I’ve recently been supporting lots more babies with tongue tie as they wait to have them separated, since many local tongue tie services are currently unavailable due to the Covid NHS meaasures.
Feeding a baby with a tongue tie is really hard – it can be extremely painful for Mum – a great deal of trauma can be caused to the nipples as baby just can’t get the nipple far back enough in his mouth, or hold the nipple in his mouth without slipping off. The feeds can be very lengthy and baby often gets tired and fractious as a result. Sometimes it can cause colic or reflux symptoms and often the weight gain is inadequate so supplementary feeds need to be given as temporary measure.
If milk has to be temporarily given by a bottle (expressed breast milk or formula) then baby will sometimes find it easier to feed from the bottle (because the tongue movement isn’t so difficult) and then getting baby to feed from the breast again can be tricky. Combine that with a Mum who’s in pain and exhausted, feeling as though she “can’t” breastfeed her baby and judging herself for that, as well as seeing baby feed well from the bottle and making assumptions that he therefore ‘prefers’ that to her breastmilk… well it’s a very complex and difficult situation for Mum, baby and Dad as well, who’s trying to usually support as best he can.
However, there are a few tricks and tactics that can be used while waiting for the tongue tie to be properly assessed and separated.
Sometimes just a different latching technique – one that achieves a deep latch like the Flipple – can make a big difference. Sometimes using the laid-back feeding position means that baby can keep himself latched without slipping off because gravity is helping him to stay on.
Sometimes nipple shields can help baby to latch more effectively and help to minimise trauma to the nipples. Although they are never a long-term solution (because baby won’t get quite so much milk and Mama won’t get quite so much hormonal stimulation), they can be a great help temporarily and provide some very welcome relief for sore nipples.
It’s even better if bottles can be avoided in the wait for the tongue tie separation (as that way baby doesn’t get confused by sucking from a teat, or used to the fast flow of a bottle) and a good way to do that is by finger feeding. This involves using a supplementary nursing system and taping the thin plastic tube to your clean finger. When baby sucks on your finger, he’s also drawing milk from the bottle via the tube. There’s no nipple confusion involved here and the flow is gentler. It’s another good temporary fix while waiting.
Once the tongue tie has been fully assessed and snipped, there’s a degree of ‘re-learning to feed’ involved for the baby because his oral anatomy is now different, so you might find you need further support with the latch and positioning for a little while.