Starring Back at Me

31 years ago a baby girl was born in an Ontario hospital. Her mother wanted to breastfeed desperately but could not get the baby to latch well. She breastfeed for a few weeks but discontinued due to severe nipple pain. She did not have support or education she needed to be successful. This story is all too familiar for many mothers today.

I used to resent that my mother didn’t try harder to breastfeed me. Now As a mother myself I realize how ignorant it is to have felt that way. Breastfeeding is a learning curve for both mother and baby. If a new mother doesn’t have support in place she can feel lost. The more involved I become in breastfeeding education the more I have come to recognize all the pieces that led to our short breastfeeding journey. One of those pieces is tethered oral tissues.

As I became more and more educated on what tethered oral tissues are how they can effect breastfeeding I stood in front of a mirror and looked under my tongue. Sure enough, there starring back it me was my tongue tie. I instantly understood why my mother was experiencing the nipple pain that caused her to prematurely end our nursing journey.

Tongue ties, lips ties and buckle ties. Researchers believe that these soft tissue ties are a normal part of embryonic development but for some of us they do not dissolve. For a seemingly large portion of the population these soft tissue ties cause long term setbacks, one of them being breastfeeding.

I often hear “cutting tongue and lip ties is a fad”, “it is completely unnecessary” “it will stretch” “it seems like every baby has them these days!” I would be pleased to put these ideas to rest but first it’s important to understand how breastfeeding works.

I could write pages and pages solely dedicated to the ins and outs of breastfeeding. Oh wait! Someone has. In fact I have read more in my time becoming a lactation counsellor then I ever did to become a bls paramedic. So I’ll boil it all down for you. The tongue plays a vital role in achieving and maintaining a good latch.

In recent years researchers have discovered that a baby’s tongue does not simply “milk” the breast but creates a vacuum! The tongue needs to be able to move freely to the roof of the mouth and back down again to create this vacuum. The negative pressure pulls the nipple in, elongating it and ejecting milk into the baby’s throat. The tongue also needs to be able to cradle and move freely in a parastatal movement to keep the breast tissue deep in the mouth. If the lip is tied it may restrict the range of motion and ability of the lip to flange and create an air tight seal. If the tongue is tied it can also restrict mobility, thus not creating a vacuum needed to efficiently move milk from the breast.

Now that we understand why the lips and tongue are important for efficient breastfeeding lets tackle a few of those misconceptions.

Cutting a tie is just a fad now- a -days. Firstly what parent jumps on a band wagon that involves their precious baby and a dental procedure without rhyme or reason? I think the people claiming this haven’t ever breastfed a baby that has to compensate for the lack of vacuum by using F5 Suction to move milk. If they have they would understand how necessary it is. A fad is snap chat. Not laser of soft tissue. Most Parents want what’s best for their little ones. If all signs lead to tethered town, guess where you’re going?! Don’t fall into the fad of always trusting what others say, even some professionals! Do your research and if something doesn’t feel right it most likely isn’t! Be an advocate for your baby.

“It is completely unnecessary”. Who determines what classifies as necessary or not? From my experience is the uneducated who makes ignorant statements like this. When I say uneducated I’m not referring the lack of 8+ years your pediatrician has. I’m referring to the lack of breastfeeding and oral tie education peds and many other medical professionals lack. Even during my lactation education tongue ties were dismissed! It is most definitely necessary when it is truly restricting movement affecting breastfeeding. Period.

I can’t help but laugh out loud when I hear someone tell a mother the tongue and lip tie will stretch or release on its own when the child falls someday. It’s 2017. We have the medical knowledge to Cure fatal diseases, we can genetically modify almost anything yet we think it’s acceptable to let a mother baby dyad suffer while waiting years for a possible non sterile traumatic event to occur. This is craziness. A tongue and lip tie that is truly restricted not only effects the nursing experience itself but the baby and mother can both experience pain. Picture your arm tied to the side of your body with a really tight bandage or sheet. You try to stretch it by moving your arm to the side but it’s so tight you only move it a cm. To free your arm you need to move it 3 ft. This is a battle you will not win.

Now for my favourite! “It seems like every baby has a tongue and or lip tie these days”. True. There is statistically quite a few of us that have these feathered oral tissues. So what’s changed? Before birth became a medical procedure in the early 1900s midwives delivered most babies. Once a baby was born the midwife would use her finger nail (which she kept long and sharp) to cut the ties immediately. I think it’s safe to say today’s regulations would frown upon the use of a non-sterile finger nail for any procedure! As hospital births with male docs delivering became standard practice sadly breastfeeding took a turn for the worst. Until recently breastfeeding was not considered a normal way to feed your baby. Thus not many mothers experienced breastfeeding difficulties. It really is a number game. If 7 out of 10 babies that are having difficulty latching have a tie and we have 70 out of 100 babies breastfeeding those numbers will be higher compared to 70% of 20 out 100 babies nursing. Make sense? This is why we are seeing it so much more today than they did years past.

As I started my business as a certified lactation counsellor I was feeling inadequate. I was using everything I was taught and still mothers were having issues. I felt like I was failing them. It really didn’t take me long to dive deep into what was going on?! There had to be something I was missing. Tethered oral tissues. I started off by reading everything Dr. Kotlow and Dr. Ghaheri (world renown specialists in this field) have ever wrote. Every blog, article and book. I then went back to those few mothers and reassessed. Sure enough the babies had tongue and lip ties.

I felt proud, excited and relieved that I found the cause of their breastfeeding hardships but more then that I felt angry. How did my CLC education completely dismiss this huge, very common issue?! Turns out I’m not the only one. Doctors, IBCLCs, nurses, midwives, dentist, ENTs all lack knowledge and education on the mechanics of breastfeeding and tethered oral tissues.

Just like I took this into my own hands other lactation support people, dentist etc have to do the same. Some, like Dr. Kotlow and Ghaheri have, but sadly some do not.

I decided it was my responsibility to be the best lactation support I can be for the mothers of my community. I want them to trust my knowledge and experience. So I travelled to Kentucky to attend a course put on by Dr. Kotlow. I then travelled to Toronto to follow Dr. Jack Newman.

In the past months I have been assessing many babies latching and a high percentage of them had ties! I started to wonder, is it me? During my time with Newman he assessed many babies, and all of them had ties that he released right there in his clinic!

That strip of soft tissue looking back at me in the mirror has been haunting me. How many breastfeeding journeys have suffered because of the lack of awareness? How many more will suffer before health care professionals make breastfeeding education a standard?

My mind has clouded much of my breastfeeding experience with my oldest son. Severe pain. Nipple hanging by a thread pain. Baby not gaining weight, not enough milk, wouldn’t latch, the list goes on. I suffered through breastfeeding for 10 months. Not a single person could help me and not one person looked under his tongue.

I laid Hudson down in my lap and took a look. There starring back at me was his tongue tie. I felt angry and disappointed. Why did the system fail us?! I had reached out to public health, drs, lactation support people and dentists and not one person helped us. My anger subsided and instead I felt empowered. They failed me because they didn’t have the knowledge. I do have the knowledge and I will not fail the mothers of my community.

31 years ago had my own mother been given the support and education she needed, my tongue tie cut, our breastfeeding journey could have been very different.

Education is the most powerful way to make change. I hope to change mothers and baby’s lives, change the attitudes of our communities’ medical professionals and educate you. Always ask questions and demand answers! No mother should feel alone or left in the dark and most definitely not in my community. I am and will always be here for you.