IF YOU ARE BREASTFEEDING I STRONGLY THAT YOU SEE A BREASTFEEDING CONSULTANT PRIOR TO ASSESSMENT AT TONGUE TIE GALWAY. The reason for this is set out below.
Breastfeeding is a skill that both we and our babies need to
learn together and it can take a few weeks to get the hang of things and to start working well
together. The first few days can be hard, there can be some temporary pain even when things
are going ok, and pain can linger on when the latch isn't quite
right regardless of a frenulum. In fact one study found that 92% of mums encountered problems
or pain in the early days. If tongue-tie incidence is below 10% then most mums must have
issues due to other factors. Growth spurts, changes in milk supply and the normal fussy periods
can make things more complicated. The symptoms associated with a tongue tie (e.g. clicking,
pain, slow weight gain, reflux etc) can also be caused by issues other than tongue tie and in some cases
changing positioning, getting a deep latch or working on your breastfeeding management can
resolve problems. Some babies with a tongue tie feed perfectly well. Performing a frenotomy on a normal frenulum won't resolve any breastfeeding issues and
no one wants an unnecessary procedure done to a baby, so checking other steps first makes sense.
There is breastfeeding support available throughout Ireland to mothers who want to breastfeed or are breastfeeding here.
The ideal healthcare provider for lactation support is an International Board Certified Lactation Consultant (IBCLC). Your midwife or public health nurse also may be an IBCLC. Some IBCLCs are also craniosacral therapists. In the absence of a lactation consultant, midwives, clinical midwife specialists, public health nurses, GPs, neonatologists and paediatricians may be in a position to provide support if your baby has a tongue tie.
Those babies who have had a frenotomy really benefit from early, regular breastfeeding support post-procedure as they have to learn how to use their more mobile tongue correctly on the breast. This is not to be viewed as an optional extra. To quote Dr Bobby Ghaheri, "if i ask you to train for a marathon for three months, but during that 3 month period your shoe laces are tied together, you will develop a specific way of running the marathon. but if i untie your shoes the morning of race and ask you to run a marathon in a normal fashion, your training for three months won't help you much. You have developed a different skill set and muscle strength to compensate". Despite the fact that a small proportion of babies are 'eureka babies', who adapt immediately to their new lingual freedom, it's not reasonable to expect both mother and baby to feed normally straight away after frenotomy, and so require ongoing support.