Looking down at my newborn baby’s crinkly face, as she slept peacefully in my arms, I was in absolute awe and wonder. What an amazing experience it was to enter this wonderful world of motherhood. As I lay there, revelling in this moment, little did I realise that the next 12 months would become a long journey of confusion.

When I had my first baby, I received some initial support from the midwives, to establish breastfeeding in hospital. A few weeks later I saw my GP for a check-up and asked my GP about some issues my daughter was having. My GP assured me that my daughter ‘just had colic’, and should be feeding every 4 hours now that she was 4 weeks old. 

For the next 12 months, we were to suffer extremely broken sleep due to my daughter’s ongoing problems with trapped wind which was causing her abdominal pain. From 5 months onwards in particular I refer to as the ‘zombie zone’, as I’m not sure how I even functioned.

Late in her first year, I discovered that my daughter had a lip and tongue tie. In my determination to find a solution and bring relief to my daughter, I found an experienced provider of lip and tongue tie procedures and my daughter had her lip and tongue ties released. After the release procedure was completed, we experienced a great wash of relief over us and our little family, as she finally started sleeping more peacefully, with much less trapped wind and much less pain in her poor little body.

A year earlier, with that 4 week old baby in my arms, how was I supposed to know that my GP had no training in breastfeeding or tongue ties? In fact, almost no one that I had consulted since the birth, including the expensive private paediatrician, the midwives at the hospital and the staff at the GP clinic, had more than 10-15 hours of breastfeeding training in their qualifications.

This is something I believe all new mums should know about, preferably, before they even have the baby! The common story of a new mum seeing more than 10 medical professionals and receiving terrible breastfeeding support just breaks my heart. I want mums to know that there is support out there but it is not with the professionals that you would initially expect to be able to assist.

Regarding tongue and lip ties, often when mums ask in mum-to-mum support groups about issues they are having with breastfeeding, the suggestion of oral restrictions as a possible cause is made. Those mums seeking advice will then ask their GP at their next visit, as their standard care provider. The GP will most often dismiss the suggestion, lecture the mum on avoiding this so-called 'fad' or simply say that ties don't affect breastfeeding.

Why do GP's dismiss tongue ties?

1. They don't have any specific training in oral restrictions, oral function or breastfeeding.

We know that general health practitioners’ qualifications do not cover tongue ties or their impacts on breastfeeding, airways, speech or eating. Even obstetric GP's do not have any extra training in breastfeeding! So unless the particular GP has sought additional training, you may wish to take their advice with an open mind to other possibilities. The number of GP's who have completed training related to tongue ties is very low in Australia.

2. They don't see it often enough.

Breastfeeding mothers make up only a small percentage of the patients in a GP's clinic, so they are not likely to recognise patterns, witness increases in issues or have the opportunity to connect the dots.

3. They don't know what they don't know.

A lot of tongue tie knowledge has become available in the last 10 years only, and as a nation, we're still waiting for that knowledge to filter down to most medical professionals and tertiary education. Often GP's are not aware of International Board Certified Lactation Consultants (IBCLC's) that they could be referring mums to for breastfeeding issues. They often do not know that many infant health issues are actually related to breastfeeding.

I went on to have a renewed experience with my daughter, enjoying breastfeeding together. She is now a happy and confident child, who is enjoying life.

If you have consulted various medical professionals and you are not feeling confident in their advice, I can help. I am a Mama, Breastfeeding Mentor and Parent Advocate and I help mums experiencing issues with breastfeeding, lip and tongue ties to find the next step in their journey. In my coaching, I incorporate evidence-based advice from the World Health Organization (WHO) and other leading health bodies.  We can work through what you've experienced so far and develop a plan for you and your child.

Let’s move you from confused to confident!

If you've followed me for any length of time, you've probably heard me talking about tongue ties.  You might be wondering, what is a tongue tie anyway? How do tongue ties happen? Why do some people have tongue ties, and some people don't? We all have a frenulum under our tongue. It's a mucous membrane that limits the range of movement. 

When we're in utero, in the early stages of pregnancy, when the tongue develops, the frenulum is actually tethered all the way to the tip of the tongue. Our tongue has no movement at this point.

Late in the first trimester, the process of apoptosis occurs. Apoptosis is a programmed cell death and that removes certain cells that we don't need anymore, such as the webbing between our fingers and toes, and the frenulum under our tongue. In the process of apoptosis, the frenulum under the tongue is meant to recede all the way to the back so that we have full range of movement.

When that process doesn't occur or doesn't occur fully, that's when we are left with the restriction in the frenulum, which inhibits the free movement of the tongue, and is then defined as an oral restriction, or tongue tie. 

When you think about how critical our tongue is for eating and drinking, including swallowing, as well as breathing and speech, we use our tongue for so much. So, you can understand that if you have a restriction and you don't have a full range of movement in your tongue, this can have impacts not only for breastfeeding but across your life.

If you have had a tongue tie diagnosed in your baby or toddler, and you're considering having it released, but you're confused about the options and why costs vary so widely, I can help! I have a pre-recorded workshop available that covers everything you need to consider when looking at tie release for your infant or toddler. You can sign up here for an instant download: Navigating Tongue-Tie Release

Traversing the minefield that Google delivers you when you’re looking for information online about tongue tie almost requires a bomb-squad. So, let’s look at some myths and truths about tongue tie.

Firstly, there are a few terms used for tongue tie, including ankyloglossia, tethered oral tissues (TOTs), oral restrictions and ties.

In the normal development of a foetus, the frenulum tissue under the tongue recedes during the first months of pregnancy. When that tissue does not fully recede, a restriction remains. This is a tongue tie.

Let's cover 3 common statements that you hear about ties. Are they myths, or are they true?

Statement 1. Ties don't exist.

This is a myth. Straight up. Let’s talk about why.

References to tongue tie date back to Aristotle in the third century BC. There are also biblical references in the books of Job and Mark. In addition, statements regarding ties and their treatment have been published by the American Academy of Pediatrics (AAP), the Canadian Pediatric Society, and the American Academy of Pediatric Dentistry.

So the evidence is quite clear that oral restrictions do exist, and have existed in humanity for a very long time. There’s a separate argument that anterior restrictions exist, but that submucosal ones don’t exist, I’ll cover that in Part 2 of this blog.

Statement 2. Ties don't affect breastfeeding.

Some medical professionals will acknowledge that ties do exist, but they'll reassure you: it’s ok because they don’t affect breastfeeding. Again, this is a…myth, and anyone currently trying to breastfeed a baby with suggested tongue tie will likely confirm this too!

Here's a list of conclusions from studies showing that ties have a negative effect on breastfeeding:

The association between breastfeeding difficulty and tongue tie has been recognised for at least 500 years (Obladen, 2010)

Tongue tie can affect the way a child eats, speaks and swallows, as well as interfere with breastfeeding. (Mayo Clinic)

Free movement of the tongue is critical to the action of breastfeeding. (Geddes, 2008)

Most important of these is the research undertaken by Dr. Donna Geddes of the University of Western Australia.

In this video, you'll notice that the tongue creates a vacuum. You can see that if the tongue is restricted in any way, it’s going to affect that action and impact on breastfeeding.

In addition, this list of symptoms was registered by mothers in a recent study.

Poor latching; falling asleep while attempting to nurse; creased, flattened or blanched nipples after nursing; gumming or chewing of the nipple when nursing; poor or incomplete breast drainage; slides off nipple when attempting to latch; severe pain when infant attempts to latch; cracked, bruised or blistered nipples; reflux symptoms; poor weight gain; colic symptoms; bleeding nipples; plugged (blocked) ducts; mastitis or nipple thrush; infected nipples or breasts. (Ghaheri, 2016)

The important thing to note is that in this study, and in every study conducted on tie release, improvements in symptoms were noted post-release for almost all participants. This means that the previously restricted tongue was definitely having a negative impact on breastfeeding.

Statement 3. Ties stretch as a child grows.

Which, you can probably guess is a… myth.

In this study from 2014, Professor Marchesan and her colleagues sought to understand the histological make up of the altered lingual frenulum.

'In ankyloglossia, bundles of elastic fibers positioned near the epithelial lining contribute to the restriction of the tongue movement, interfering with the oral functions. The highest concentration of type 1 collagen was detected in all types of lingual frenulum. Due to the fact that type 1 collagen is resistant to traction, stretching exercises may not be helpful to elongate the lingual frenulum.' (Marchasan, 2014)

The conclusion of the study was that lingual frenectomy (tongue tie release) may be considered the appropriate procedure to release the tongue in order to provide better oral functions.

So, there you have it; 3 common statements about tongue tie, and clear proof as to why they are myths.

Did you find this blog helpful? If so, I'd appreciate a like, share, or tag a friend who might need to read this information.

Have you discovered your infant or toddler has a tongue tie, and you're wondering what your options are? Don't worry, I've got that covered! You can sign up here for an instant download of my pre-recorded webinar: Navigating Tongue Tie Release.