By Regular Mummy Contributor Amanda Howard (@littlenancygifts)
Tongue tie. It is a real thing.
I feel like there will be so many mums reading this saying "Duh, I already knew it was a real thing" but I’m writing this as reassurance to myself and all the mums who knew there was something up with the way their baby breast fed. IT IS A REAL THING.
I had heard of tongue tie but never heard of upper lip tie until September last year (2014). But boy had I experienced the symptoms it can cause.
I guess that's where the first problem lies with tongue tie or upper lip tie. Some children can have tongue tie or upper lip tie and they are able to adapt or adjust their mouths in order to breastfeed without issues, eat solids without issues and the tie itself doesn't cause issues for mum. But sometimes it does cause problems. It does cause issues, stressful painful issues that make everyday parenting harder.
My eldest son was born in March 2012. I was lucky enough to be able to breastfeed him for 12 months without too much drama… and by drama I still mean excruciating pain when latching for the first 12 weeks or so, nipples shedding skin (whoa nice visual?), constant leaking on one side while he fed on the other, tingling nervy pain shooting up my chest and into my neck and face while feeding for about 10 months, what I thought was a ‘too much milk’ flow issue as my son would gag after being on the breast for five minutes, would need to sit up, be settled and then re attach. This led to me expressing right before each feed to take the edge off the flow in order for him to be able to feed comfortably.
By about the 10 month mark we were golden, totally rocking this breast feeding thing… just in time to start weaning at about 11 months. He transitioned to cows milk without worry or allergy, so really I am one of the lucky ones! It was a special and unique experience. I don't think I can honestly say that I ‘loved’ breastfeeding. I enjoyed the closeness and the connection it meant at that time, but once I reached 12 months and he was happy to move on as well, I was quite comfortable to stop and really didn't miss it.
Fast forward two and half years later to the birth of my second son. From the first time he latched I knew something was off - for one, his top lip curled over his top gum and it hurt. A lot. Not just the normal "there's a tiny mouth sucking furiously at my nipples" pain, but real uncomfortable something-is-not-right pain. I expressed my concern to the midwives who were tending to me, saying “he feeds strangely”, “his mouth doesn't look right”, “his top lip is curled”, etc.
I had amazing midwives and care and in no way am I trying to indicate that they were negligent or negative in any way. Bar one night shift moody midwife (why is there always one?) I can honestly say the midwives and Dr’s who cared for me were simply amazing.
But….. training seems to be varied from midwife to midwife and Dr to Dr when it comes to tongue tie and upper lip tie. It seems even one's personal opinion on the subject comes into play. Where does that leave the new mum who is desperately asking professionals for help?
In my initial stay at hospital I had my attachment checked by two or three midwives. My son was checked for tongue tie and I was told he was fine.
I was seen again by a maternal health nurse at home - a trained lactation consultant who checked my attachment and again said "all good", despite me again explaining the issues, pain, his top lip etc.
The symptoms that occurred for both him and I were:
Him - constant wind, I'm talking unsettled whining and crying from 12 midday till 3am most days for 10-12 weeks.. he wasn't able to get a proper secured attachment so with the breastfeeding came lots of air = windy baby.
Me - split nipples resembling a paper cut, blocked ducts, and one split that resulted in a trip to emergency for help as I couldn't feed on it, even with nipple shields, a blocked duct for a number of days and feared a mastitis infection was on its way unless something changed. Again at this stage (six weeks old) I was checked by a lactation consultant, and a Doctor, and told my attachment was fine and that my baby was not tongue tied.
At my son's eight month maternal health check (with a different maternal health nurse) she asked me how the breastfeeding was going. I explained I was pretty over it to be honest, I had reoccurring blocked ducts and damage and it was all getting a bit much. She asked if my son had ever been checked for tongue tie. I explained yes he had, but absolutely feel free to check him again because I have felt like since the beginning there was something different about the way he breastfed.
On first glance she said, "Hmm I think he has upper tip tie. His tongue looks okay though. I’ll get the name of a dentist who does treatment on tongue and upper lip tie".
WHAT IS THIS? I couldn't believe it. At this point in time I had never heard of upper lip or frenulum tie - I had no idea that this could possibly be causing all these problems.
I was straight to the GP for a referral - who also, by the way, gave me the whole "that won't be the issue, that's not anything" speech after I explained my concerns and BEFORE he looked in my son's mouth. Once he looked at his top lip and how thick and tight it was attached to his gum he then said, "Actually I've never seen one that thick and tight before. I can see why that would be causing problems. That's why you shouldn't speak before you've assessed the person." HALLELUJAH!!!
This scenario leads me to believe that every single other nurse, midwife, and Doctor had not even looked at my son's top lip, let alone assessed it for requiring treatment. Or perhaps without experience and exposure to an upper lip tie they weren't aware of what to even look for? I cannot express how frustrated I was the at this point. After eight months of a windy unsettled baby, sore, split nipples, blocked ducts, mastitis scares and pain, my god the pain!
Within a month we were attending our consultation for both my boys with Dr Jeffrey Kestenberg - from Coburg Dental Group who performs laser surgery for tongue tie and upper lip tie.
My youngest was diagnosed with a level 4 frenulum tie requiring laser correction (he did not have tongue tie)
My eldest was diagnosed with - rear tongue tie and level 4 frenulum tie requiring laser correction.
My eldest son's symptoms, while more subtle than his brother's, became more obvious as he was older. I now know that because of his rear tongue tie his tongue did not control the milk flow efficiently enough (hence the gagging when breastfeeding). He also could not control solids when we first introduced those and would, choke, vomit and gag CONSTANTLY. He was on soft mushy foods and finely chopped foods until he as almost two, where it appears his mouth learned to compensate for the tongue tie and he was able to handle larger bits of food however we still had gagging episodes. He also had a large gap between his two front teeth - caused by the frenulum attaching to the roof of his mouth behind his two front teeth.
After laser correction - My eldest has had no way near as many problems with solid foods, his gap in his teeth also closed up dramatically.
My youngest had no more issues with breastfeeding, and I was pain and issue free as soon as the surgery was done.
Needless to say we already have out appointment booked for our third baby due in December to be assessed by Dr Kestenberg.
Upper lip tie - It is a thing. Who would have known? I feel like there is a lack of belief or training by professionals in the maternal health field to access and recommend treatment for upper lip tie. It needs to be recognised as a potential issue for breastfeeding and babies oral health in general. It appears, in my experience, that the stigma within the medical profession is "upper lip tie doesn't cause any problems". Well, in my non-medical opinion and based solely on my experience alone, it CAN and did for me.
I also need to mention how amazing Dr Kestenberg was with the kids, my husband and I. He was extremely knowledgable about the subjects of laser, upper lip tie and tongue tie. He not only explained things clearly and concisely to us, he also validated all the feelings and things I had been saying for eight months as a mother and breastfeeder to my babes. I can't thank him enough for treating us all so well and professionally.
*NOTE: this is in no way a commentary on the medical profession or promotion for Dr Kestenberg - it is the author's honest account of her personal experience.