Tongue-ties

Myth: It's normal for breastfeeding to hurt for the first few weeks.
Fact: It's not.

I thought I was normal when my boobs were sore, uber-painful, bleeding, cracked and chafed at three months postpartum. Everyone said they'll stop being painful at around 3 months. It's true that they got better then, but this is NOT the norm. There must have been an underlying problem.

When Sam was 3 months old, I called Chonyi Glassman, a lactation consultant and IBCLC. After a full assessment of his mouth and sucking capabilities, she determined that he had a posterior tongue-tie which isn't so visible to the eye when you look at him face to face. Also, she said he doesn't suck well, probably because of the tongue-tie. She recommended asking my pediatrician about it. I asked him and he said that since his tongue can't reach past his lips, I should take him to a pediatric ENT. Then she measured how many ounces Sam consumed in a feed. It was 1.5 ounces - but he wasn't so hungry at the time. Still, that amount in 10 minutes is hardly efficient. These are the pacifiers she recommended to help his sucking become stronger.

So what is a tongue-tie? Grab a mirror and stick your tongue out at it (say "ahhhhh"). Notice that string-like band connecting your tongue to the floor of your mouth? In some babies it's either too short or too thick, and this restricts the movement of the tongue. If it's further back, it's a posterior tie. This doesn't let a baby suck properly. It can even cause speech and feeding problems later on. It's also genetic. In fact, people with an MTHFR gene mutation are prone to midline defects, and tongue-tie is one of them. I know this runs in my family and a niece/nephew or two has had a tongue tie.

Other signs Sam presented that can be tied to tongue-tie (at the time I did not realize they were all connected to his condition):

• Narrow and painful latch
• Vasospasms (spasmodic nerve-like pain in the nipple)
• After a feed, nipple looked like the top of a lipstick
• He would latch and unlatch repeatedly during a feed
• He couldn't stick his tongue out past his bottom lip
• Top lip curls under and cannot stay curved outward during a feed
• Breasts never really felt empty after a feed

My pain mysteriously disappeared one day when Sam was three months old (not too long after my appointment with the LC), an experience you can read about here. If you don't have patience to read about that, suffice it to say that BFing became enjoyable - finally! - and I didn't have any major motivation to go to the ENT and check it out. But then I found out about the ramification of leaving it unresolved (see above) so one day I booked an appointment for the ENT, whose next availability was in two months from then! Read on to see how his tongue-tie was resolved....