Booby Trap: Docs Who Won’t Snip Tongue-Tie, Thousands of Breastfeeding Moms & Babies Suffer

A miserable, tongue-tied baby, courtesy of flickr.com

Kudos to the researchers at the University of Florida for drawing attention to a major “Booby Trap” in helping mothers achieve their personal breastfeeding goal, as published online in Pediatrics. Many in the breastfeeding community have known for a long time that an unusually short frenulum, the connective tissue under the tongue, is more common than people realize and can be easily and quickly snipped by credentialed professionals to allow the baby’s tongue to move properly and milk the breast.   If left undiagnosed and untreated, this condition, commonly called “tongue-tie,” can in severe cases result in low weight gain with a great deal of frustration and suffering for the baby, and extreme nipple pain,  mastitis and frustration and agony for the mother.  Contrary to popular belief, not all doctors are permitted to perform this procedure, so it is important to find one that is (see bottom section).

Says Neonatologist Sandra Sullivan, MD in an article from Futurity.org:

“It is called a frenotomy, and it is far simpler than a circumcision, which we do fairly routinely . . . It literally takes longer to fill out the consent form for the procedure than to do the actual procedure itself.”

The tongue motions required to breastfeed are more complex than those required to drink from a bottle (hence the benefits to the baby’s jaw & speech development).  Sullivan explains:

“If you take a bottle with an artificial nipple, there is not a lot a baby has to do to get milk.”

“To get milk out of the breast, they have to make a vacuum and if they cannot get their tongue to the roof of their mouth, they cannot do this. They also need to use their jaw and tongue to move the milk along through the milk ducts in the breast.

“If they just bite on the nipple (like a bottle), first, it hurts (the baby’s mother) a lot and second, it blocks off all those little tubes, which keeps the milk stuck in the breast.”

Isabella Knox, associate professor of pediatrics at the University of Washington says that  4 million babies are born each year, so 40,000 to 100,000 babies are affected by the condition.

“That’s a lot of babies,” Knox says. “I don’t think general pediatrics training gives us a lot of skills in supporting breastfeeding . . .  we don’t really know how to help somebody and for some people it is not always a priority.”

According to Futurity.org, “Sullivan is part of an international organization focused on issues related to tongue ties. She and other members of the group’s screening committee are working to develop a screening tool that would help nurses quickly screen for a tongue tie while assessing the baby after birth.”

“There is not a lot of literature about frenotomy, and there are still a lot of doctors who say, ‘Is this really necessary?’” Sullivan says.

“Whether or not there is an epidemic or whether we ignored tongue ties and are looking for them now, this is something that is coming up more often in nurseries.”

Danielle Rigg, CLC & Co-Founder of Best for Babes, who experienced tongue-tie with her second child  says that “doctors and health care professionals are not only unaware of ankyloglossia or tongue-tie, they often confuse “frenotomy,” which is a very simple, relatively painless and easy to perform procedure for newborns, with “frenectomy,” or “frenuloplasty” a more involved procedure used to free the frenulum in older children and adults who have shown signs of speech and mechanical pathology.  Because of this confusion, it can be hard to find a doctor or health care professional who will perform it.  The other problem, according to Jenny Thomas, MD, IBCLC is that contrary to popular belief, not all doctors (like herself) are allowed to perform the procedure, even if they recognize it and want to fix it.   “Most area hospitals, clinics and malpractice carriers consider this MORE than a minor office procedure and classify it validly as a surgical procedure, albeit a quick one. That means, for those places, you need surgical credentials (proving you’ve been mentored and have done enough procedures to not get sued). You then get surgical privileges in your institution and then subsequently need increased malpractice insurance,” explains Dr. Thomas.  From what we understand from Dr. Thomas, some hospitals have an ENT (ear, nose & throat doctor) on staff who is educated about tongue-tie and performs all needed procedures, and paying  increased premiums so all doctors can perform them isn’t necessary.  (And then there is a whole debate about whether doctors are over-performing the procedure to make money.)  However, from what we’re hearing from moms, there are plenty of hospitals that don’t have a credentialed doctor performing the procedure, and at those hospitals, moms are up a creek.  To make it worse, some lactation consultants (even IBCLCs) are not experienced in recognizing the condition either, so it’s easily missed.    (On the other hand, we’ve heard of lactation consultants who have, in a pinch, used a sterilized fingernail to slice the frenulum).

Purchased from Dreamstime.com

Danielle had to track down an oral surgeon, the only one in her area (at that time Montclair, New Jersey) who was willing to do it.   “I went straight from the hospital, and although my daughter was less than two days old, she had already learned painful latching habits and I was already bleeding.  The procedure took less than a minute, there was no blood, my daughter didn’t even cry,” says Danielle.  “When I tried to thank the surgeon, Dr. Richard Riva of Chatham, New Jersey, he said ”you go nurse that baby, tell me how it feels, and then thank me’.  It immediately felt much better, though as a CLC I knew I would have to work with my daughter to help her re-learn a proper latch before all the pain would go away.  When I expressed my gratitude to Dr. Riva, here were his words of wisdom:

“Every child deserves to have the pleasure of  breastfeeding successfully, and every child deserves the pleasure of licking an ice-cream cone, both of which are aided by this procedure.”

We’d like to add, that every mom deserves to have a positive breastfeeding experience without the trauma of severe nipple pain caused by this condition and other undiagnosed but easily solved breastfeeding issues.  Danielle should not have had to leap through the extra hoop of finding an oral surgeon outside of the hospital.  Best for Babes hopes that the American Academy of Pediatrics will push for every hospital to have a credentialed doctor who can perform the procedure, education on diagnosis as a requirement in the core pediatrics curriculum in medical school, and that the nurses associations will do the same. While they’re at it, they should require doctors to complete at least a week-long training similar to what the Healthy Children Project offers to train certified lactation counselors, and/or work with the Academy of Breastfeeding Medicine to develop a curriculum.  Luckily, pediatricians who are already Fellows of the Academy of Breastfeeding Medicine (look for FABM after their initials, similar to FAAP for Fellow of the American Academy of Pediatrics, and FACOG for Fellow of the American College of Obstetrics & Gynecology) are educated in all things breastfeeding.    We’re sure  our friend and supporter Dr. Ruth Lawrence, Chair of the American Academy of Pediatrics Breastfeeding Section, has been working on this for years.

What can parents do

1.  Get a second opinion. If you suspect your baby has tongue-tie while still in the hospital, ask if there is an ear nose or throat doctor (ENT) on staff who is trained in diagnosing tongue-tie and performing frenotomies.  You may want to get the opinion of a highly recommended IBCLC (you made need to bring someone in from outside the hospital).  Tongue-tie is not a black and white issue and some will see a problem where others have missed it, especially if you don’t have the more easily recognized type 1 or type 2, but the harder to diagnose and less common type 3  (See this Motherwear article about an IBCLC who wasn’t able to diagnose her baby’s tongue-tie).   If you can’t get help from within the hospital, see an ENT in private practice, an oral surgeon, or a dentist.  Read the stories here (scroll down) of moms who have navigated this booby trap.

Earth Mama Angel Baby is a proud sponsor of Best for Babes

2.  Politely and diplomatically educate your pediatrician, and other health care professionals and encourage him/her to be part of the solution.  Many doctors don’t know about breastfeeding issues because they weren’t trained, but when enrolled instead of attacked, can be powerful advocates for change.  Let them know about this awesome resource just for them: www.tonguetieclipit.com.

3. Spread the word to moms. Share this page with any expecting or new mothers.  If we can prevent even one mother and baby from suffering through this unnecessarily, we will be ecstatic!!

4.  Be gentle to mothers who couldn’t breastfeed. There are a lot of mothers out there whose babies were not diagnosed with tongue-tie, suffered miserably, thought they couldn’t produce enough milk, and agonized over their baby’s lack of sufficient weight-gain, blaming themselves or their babies, and quit breastfeeding long before they intended to.   We never judge a mother who quit breastfeeding as “not being committed” because we can not truly stand in her shoes, and most of the time she has been booby-trapped and didn’t know it.

5. Write to the American Academy of Pediatrics, send them a link to this post, and send a copy of your letter to any media contacts, urging them to remove this booby trap.

6.  Be the change. For the last few decades, the focus has been on supplementing babies with formula instead of fixing the problem.  This is going to take work to change, as the formula companies conduct training for health care professionals that teach them how to prey on the fears of mothers that they won’t make enough milk, and will need to supplement with formula, instead of giving them proper medical care.   Sad but true.   Through mainstream marketing and  educational efforts like this blog, our WHO-Code compliant advertising campaign, celebrity interviews, and popular media coverage, we are reaching millions of parents with the information they need to make informed feeding decisions, and achieve their personal breastfeeding goals.   Help us or donate!

7/3 This post was edited to clarify that not all doctors are allowed to snip frenulums.

7/4 Great comment from our Facebook discussion:

“My son has a tongue tie we didn’t find out about it till he was 10, after years of speech classes at school.  That plus nipple confusion caused us much stress trying to nurse and we gave up a lot sooner than we wanted to.”
We can’t help but wonder, how many children and adults have suffered from preventable speech problems because we live in a bottle-feeding culture? It should be added to the next study on potential cost savings.    If more babies were diagnosed with tongue-tie properly, not only would moms who want to breastfeed have a better chance of succeeding, but some speech pathology in formula-fed babies could be prevented.  It could save parents and children much worry, distress, poor performance in school, teasing from friends, etc.  So not diagnosing and treating tongue-tie is a booby-trap for breastfeeding AND formula feeding parents!

Have you experienced this “Booby Trap”?  Have you had any success with educating your doctor or health care professionals?  Let’s hear it!



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42 Comments | Last revised on 07/03/2010


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42 Responses to Booby Trap: Docs Who Won’t Snip Tongue-Tie, Thousands of Breastfeeding Moms & Babies Suffer

  1. This is an excellent post on an important issue. My son had a severe tongue tie and had it clipped twice before he was able to nurse. He latched on for the first time when he was 7.5 weeks old.

    I wrote about our ordeal here:

    http://www.phdinparenting.com/2008/12/29/our-breastfeeding-story/

  2. I work with fresh newborns and pediatricians in a maternity setting. There is 1 pediatrician who will snip a tongue tie but there is a hot debate over this subject, resulting in all of the others not doing it. Some feel that there is no strong research based evidence to make this a practice a fixed guideline. What happens is that since this is not widely practiced, in my work place, peds don’t feel comfortable offering the service.

    Thanks for the great post on this boobytrap.

  3. Valerie Jones says:

    Thank you so much for this article. My son is 4 mo and mildly tongue tied. His pediatrician refused to treat it and referred us to an ENT, so that’s more time we have to wait. It was the lactation consultant we hired that told us about the tongue tie, NOT our pediatrician. He never looked in either of my kids’ mouths, even when I couldn’t breastfeed my 1st and had to supplement.

    • Stephanie Wargin says:

      My son’s doctor said the exact same thing, he said “he’ll grow out of it.” I refused to let my son starve when my nipples turned purple and bled so I supplemented. Since supplementing helps him with weight, the doctor said it wasn’t an issue because his health is fine. Thought I was happy he was eating, I REALLY wanted to breastfeed and couldn’t. I managed to breastfeed during the day and supplement at night for 4 months before my breast could take no more. My son is now 19 months and still severely tongue tied. His appointment is at the end of this month to get it clipped. I had to convince his doctor to send a referral to the ENT I had found myself. My advice to ladies is if you want to breastfeed (because it is better for them) then don’t listen to these doctors, go out and have an ENT do it asap. It will help so much. I regret listening to my sons doctor for so long but I am happy it’s finally getting done.

  4. Top Sheff says:

    This article just reminded me why we had our sons tongue clipped. I was bound and determined to bf and I knew it would be challenging the first few weeks. Before he was born I made sure I had a support system available and ready to go. My son never lost weight (as to my high milk production) but when we finally saw a fabulous ped ENT in our area he was amazed that my son had never had a bottle.

    We had him clipped at 6 weeks and had to re-learn how to breastfeed. It was a long road but I am so very happy that we made the decision to have him clipped. At 9 months we are a very happy, healthy breastfeeding pair. We aren’t even close to stopping!

  5. Rebecca says:

    Great post! I’m wondering if you could provide more info re: your edits. Why are some doctors not permitted to perform frenotomies? Who prevents them from performing them or regulates that procedure?

    Thanks!

    • Bettina says:

      From what I understand via Jenny Thomas, MD IBCLC, the institution, i.e. the hospital, clinic or health care facility, determines the “privileges” awarded to doctors practicing there. At some facilities pediatricians are allowed to snip frenulums. At others, not. Apparently it also has to do with the liability insurance coverage a physician has; specialists such as ear, nose & throat doctors, oral surgeons, even some ob/gyns who do surgery, have more insurance coverage. Therefore some pediatricians understand the importance of diagnosing and treating tongue-tie but can not perform this simple procedure because of hospital regulations on who is allowed to perform surgery.

  6. Paloma de Agua says:

    I’m a homebirth midwife, and I have been doing this procedure for my babies who need it for about 15 years. I use a pair of very tiny iris scissors and a great deal of patience waiting for baby to open their mouth. There is no bleeding or pain, and I first do a very small snip, then hand baby immediately to mom to latch. The difference is IMMEDIATE! Mom is the best judge as to whether or not one tiny snip is enough because she can tell if the baby can now extend it’s tongue over the gums to “Spoon” the areola.

    I have found too, that referring theses babies out for cranio-sacral work and doing some suck training usually resolves the issue completely within a few days. If a baby is tongue-tied it makes a different suck motion akin to chewing, which can cause nipple pain even after sniping the frenulm I explain to my moms that her baby has been doing it this way for it’s whole entire life even if it’s just two days old, and it takes a little work to retrain the baby to suck the nipple in rather than chew it.

    Thanks so much for writing about this, and it just breaks my heart to see a very easy and simple procedure turned in a medical event with the attendant liability fears and increase in cost by relegating it to the domain of specialists and facilities.

  7. When I hear from midwives about the quick snip that constitutes frenotomy, I marvel at all the fuss around this “procedure” (of course, doctors call everything a “procedure” even VBAC, in which they are simply supporting a woman to give birth vaginally after a previous cesarean!) and the trouble parents are expected to go to in order to have a tongue-tie resolved in a timely fashion so their baby can learn to latch and nurse correctly. Is this really a procedure requiring training and skill–or a “quick snip”?!!

  8. Caligirl06 says:

    My 7 wk old son has this nurses terriable locating a doc in Orlando FL to do this. Pedi in hospital said nobody really does it these days they will grow out of it. Not true he cries when he nurses and can’t really use a bottle. Doctors need to clip these in the hospital after birth. Why make a baby and mom suffer?

  9. SarahB says:

    Two out of three of my babies have been tongue tied. It took a lot to get my family practice doctor to do this even though he can and does in severe cases. When I showed him my daughter couldn’t nurse he finally did but not without her losing weight and my supply taking a hit first. I really had to push for it and she was my fist baby and I really didn’t know what I was doing. I had a mother/baby nurse help me put all the pieces together.

    I had a 31 weeker who I immediately recognized as tongue tied. I had to really push and then go to the only neonatologist in the unit that would do it. It was a real pain but I am so glad I did it! It is such an important thing if mom wants to successfully breastfeed!

  10. Kerry says:

    my son was born tongue tied. Thankfully I had a Dr. that snipped it when he was only 2 days old. Thank godness because he is almost 4 months old now & happily nursing!!

  11. I second, the get a second opinion part. My daughter was tongue tied and we got her clipped on day 6. It didn’t do a damn thing to help breastfeeding. So when she was eight weeks old, I took her to an ENT that said she needed a second, deeper cut to truly free her tongue.

  12. Paula says:

    My son’s “very slight” tongue-tie was not caught at birth while at the hospital, where the nurses hinted at keeping our baby in the hospital due to weight loss. Nor was it caught for the three weeks following as we visited with the hospital LC, and our pedi for numerous “weight checks.” At three weeks of age, our L&D nurse called us at home to ask how things we going. I said that breastfeeding hurt like a b*tch. He asked (yes, he was male) if my baby had a “heart-shaped” tongue. My reply? I had never seen his tongue. I met him and an LC at the hospital and they said it was very slight. Our pedi, then the pedi ENT concurred. They said clipping it may or may not help, but risks were minimal. We had it clipped at lunchtime by the pedi ENT, and by 3 pm things were already getting better. At five weeks post-partum, my son regained to birth-weight, and at 8 weeks I was healed. It’s a good thing he started off big, our pedi said. And, somehow, from “expressing” into my newborn’s mouth, my supply had been saved.
    After my experience, the hospital LC began to include a pamplet about tongue-tie in materials for new moms. And I heard the family stories about how my cousin nearly died (late 1960’s) when doctors couldn’t figure out what was wrong. Clipping tongues was discredited at that time, even though it had been routine (in the 40’s when my parents were born). I learned that it is hereditary, and more common among males. If my sister or I had had tongue-tie, no one would have known since we were part of the bottle-fed generation. It is worth talking to your mothers, aunts, and grandmother’s about their birth and breastfeeding experiences to try to discern if it’s in your family.

  13. Missy says:

    I’m pretty sure this was one of the main reasons my son and I had a horrid time getting breastfeeding going. I had asked the doctor about it, but he had just sort of scoffed at me and said “they dont do that anymore.” So.. my son wasn’t gaining weight, had to supplement, weekly trips to see the CNM to have him weighed and have her watch me breastfeed him, ended up on reglan for who knows how long. I wonder how things would have gone if I had gotten a second opinion… but now I have a plan if it is an issue for the next baby!

  14. Sara says:

    This was almost out big “booby trap”- I am so grateful (and proud!) that *I* caught this when my son was 3 days old. I read Ina May’s Guide to Breastfeeding a few days before my son was born and there was a brief section on the tongue-tied baby, which fortunately I noticed. While nursing my son, in agony from the pain, I could tell something just wasn’t right. I looked in his mouth and wondered- is this tongue tie? We had seen 2 different pediatricians while he was still in the hospital, neither one even looked in his mouth. The hospital LC was not available during the 5 days I was in the hospital, of course, and had it not been for ME knowing what to look for, this would probably not have been found and I would have ended up exclusively pumping. When I showed my pediatrician his tongue tie at 5 days old, he shrugged and said it was no big deal. Even though he knew I was breastfeeding!! I had to advocate for myself and my son, and the hospital and my pediatrician failed us both. I needed to do lots of research on my own (the last thing I really should have been having to do with a newborn!) finding an ENT who would do the frenotomy. My son had his frenotomy at 9 days old and we saw an immediate improvement. It baffles me that this isn’t the first thing pediatric hospitalists look for in newborns. How many breastfeeding relationships could be saved if they did this, and every hospital had an ENT on call at all times ready to clip the frenulum? It can be such an easy thing to catch and fix, and can do so much for moms and babies.

    • Chris says:

      Ha! I’m the mom in that section of the book (Ina May changed the names). I was at a midwifery workshop at The Farm and was telling the story of the twins tongue-tie one night at dinner when Ina May asked if I would write it down and send it to her. It’s unbelievably cool that it helped a mom and her babe. Frenotomy really is a quick snip procedure, and the younger the baby, the easier it is. Dr. Coryllos snipped my girls at 6 weeks, and both had posterior TT and required a deep cut. There was only a drop of blood on the cotton pad, but the good doctor was adamant in the training that the pad be pressed to the wound for two minutes on the off chance that there was a little blood vessel running along the frenulum.

  15. Heather B says:

    I had my sons clipped when he was 8 days old after a lactation consultant at the hospital in Clearwater, FL recognized it. We went locally to an ENT that did it. The only thing I didn’t like was that nothing was offered nor recommended for pain. Although some children seem to not feel anything, no blood etc my son screamed bloody murder, 2 snips were required and there was quite a bit of bleeding. It was traumatic for both him and me :-( Ultimately I would do what is best but if I had another child needing this done, I would demand that the frenulum was numbed…. Maybe if he had it done in the first day or two of life it would have been different, who knows.

    I do agree though that undiagnosed cases probably result in unsuccessful breastfeeding with the mom never really knowing why it wasn’t going well or is advised of the overused diagnosis of ‘not making enough’…..

  16. Gretchen says:

    My oldest (son, now 3 1/2) was tongue-tied, and I recommend getting the frenulum clipped to ANYONE who has a tongue-tied baby!!! We didn’t get it diagnosed until he was 15 days old when my nipples were so cracked/bleeding/sore that I had developed a Stage 3 nipple infection. I made an appointment with an ENT, but he told me there wasn’t a problem; I just had to wait for my son’s mouth to grow (in essence, my breasts were too large for his small mouth!!!! Can you believe this???). We finally were able to consult with an LC based in NYC (3 hours away from us) who was doing a study on Type 3 Posterior tongue tie, and she diagnosed it OVER EMAIL THROUGH PHOTOS that I took!! My son was a little over 4 months old. We finally got it clipped, and it was an INSTANT breastfeeding difference!

    THANK YOU for this article! I’m amazed that this problem is more common than I thought and yet still nothing is being done. Because of my experience, I always mention it in the breastfeeding class I teach for Nursing Mothers Counsel (Bay Area, CA) and make sure that the moms I help know about it.

    • Jen Christopher says:

      Hi there,

      Can anyone help me?

      My daughter is 6 weeks old and has a posterior tongue tie (not sure if it is 3 or 4). She was diagnosed by Dr. Jack Newman via email using photos.

      I had 1mm clipped by Dr. Robert Wesman at the Oakland Children’s hospital, and while I no longer have excruciating pain, she still does not extend her tongue over the gumline when latching on (I had it clipped 3 weeks ago). It is still painful from the shallow latch.

      They mentioned that the frenulum is really thick, but cannot cut any more without using general anesthesia (hospital policy).

      I have spent considerable amount of time to find someone who will clip it without anesthesia, even though Dr. Newman says it is a simple procedure and he clips this type of tongue tie regularly.

      The only person we have found that *might* be able to do it is a dentist/oral surgeon in San Ramon (we are in San Mateo county) and it is $400-600 just for the procedure. He would likely be using a laser.

      We have Kaiser, but the pediatrician did not recognize it. He was willing to refer me to the ENT either at our local RWC hospital, or Santa Clara, but we were unsure about their willingness to clip this sort of tongue tie, or even to recognize it as a problem.

      Do you know of anyone who can clip the tongue without anesthesia and without costing an arm and a leg? Has anyone had any luck with this sort of tongue tie at Kaiser RWC or Santa Clara? Any help is appreciated!

      • Bettina says:

        I tried to respond last week from my cell phone, sorry it didn’t go through. Have you tried your state breastfeeding coalition for referrals to knowledgeable docs in your area? Another resource is the birth & doula community, they often know which doctors are willing to perform procedures like this one.

        • Jen Christopher says:

          Just to follow up- I finally found an expert with posterior tongue tie that uses a laser. Dr. James Jesse of Colton, CA. We flew down to Southern CA for the procedure and it went well! Still having some pain due to poor latch, but will be seeing an IBCLC soon.

  17. S.A. says:

    I’m so glad you’re talking about this issue as it’s a huge Booby Trap! Both of my sons struggled with tight frenulums. Neither were severe, but certainly tight enough to cause nipple and tissue damage and make nursing traumatic for me.

    With my first son, our prediatrician’s office claimed that clipping the frenulum is never needed (contrary to what our LC was suggesting). One of the older doctors claimed he’d only clipped two in his career with one being “because the parents insisted”. Their whole practice had a rule of not performing the procedure. And I live in one of the most “pro-breastfeeding” communities in the country. So we went around them and straight to the pediatric ENT. The frenotomy combined with CranioSacral therapy did wonders and saved our breastfeeding relationship.

    With my newborn, we very quickly identified the frenulum issue. The LC told us these tight frenulums run in families. So we went straight to the pediatric ENT again. A quick fix for horrible pain for mama.

    Thanks Best for Babes for advocating for mamas and babies!!

  18. Annie says:

    I think one of the biggest issues we need to look at is the amount of heartburn, reflux, GERD and sleep apnea we see in baby boomers and other adults today. Let’s ask everyone of them,”Were you breastfed?” I think this whole epidemic of reflux can be traced back to huge populations who were either bottlefed by choice or their mom gave up due to severe pain due to tongue tie. The only bottles out there were short-shanked nipples that did very little to train an infant to develop a proper suck/swallow which led to the peristalic motion not being properly developed or used which developed into chronic heartburn, reflux, GERD and sleep apnea. This is a HUGE reason to do frenotomies. Look at the sales of digestive aids and ask yourself WHY?
    If your baby has a suck/swallow/LATCH issue and your nipples are showing the wear and tear of this SEE A LACTATION CONSULTANT and if she can’t figure it out, SEE ANOTHER ONE and keep looking until you get the answers you need!
    If you are a Lactation Consultant and you think you are not seeing any tongue ties then get trained in how to spot them. Know what to look for, know what to feel for. On average I would say 1 in 4 babies I see (small private practice) has a tongue tie of some level.
    WE NEED TO HELP THESE MOMS. THAT IS OUR JOB.

  19. Dani Arnold says:

    My I repost your article here on my blog? This is vital information and I’m currently writing and article on tongue tie – as my own son was just diagnosed as being seriously TTied at 4 months!

  20. Gina says:

    My first daughter, born December, 2005, was born tongue-tied. Thankfully, it was diagnosed by the lactation consultant within 24 hours! It did, however, contribute to a challenging nursing relationship for six weeks. I remember being late to my 6-week checkup because my daughter finally latched on and nursed well for the first time EVER 30 minutes before my appointment. I decided the doctors and nurses could wait…this was truly a miracle!

    Anyway, it is a relief to see this is a bigger problem than I realized. I am due any day with baby #3, and plan to have this one checked right away for being tongue-tied! And I plan to address it immediately and be insistent and persistent until it is resolved.

    Kudos to the ladies out there who stuck it out for weeks and weeks (and even months and months), enduring much pain while breastfeeding. I thought my story was bad, having a miserable nursing relationship for six weeks. But it turns out my six week misery would have been welcome to some of you troopers!

  21. Joanne says:

    Good article when checking out information – glad to see it! My baby boy has apparently a posterior tongue tie which was spotted not in the hospital at birth or when we were re-called to stay in the hospital for weight loss and all sort of other reasons for not feeding were made but by midwives (UK) and the health visitors. They are pro baby feeding well and comfortably. My health visitor told me that symptoms includfeeding for small time periods of trying to feed & baby is overcome with tiredness – not helping baby then an arduous time of waking baby to re-latch an uncomfotrablt nipple begins. This is always followed by awful which if baby’s latch is not correct may be accounted for by taking in extra air as the vacuum is poor around the breast. All of the above things taly – I have an appointmnet tomorrow at the hospital with the breastfeeding expert tomorrow – so hopefully they will sort it out. Apparently also a posterior tongue tie may also lead to baby having a poor swallowing mechanism i.e. milk comes back out & dribbles lots with breast & bottle. We have supplemented with expressing & a breastflow bottle (mimics the breast & has 2 teats) baby stil routes for the breast so it has been worth the money as baby tries both. Also baby’s tongue may not cover the lower gum so you get a ‘gummy’ latch! – I’ve learnt alot in the last 3 weeks (baby’s age!. The health visitor said mum knows if baby is not feeding efficiently so persue this. Also that it’s better now in case of any speech impediments later on or the use of general anaesthetic for baby when he is older as it’s then harder to sort out.

  22. Risha says:

    My second child went undiagnosed with a tongue-tie until 8 months. From the start, she was not a great nurser, but she did gain enough weight to keep the concerns of her dr and my lactation consultant at bay. I also did not experience pain. Yet something didn’t feel right to me, and I asked the LCs that I was meeting with at a weekly support group about tongue-tie. They dismissed the idea immediately once I told them of her weight gain and my lack of pain.

    When she was around 4 months old, things changed. She started pulling on my nipples, and fighting the breast during feeding, and I could tell that my supply was diminishing. It was still four more months before things really got to the point where she was no longer gaining weight and feedings were very difficult. I had also tried to introduce her to baby food around 6 months, and she would gag on the spoon. I felt as though her tongue was in the way of being able to get the spoon into her mouth. I finally asked her dr to refer us to an ENT.

    The ENT saw immediately that she had a short, thick frenulum. By this point, we were faced with the necessity of a frenuloplasty due to her age. It was terrifying giving my baby over for surgery and general anesthesia, and she suffered from “anesthesia hysteria” for several hours afterward. The most heartbreaking thing about it was that once her tongue was free to make breastfeeding easier, she absolutely refused to even attempt latching. I pumped my milk for a while, but my breasts were in such bad shape from her bad latching that it was incredibly painful, and I only lasted about 5 weeks before she was completely on formula.

    An important point that I discovered later shed some insight into why things weren’t that bad during her first four months, thus leading medical professionals to dismiss the idea of a tongue-tie. A couple months after my baby’s surgery, we consulted with a group of developmental therapists regarding her continued issues with eating solid foods. The speech therapist that spent time observing her informed me that babies are born with one type of suck that is reflexive in nature, but then it developes into a different type of suck around 3-4 months of age. The reflexive suck must have made it easier for my baby to draw milk from the breast in those first few months, thus giving the appearance of things working as they should. Additionally, I had quite a bit of milk in those first few months that pretty much just sprayed into her mouth.

    My husband and all of his siblings were born with tongue ties that were clipped in the hospital following birth. I suspect that I may have had one that when undiagnosed because my mother was never able to breastfeed me, and my frenulum is very short. Needless to say, I will be insisting that any future children be examined in the hospital by someone who knows what they’re looking for so that hopefully I can avoid this in the future, and I readily share my story whenever I can to make other moms aware.

  23. Deanna says:

    My son was transfered immediately after birth in 2007 to The Hospital for Sick Children in Toronto. He had a pre-diagnosed congenital birth defect and we knew he would spend several weeks in the hosptial to be reapaired and for recovery. His defect involved his bowels, and for that reason, I was not able to breastfeed until his bowels could prove themselves. So, I pumped for the first seven weeks. They used my milk to feed him via NG tube in small, controlled doses. At one point before I began bf, I noticed he looked tongue-tied, I brought it up with various drs taking care of him, as well as the lactation consultant when I finally met her, but everyone said it wasn’t a problem just to leave it.

    I finally got to breastfeed my son just before he turned 7 weeks, and two days later, they determined he was healthy enough to go home. I figured bf might take a bit of work considering he was 7 weeks old when we got started, and immediately I started feeling pain, I just brushed it off as I was happy to be home finally! I saw my family dr., a pediatrician and had three appts with the local lactation consultant. My family dr just shrugged, my ped stuck her finger in his mouth and said “see, he just has a really strong suck, that’s why you hurt, try giving him formula inbetween feedings to see if your nipples will heal at all” the lactation consultant really tried to help, but obviously didn’t know what the problem was. Finally, after doing my own research, I convinced the LC that the problem must be the tongue tie, I was doing everything else right. She pulled a dr. in who wrote a requisition for an ENT visit. I called the ENT who told me I could have an appointment in 3 – 4 weeks! This was already 3 weeks into breastfeeding, and my nipples were a disaster! My mom was afraid he would just suck them right off me they were so damaged. I was in agony and SO tired as the poor little guy was constantly wanting to feed – he wasn’t getting enough milk each time so he just kept nursing. FINALLY I was told of Dr. Jack Newman who mercifully was a short 45 min drive away from me. The blessed man responded to my 3am email by 7am and I had an appointment in less than a week. The tongue tie was cut in the office, to ease the baby’s pain I was ready to breastfeed immediately and that was it. His pain was gone after that first feeding, my pain was diminishing (turns out I had developed thrush from being so damaged so long, so I had to deal with that before the pain was gone entirely), and we had a beautiful year long breastfeeding relationship.

    I often say I’m stubborn to a fault, and I know it was my stubborness that made me endure so long, I even had the HUGE full tin of formula, I received for FREE through the mail that I went to only once in the night, then the next day, I threw out the whole tin – they ALMOST won!! Now, I return to sender if I get anything in the mail from a formula company.

    that’s my story! :)

  24. All I ever wanted was to breastfeed my son. I waited so long to have a child and breastfeeding for me was my only option. I day dreamed about co sleep with him while breastfeeding him before he was even born. After my son was born, within a few hours of trying to breastfeed my nipples were destroyed, they were in pain and bleeding. It was horrible. He was hungry and I had to give in and gave him formula. I kept thinking how hard could this breastfeed thing could be, what was I doing so wrong. We kept trying and it was so painful. On the day of our discharge, a lactation consultant told me it was possible my son was tongue tie and to have an ENT look at it. Well I total forgot, we were so worried about his rising bilirubin levels and the doctors were so worried about his low birth weight of 6 lbs, 10 oz. He was only able to drink 2oz every 2 hours and only slept 30 min every 2 hours, it was horrible. He cried most of the time. He was seen by three different Pediatricians and no one picked up on the tongue tie issue even though I told them I was having problems breastfeeding. Even my midwife didn’t mention it was a possibility, they referred me to a lactation consultant, but this was at my 6 week appointment. And at the time my insurance wouldn’t cover a lactation consultant. After two months of trying to still breastfeed him and no insurance to cover an lactation consultant I searched the internet trying to find a reason why we were having so many problems. I found information on tongue tie, called my pedi for an appointment, they confirmed my son was tongue tied. From there I went to an ENT, who insisted it wasn’t necessary and he couldn’t guarantee by clipping his tongue it would help with breastfeeding. When he said “he would try”, I said no, we will not try anything. The next day we drove about 1 hour to another ENT and within 5 min, my son’s tongue was fixed. The problem was, one my son was so used to the bottle, two I had no milk since I was so tried from not sleeping and no support I wasn’t able to continue pumping. And he he was so traumatized from us trying to breastfeed, he wanted noting to do with breastfeeding. I ended up have to put him on a raw milk formula, since he was also having problems with commercial formula.

    Today I thank God we survived the first year, and I still blame myself for not knowing. I still want him to breastfeed, even at 22 months. Especially now, because he doesn’t want to give up the bottle and I just wanted to have that experience so bad, I’m 42, so I might never have that opportunity again. and even if I do, I will always want him to breastfeed, to have that closeness, that bond.

    • Bettina Forbes, CLC says:

      Your story makes me want to cry. It also fuels us at Best for Babes to fight for all the mothers, like you, who were robbed of a positive and empowering breastfeeding experience. I encourage you to take your story to the media in your area, and use it to put pressure on institutions like hospitals and medical schools to properly educate and prepare health care professionals and reward those who truly help moms achieve their breastfeeding goals.

  25. Erin says:

    This is a wonderful article! I am having nursing problems and I have tried just about everything and it still hurts. I am convinced it must be a posterior tongue tie and we have an ENT appointment this week. I am praying that this doctor knows what they are doing and can help us so we don’t have to find another one for yet another opinion.

  26. Jodie says:

    I am fortunate that my pediatrician, Dr. Tolkin, a top doc in the city of Toronto, had no problem clipping my son’s mild tongue tie today. Although it was mild, he could not latch as effectively as he could and as a result, I heard him “click” repeatedly at the breast, a result of the suction not being maintained throughout the feeding and resulting in frustration (for both of us) lots of gas and my supply decreasing. I cannot believe how much resistance moms are met with when it comes to this simple procedure.

    Back in the day midwives kept one fingernail sharpened and routinely clipped the frenulems of newborns. Not too high tech but it did the trick. Now in some cases referrals to ENT’s etc are needed for this simple but effective procedure. And in some cases the doc outright refuses to do it. It’s crazy that a mom would be denied having a simple procedure done that could make the difference between breastfeeding and not. I’m glad I came across this and will fwd it to several expectant moms I know.

  27. Alicia Kulishov says:

    I am so thrilled to find an article that hits on a major problem in our country.

    Unfortunately, our family has experienced this country-wide dilemma first hand. When our son was 2 months old we had his tongue clipped by a ENT doctor. The doctor clearly had no experience with clipping the frenulum of infants so when our son began to cry and struggle the doctor clipped anyway and snipped too high cutting his actual tongue! This was the WORST medical experience of our lives. We were so upset.

    We were told to go to a doctor who specialized in breastfeeding medicine in our area. She essentially made a snip that corrected the first botched procedure. We were fortunate to have a specialist for babies in our area but others are not so lucky.

    Thank you BFB for your work in increasing the awareness of such an important issue!

  28. Mandy says:

    Danielle Rigg’s experience with her second child’s frenotomy is identical to my second child’s. I was one of those women “up a creek” in the hospital. When my son was barely 24 hours old, my husband and I both noticed the fact that he had a heart-shaped tip on his tongue- classic evidence of tongue-tie. That would explain why I was having such trouble breastfeeding him. At that point I was already feeling a lot of nipple pain. When I brought it up to the nursing staff, they acted as if they had no knowledge of tongue-tie. I had to explain to them what it was. My first born had a frenotomy when she was 3 months old, so that is why my husband and I had experience in identifying the problem. I inquired if there was anyone on staff who could perform a frenotomy. There was no one. The pediatrician who came in the next morning confirmed that he is indeed tongue-tied. The lactation consultant encouraged me to wait a week or so to see if it stretches out on its own. At that point my nipples were bleeding, so there was no way I was going to wait. I was disheartened by the fact that no one on staff would help us. I had to eagerly wait for discharge, which thankfully was when he was only a day and a half, then I headed straight to the same oral surgeon Danielle went to- Dr. Riva- and he performed the procedure right away. My son didn’t even whimper. It was so quick. The healing process took several weeks, as my nipples were already beaten up. He bottle fed pumped milk in lieu of breastfeeding, so that I could heal and when he did actually nurse, I had to train him all over again because he didn’t know how to control his tongue. It took about a month and a half for things to become normal. Had I not been educated about it already and pursued the procedure on my own, I don’t know how I could have continued to breastfeed. I do feel bad for the women who don’t know anything about this and eventually give up (if they don’t want to give up). As it turns out my son now needs a frenotomy on his upper lip area, so I will be seeing Dr. Riva again pretty soon.

  29. Chanda says:

    Can someone email me a doctor, dentist or specialist who will do this procedure in Southern California.
    maticakes4u@gmail.com
    thank you
    Chanda

    • Bettina Forbes, CLC says:

      Hi Chanda, we suggest you contact your state breastfeeding coalition, La Leche League chapter (www.llli.org) or breastfeedingusa.com chapter. You can also ask an IBCLC by going to http://www.ilca.org and typing in your zipcode to find an IBCLC near you.

  30. Macey says:

    My daughter is now two years old and is going in for surgery tomorrow to get her tongue snipped. I was really upset when at her two year Well Child Check our new Pediatrician was telling us about her being tongue tied for the very first time. I had a lot of trouble trying to breast feed her and had to eventually go to the bottle, but the hospital I delivered at which is supposed to be the best hospital in the state failed to mention anything to me about it, even though I was having a really difficult time breast feeding. Our old Pediatrician didn’t say anything to me about it when I was constantly complaining about her not latching and feeding well. So here we are two years later going in for surgery. I’m so nervous to put my child under to do such a simple procedure that should have been taken care of right after birth! I hope no one else will have to wait this long to get this problem taken care of.

    • Bettina Forbes, CLC says:

      Unfortunately other mothers will have your exact experience unless we are able to mount a campaign to insist that all pediatricians complete basic training in lactation management. I am sorry for your experience and best of luck!

  31. Pingback: From Booby Trapped to a Tongue Tie Pioneer: An Interview with Dr. Evelyn Jain | Best for BabesBest for Babes

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