. Sea monkeys. OK, everything but that last one. And still, nursing remained painful. I continued to nurse because of the many, many reasons that nursing is best, but it was challenging. Running out of other possibilities, we considered tongue and lip ties.
I never knew that it is not normal to have a flap of tissue connecting your tongue to the bottom of your mouth, or your lips to your gums. I’ve always had them, and fortunately, I have no significant problems. But apparently, this is abnormal, and can cause all sorts of problems, one of which can be painful breastfeeding. A lip tie can prevent a baby from getting a proper latch or remaining latched. A tongue tie can do the same.
When Alexis was born, I noticed a small ridge running vertically down the middle of her upper gum. Not knowing a lot of new babies, I assumed this was normal. In fact, it was part of a rather thick and extensive frenulum– fibrous tissue that connected her lip tightly to her gum. In Alexis’ case, the lip was connected to the gum, and then the tissue continued down and around behind the gum into her hard palate. I didn’t take a picture, although I found a few old pictures where you can see a little bump of the tissue on her gum. Hers looked a lot like the class IV lip tie on the first page of this PDF document.
Unaddressed, it could result in a gap between her front teeth, cavities, and dental problems into adulthood. Lip ties can also cause painful gas, as a lip-tied baby tends to swallow a lot of air while nursing. Alexis certainly did. We spent many an early night bouncing and burping, struggling to get out the gas that clearly had her so uncomfortable. Tongue and lip-ties can cause gagging, sleep apnea, speech problems, and developmental problems with the jaw. More immediately, an unaddressed tongue or lip tie can result in early weaning, either due to the persistent pain or because the failure to latch well can lead to a decrease in milk supply, which is a slippery slope.
So we made one of the hardest parental decisions we’ve had to make in Alexis’ short life and took her to a dentist for evaluation and treatment. Alexis had the lip tie, as well as a minor tongue tie. We agreed to have both revised, which the dentist did with a laser. Often, tongue and lip ties are revised or clipped using scissors and/or scalpel in a procedure that involves general anesthesia. I would prefer to avoid using general anesthesia on my little girl if at all possible, and with a laser, the only anesthetic necessary is a little topical gel. I’m not sure anything but a laser could have been so precise, or removed as much of the tissue that was on the gum itself.
The entire process took only a few minutes. Alexis remained conscious, and was none too happy about being swaddled and having the dentist’s fingers in her mouth. Even as a new baby, she didn’t like to be swaddled with her arms tucked in. It was hard to watch my poor baby struggle and cry through the procedure, knowing that I had decided it should be done. But I also knew that this is a condition that would probably result in other uncomfortable problems and procedures if left untreated. Fixing it now was the lesser evil. As I was the one to hold Alexis still during the procedure, I got an excellent view of what was done. There was absolutely no bleeding. Her cries were angry, but they weren’t cries of pain. Once it was over and she was out of that awful swaddle, she calmed down quickly.
Within an hour, she had taken a short nap, nursed, was smiling, and seemed just like her normal sweet self. A little later, she got fussy and after a couple of aborted attempts, refused to nurse. It was clear her mouth was sore and she was hungry. We gave her Tylenol, focused on distraction, and did skin-to-skin snuggling. After taking another short nap, Alexis was back to nursing. Painlessly! We have a little recovery time to go through, which includes stretching her lip to prevent it from healing together, but this will be quick and bearable.
For mamas struggling with painful breastfeeding, I encourage you to explore the possibility of tongue and lip ties. Find a lactation consultant who knows about them and can help. I felt the difference as soon as the procedure was done. Nursing has been painless ever since! And while Alexis didn’t enjoy it, I’m positive the whole thing was much more traumatic for me.