Breastfeeding a Baby with a Tongue Tie
Are you curious if your baby has a tongue tie? Are you wondering how to bottle feed or breastfeed a baby with a tongue tie?
The good news is that there are many options for babies with tongue ties. And some techniques will help you breastfeed your baby if they’re tongue tied.
And take heart, this study found that 40-70% of babies would breastfeed normally, even without getting tongue tie surgery. Just stick with it, use the techniques in this article, and find some support if you need it.
Do you need to get the tongue tie clipped?
First thing’s first, do you need to get your baby’s tongue tie clipped? There’s a lot of debate around that question (you can read more about it here).
Healthcare providers can’t agree on tongue ties and whether clipping is necessary or not. But what they CAN agree on is the vast differences between people.
Some babies have bigger jaws, some smaller. Some moms have bigger breasts or nipples than others. Babies might have larger tongues – and all of those things are just a variation of normal.
So it’s no wonder there’s disagreement.
Some babies’ tongues attach very far forward (called an anterior tongue tie) while others attach farther back.
Because of all these things, function is the most important thing when determining whether to have surgery on the tongue tie.
If a baby is gaining weight and breastfeeding doesn’t hurt – no matter what the tongue looks like – don’t worry. With time many babies that have a suspected tongue tie outgrow it as their mouth grows.
But if breastfeeding your baby with a suspected tongue tie hurts, seek help. It might not be a tongue tie at all but a breastfeeding aversion – which is behavior-related, not a physical problem.
Other possible conditions that can cause painful or difficult breastfeeding include:
- Low Tone
- Feeding Aversion
- Flat/Inverted Nipples
- Bad Positioning
- Shallow Latch
A tongue tie isn’t always the culprit with breastfeeding problems. The most important thing to do is to seek help from a lactation counselor. They can help you work through breastfeeding problems before you get surgery for your baby.
A true tongue tie is only in 5% of babies, so determine it’s necessary to get it clipped. If you’re going down a list to try and figure out the problem, surgery should be at the bottom.
There are other options you could try first such as:
- Baby Chiropractic
- Craniosacral Therapy
- Speech Therapy
- Different Breastfeeding Methods
- Giving it Time
Trying any of these things doesn’t include surgery. They are less invasive and come with fewer side effects.
If you determine that your baby has a tongue tie, but you don’t want to put your baby through a clipping or laser surgery – you can still breastfeed!
Ultrasound studies show that the tongue moves less than originally thought during feedings. With different techniques, you can still breastfeed your baby with a tongue tie.
Breastfeeding a Tongue Tied Baby
There are a few options for moms to try breastfeeding their tongue tied baby. They include:
- Achieving a deep latch.
- Having proper positioning.
- Making micro-adjustments during a feeding (the Gestalt Method).
- Stretching and moving your baby’s mouth before latching.
I came across an amazing story here. This mother talks about breastfeeding her baby and how important it is to get a DEEP latch. She gives examples of pre-feeding exercises that may help.
The exercises are:
- Massage baby’s TMJ for 3-5 seconds on each side in a circular motion towards their ears.
- “Fish” baby’s face 3 times by squeezing their cheeks.
- Tap on your baby’s lower lip with your index finger.
- Tap a second time in your baby’s lower lip, and wait for your baby to stick their tongue out FAR.
- With your baby’s mouth open, put your index finger in their inner cheek and push it outward. (This looks a lot like what you would you to make the “popping” noise with your own cheek.) Do this 2X per side.
I would also add these steps:
- Have baby suck on your finger. Feel their tongue wrap around it.
- Pull your finger out slightly and let your baby suck it back in.
- Do the “guppy”: place your baby on your lap with their head at your knees. Gently let their head hang off your knees so their head is upside down and body horizontal. This will help their tongue stretch.
Then, follow all the steps to get a good latch:
- Get comfortable.
- Line up baby’s ear, shoulder, and hips.
- Make sure the baby’s chin isn’t extended or tucked.
- Consider compressing your breast to get more breast tissue inside your baby’s mouth.
- Line up your nipple with their nose.
- Wait for the baby to open WIDE.
- Latch your baby deeply.
When breastfeeding your tongue tied baby – it’s best to start before your baby is ravenous. A hungry baby tends to be impatient so try these steps before they’re starving.
And as the mother in the above article says, just stick with it! Things get a lot better after the first month or so.
Another thing you could try is the Gestalt breastfeeding method. The creators of this evidence-based method state that it “aims to optimize positional stability and intraoral breast tissue volumes for pain-free effective breastfeeding.” They explain:
“The word gestalt (pronounced “ger-shtolt”) means a whole that is more than the sum of its parts. Gestalt breastfeeding builds on the theoretical foundations of complexity science, physiologic breastfeeding initiation, and new understandings of the biomechanics of infant suck elucidated in ultrasound studies. It also integrates simple psychological strategies from applied functional contextualism, popularly known as Acceptance and Commitment Therapy, empowering women to attend mindfully to breast sensations and their infant’s cues.”
For only $30 you can buy the gestalt breastfeeding program here: https://education.possumsonline.com/programs/gestalt-breastfeeding-online-program
If you’ve decided to get your baby’s tongue tie released (lasered or cut), there are still special considerations for breastfeeding after tongue tie surgery.
Breastfeeding After Tongue Tie Release
If your baby gets their tongue released, you should breastfeed them almost immediately afterward. Generally, the 5% of babies that have an obvious, severe anterior tongue tie will have immediate relief.
Moms notice that their pain reduces significantly and their baby feeds easily within 5 minutes.
However, outcomes may differ depending on the kind of tongue tie surgery and the aftercare it requires.
For example, laser surgery requires extensive stretching of the baby’s mouth for weeks following. Every 4 hours around the clock, their tongue must be painfully stretched into the back of their mouth.
Stretches like these can cause an extreme breast and feeding aversion because the baby associates their mouth with pain. So sometimes breastfeeding your tongue-tied baby after surgery can get worse.
In contrast, doing a more shallow snipping procedure doesn’t require extensive aftercare. Simply breastfeeding after clipping the tongue tie should be enough to prevent it from reattaching.
If Breastfeeding Doesn’t Get Better After Tongue Tie Surgery
Breastfeeding after a tongue tie surgery doesn’t always get better. Some providers recommend getting the tongue tie snipped or lasered again.
But if the revision didn’t work the first time, a second time will rarely help. I’ve even heard of babies undergoing surgery up to 4 times because things never got better for them.
Having surgery that many times can create scar tissue which may cause more of a problem. And it can cause extreme aversions for the baby – feeding aversions or anything to do with their mouth.
If breastfeeding after a tongue tie release doesn’t get better, I highly recommend getting feeding help.
I can help you with breastfeeding struggles you may have. Contact me here for a virtual consultation to talk about your options.
Bottle-Feeding a Tongue Tied Baby
A tongue tie is far more likely to affect breastfeeding than bottle feeding. However, some mothers report that bottle feeding is difficult for their babies with tongue ties.
For babies with tongue ties, feeding could take a very long time. Sometimes bottle feeding a tongue tied baby takes up to 45 minutes for just a few ounces.
When a baby bottle feeds with a tongue tie, they squeeze the milk out of the bottle nipple by compressing it. Their tongue moves very little.
Some babies with a tongue tie leak milk out the sides of their mouth when bottle feeding. That’s because it could be harder for their mouth to make a seal.
All this said, just bottle-feed as you normally would. Burp your baby often and consider doing paced feedings. I explain how to pace feedings here.
It’s okay for feedings to take some time as long as your baby is getting enough to eat. Often with time, bottle feeding a tongue-tied baby will get better as they get used to it and their mouth grows.
Breastfeeding & Bottle Feeding Babies With Tongue Ties: Summary
Feeding problems are very common for babies. They may even be more common than babies that don’t have problems. Just because your baby has feeding problems doesn’t mean they have a tongue tie.
The most important questions to ask yourself are:
- Is my baby gaining weight?
- Is my baby healthy?
If the answer to those two questions is yes, then you’re doing great!
Cutting a baby’s tongue doesn’t guarantee that things will improve. First, try finding support and ruling out other feeding difficulties. With a little support, you might find that you and your baby can overcome breastfeeding or bottle feeding problems.
For more information about breastfeeding a baby with a tongue tie, check out these evidence-based articles:
Kealy Hawk, BSN, RN, CLC
Kealy is a Registered Nurse, Lactation Counselor, and most importantly a mommy! Her own baby feeding struggles gave her a passion to help moms throughout their feeding journey. She specializes in breastfeeding support and evidence-based formula recommendations. To talk with Kealy or take one of her breastfeeding or formula classes, visit https://littlebearcare.com.