Breastfeeding & Identifying Posterior Tongue-Tie

Both of my boys had and have a posterior tongue tie. Both were difficult to breastfeed.  When I say difficult, I mean painful.  I suffered from painful shredded nippes, blocked ducts and vasospasms during our feeding journey.

“Tongue-tie (ankyloglossia) is a problem affecting some babies with a tight piece of skin between the underside of their tongue and the floor of their mouth (lingual frenulum). It can sometimes affect the baby’s feeding, making it hard for them to attach properly to their mother’s breast.”

NHS Choices

The problem was the lack of support knowledge.  Don’t get me wrong, there are some wonderful peer supporters and breastfeeding groups in the UK, in fact, where we used to live in North Kent I could have attended a different breastfeeding group every day.  When I experienced pain breastfeeding my first child, Chaos (who is now 3 1/2) nobody ever thought to examine him.  I meanwhile was examined a little too much…Exposing my boobs in public in front of complete strangers daily trying to get help breastfeeding!

I saw everyone you could ever image possible and was constantly told, it’s all about positioning, it will get better, try the rugby hold, use the ‘flipple’, squeeze and present your boob like a burger so the baby has a full mouth…do this…do that.  Actually whereas positioning to achieve a deeper latch did help reduce the pain somewhat my nipples were still shredded because the tongue-tie wasn’t going away by itself.  It took me 8 long and painful weeks to research for myself and discover my this, too long!  You can read more about my breastfeeding journey here.

Your nipples do take a little time to adjust to your little chomper, but if you are in pain breastfeeding after the first week, don’t wait as long as I did, please see a tongue tie specialist as soon as you can.

I hope I can save you doing some research by giving you some tips:

Examine your baby:

  • Lie your baby down, slide your finger (trimmed fingernail!) under your baby’s tongue.
  • Sweep your finger from one side of the underside of the tongue to the other, whilst applying slight pressure pushing your finger towards the back of the baby’s tongue.
  • If you can sweep your finger left to right without feeling an obstruction then there  is probably no tie.  If you finger is stopped by a tie in the middle of the tongue then your baby could have a Posterior Tongue Tie (PTT).

It is notoriously difficult to identify a PTT so if in doubt, seek help from a professional, details listed in the ‘what are my options’ section below.

Examine yourself:

Tongue ties are generally genetic.  If you baby has one then it is more than likely that you, or your baby’s daddy has one.  When I found out Chaos had a PTT I had no idea at all that I actually had one too!

  • Open your mouth as wide as you can.
  • When your mouth is at it’s widest try and touch the tip of your tongue to the roof of your mouth
  • If you can’t touch the roof of your mouth, you tongue is most likely restricted.

All I can say on this one is that some restrictions obviously cause more problems that others.  I would never have known about my PTT if it wasn’t for the boys.  I was bottle fed as an infant.  I have always been able to lick ice cream.  I occasionally catch my frenulum in between my teeth and bite the underside of my tongue.  My bottom teeth are also all crooked, the ‘eiffel tower’ effect, all pulled in from the tie.  Many also believe you are more prone to migraines and TMJ if you have a tie as basically your tongue is pulled down, which in turn pulls your jaw down and it effects your whole jaw, neck and shoulder area.

What are my options?:

  1. NHS or private?

  • NHS:  See your infant feeding co-ordintor at the hospital.  Some hospitals have breastfeeding groups run by the infant feeding co-ordinator, with others you have to make appointments.  If you don’t know who to contact, ask your midwife to point you in the right direction.  In my experience there is no point going to your doctor, unless you already have some sort of referral, also available from La Leche League (see details below).  You should then be referred to a tongue tie clinic at your local hospital.  We had our boys ties divided in Hastings and Kings College London.
  • Private: Check with the Association of Tongue Tie Practitioners for your nearest, qualified professional.  I would recommend also choosing a practitioner who is a Internationally Board Certified Lactation Consultant (IBCLC), or one that offers support from an IBCLC.  To become an IBCLC you need to pass several exams and know your stuff when it comes to breastfeeding.  If you are paying for a division, it is worth paying for a expert who can also help you with breastfeeding advice and give advice managing your supply and positioning.  We used a private practitioner from Kent and London for around £150 (2013+2015).  Divisions of reattachments should be done for free.

2. Tongue tie division

  • Scissors: The traditional method of dividing the tongue tie. The baby is usually swaddled and the head secured, the practitioner will use blunt ended scissors to snip the lingual frenulum.  There is little or no blood and you feed your baby straight afterwards.  If the baby is older, or if the procedure is on a child or adult general anaesthetic can be required.
  • Laser:  Using a laser to divide a tongue tie is really popular in the United States, not as common here.  The only person currently dividing ties using a laser is Dr Malcolm Levinkind in Harley Street and his own private practise in East Finchley, London I believe this costs over £300.  A much pricier option but some feel that laser is less likely to reattach, read what Dr Bobby Ghaheri’s opinion here.

3. Post division Exercises

  • After the tongue tie is divided you may be advised to complete daily or twice daily exercises to ensure that the tongue tie does not reattach.  Open oral wounds want to close, the tongue wants to heal itself.  Both of my boy’s ties reattached, I didn’t do any exercises with my first, I did with my second, so go figure!  Some practitioners insist it is necessary and give you a schedule of aggressive wound management (King’s is notorious for this), others may say it is up to you, or just encourage regular feeding.  To date there is currently no research that confirms either way that post revision exercises prevent reattachment.  Kings College London, who are great advocates of post division exercises are currently undertaking a lengthy study.  Some great information over at Analytical Armadillo and Dr Bobby Ghaheri’s sites.

4. Reattachment:

  • King’s quote that there is at least a 4% chance of a tongue tie reoccurring.  Both of my  boys had three tongue tie divisions.  Both boys still have a slight posterior tongue tie.  I know for a fact that on one of my boys his tie was divided, further frenulum buried deep in the muscle at the base of the tongue may moved forward (one theory).  Another theory is that sometimes the tissue simply re-grows.

5. Do your own research:

  • As much as some health professionals are well meaning, PTTs are still dismissed and not widely recognised as causing breastfeeding problems.  Arm yourself with facts so that you can challenge and back up your findings with evidence.  I found these websites and groups invaluable:
  • Infant Tongue Tie, UK, Ireland & Europe (Facebook)
  • Tongue Tie Babies Support (Facebook)
  • Dr Bobby Ghaheri, the expert dentist and dad with babies who had tongue ties
  • La Lache League, a great place for information, better still if you have a meeting near to you, go and visit, the leaders and groups are fantastic!
  • Dr Jack Newman, world renowned expert on breast feeding, he even responds to some emails!
  • Analytical Armadillo, a wonderful breastfeeding resource with well researched opinions

Further thoughts:

There is also a huge debate over wether lip ties cause ineffectual painful breastfeeding, but that is a whole other can of worms…

Not all ties cause problems, even if your baby has a tongue tie or lip tie, they may not be affected by it now, or in later life.  I personally would not hesitate in having my babies Posterior tongue ties divided again, but it really is your person choice as a parent.  Just go with your mama instincts and do what is best for you and your baby!

Give yourself a break it is not the end of the world if you can’t exclusively breastfeed.  I made the decision to switch to formula with my first after 12 weeks, as it was too painful to continue and it really worked for us!  However, I still breastfed my second until he was two and a half years old…and yes he still has a tongue tie.

Pin for Later:

How to Identify and check for Posterior Tongue Tie. Breastfeeding with Tongue Tie by Topsy Turvy Tribe

What’s your opinion?  Were you or somebody you know let down by the NHS? Have you experience of a baby with tongue tie?

Load More
Something is wrong. Response takes too long or there is JS error. Press Ctrl+Shift+J or Cmd+Shift+J on a Mac.

71 Comments Add yours

  1. This is a really important post as I bet so many Mum’s will just think breastfeeding is failing and it is there something wrong with them. Actually it could be something like this!! Really interesting and thanks for sharing with #bestandworst

    1. Thanks for your lovely comment Sarah. We had a terrible time with it. If we could help just one mummy, so they wouldn’t have to go through what we did, I’d be so happy!

      1. Sarah Howe says:

        Thanks again for sharing with #bestandworst xz

  2. mackenzieglanville says:

    great message to share and get out there! This happened with my nephew and luckily was picked up early on #sharethebloglove

    1. Thank you Mackenzie, I’m so glad to hear it was caught early with your nephew!

  3. I never knew how common tongue tie was until a few years ago and alot of my friends babies have had it, many going private to avoid waiting. Some really good advice. #sharingthebloglove

    1. Thanks,I agree,there does seem to be a lot of women having problems. The NHS needs to figure out a quicker way of dealing with tongue tie if they want to improve UK breastfeeding rates!

  4. This is a really fantastic informational post. Nobody seems to check for tongue tie when there are feeding problems early on, and you’ve empowered mums here to check for themselves and get support that they need. #sharingthebloglove

    1. Ah thank you. Such a lovely comment! If it’s one thing I’ve learnt as a mum, sometimes you’ve just got to make things happen!

  5. Emma says:

    My son had a tongue tie, I asked them to double check in hospital and they still said no but 10 weeks later I finally got it snipped but he was so used to the bottle he couldn’t latch properly and I gave up breastfeeding at 12 weeks. I mix feed with expressing and formula but I’m hopeful next time round I have more knowledge so thanks for sharing this. #SharingtheBlogLove

    1. It’s such a shame isn’t it that they don’t have people properly trained to check for tongue tie in hospital. As long as our babies are fed and happy. Expressing is tough,well done you!

  6. crummymummy1 says:

    Little B had tongue tie too and it was hell. Great informative post! #bestandworst

    1. Thank you…it really is hell!!

  7. I feel really lucky that I think my son was checked for tongue tie by at least 5 different people while we were in the hospital, so people did seem very aware of it. But even then, I hear so often that it’s still not picked up until later on. This is such useful advice for anyone who suspects a tongue tie. I have to admit I had no idea that it could reattach, but having had surgery in my mouth and knowing how quickly that healed, it makes perfect sense. Thanks so much for joining us again at #SharingtheBlogLove

    1. You were really lucky to be checked so many times. I wish we were it would have saved a lot of heartache! Hopefully this post could help someone else go through less. Thank you again for featuring our breastfeeding post and for your lovely comments!

  8. Kirsty - Motherhoodery says:

    My son’s tongue tie went undetected despite me seeing multiple people about breastfeeding issues. I had to give up in the end because it was stressing us both out. He had his tie cut at 10 weeks. We’ve just found out he also has a lip tie….I’m shocked that this isn’t regularly checked for before you leave the hospital. Everyone that came to see me made me feel like I was just doing it wrong. Not one of them looked at Tutti to see if there was a physical problem. Of course, the fog of looking after a newborn meant I didn’t even consider tongue tie until some weeks later. x #TheList

    1. Oh no Kirsty, poor you. Your experiences sounds very much like mine with my first son. New mums are too busy to have to deal with all of this by themselves! Both my boys have lip ties too, it goes hand in hand with tongue ties. Dr Bobby Ghaheri has a great resource all about lip ties here: http://www.drghaheri.com/blog/2014/10/8/the- difference-between-a-lip-tie-and-a-normal-frenulum

  9. ohmummymia says:

    I had problem with breastfeeding as well and always when I ask midwife she was saying that baby is doing well attachment is fine and that was supportive? I fed up and start giving formula to my baby I was writing about on my blog so If you want to read it please pop in (ohmummymia.com) 🙂
    #brilliantblogposts

    1. Thanks for your comment. Breastfeeding is certainly hard work. I will pop over and have a look!

  10. I have to agree that there are not enough information about this topic. I only heard about this before but did not hear enough to get mya ttention and thank you for changing that. Thank you for making some steps to reach out and tell people and moms about this. #ablogginggoodtime

    1. Apologies Merlinda I’ve only just seen your lovely comment. Thank you!

  11. tammymum says:

    This is a brilliantly useful and informative post. I know tongue tie can be a huge issue when feeding but if identified and the right help is sought or given then it really can make the world of difference. There definitely needs to be more awareness about it! Thanks so much for linking at #forthrloveofblog xx

    1. Thanks for commenting. I do hope we are able to help someone,so they don’t have to go through everything we did! xx

  12. Emma T says:

    This is such a useful post. Will be sharing widely. One other check they do for tongue tie once older (or if you’re checking yourself) is to see if the child can lick their lips. If there’s a tongue tie they won’t be able to. It’s so strange to watch – N can do all sorts of weird things with his tongue that I can’t do (his is slightly tied), the weirdest is where most people can flick their tongue up and down, he can only wobble his side to side It freaks me out! #thelist

    1. There are so many people with tongue tie now it seems everybody knows somebody effected. Hope that N doesn’t have any other problems with his freakishly wobbly tongue! Thanks for your comment Emma.

  13. This is so important, I didn’t know any of this! This is one of those things everyone with a baby should be aware of.

    ~ABloggingGoodTime

    1. Thank you, I hope we can help in a very small way to raise awareness of tongue tie!

  14. Such a great and important post to share. There isnt enough information or knowledge shared still on tongue tie so its great when other parents share their experiences with it. Emily #brilliantblogposts

    1. Thanks for your comment Emily, let’s hope that we can make a little difference.

  15. I remember vividly both my girls being checked for tongue tie and after reading this it would be appear this is not always the case, which is such a shame. We were very lucky! But it shouldn’t come down to luck. This is a brilliantly informative post and I hope that it will go on to help other parents. Thank you for joining us at #SharingtheBlogLove Laura x

    1. Thanks Laura. I’m pleased to hear your girls were both checked. I hoe that we can help other parents so they can help a little bit quicker than we did! x

  16. Taryn says:

    Thank you for sharing your experience and well done! I haven’t experienced tongue tie myself but do know how difficult breastfeeding can be even without the added stress of tongue tie. This is a really informative post and I’m sure will be so helpful to someone going through the same thing. #sharethebloglove

    1. Thanks for your lovely comment Taryn. You’re right, breastfeeding is hard enough without complications!

  17. Great informative post about tongue ties. They seem to be more common than ever (or just weren’t diagnosed in the past like you mentioned having one yourself). They definitely cause breastfeeding problems but even when snipped, it isn’t an instant solution as some people expect. You nearly have to start over with breastfeeding and give the baby time to adjust. Thanks for sharing so much information #SundayBest

    1. Thanks for your comment Lisa. As a midwife I’m sure you see loads of tongue-tied babies! I really did expect everything to suddenly be better after the first tongue tie division but unfortunately it wasn’t. I agree with giving the baby time to adjust, the sooner the tie is snipped the better for baby and mum!

  18. My oldest had tongue tie and I too suffered from shredded nipples and mastitis. Thanks for sharing such useful information
    #sharingthebloglove

    1. Ouch…shredded nipples are one thing but mastitis is supposed to be terrible. Not at all pleasant to go through so much pain, I feel for you!!

  19. reimerandruby says:

    I’m lucky both my kids didn’t have any of this as I breastfed them both as well. Thanks for sharing this very informative and interesting post! #AnythingGoes

    1. Thanks for your comment. so pleased breastfeeding went well for you!

  20. Dave Freed says:

    We had the same problem, at it was really tough to get the little guy referred and treated. In the mean time my wife had to put up with a lot of pain and sleepless nights, and he was struggling to eat a lot. Raising awareness of this is great! Thank
    #MarvMondays

    1. Thanks Dave, sorry to hear you went through this too. I can feel your wife’s pain, hope the treatment worked for your son.

  21. This post is great, I would have no idea what to look for. It’s good for people to be able to refer to posts like this if they are unsure or learning about the topic.

    #MarvMondays

    1. Thanks for your comment, I hope that we can empower people who are having problems to get further help!

  22. nsalama1 says:

    Such a helpful post. My son had a tongue tie and it was identified very early on so he had the snipping procedure when he was around 5 days old. I wish this post had been around a few years ago! #Sharingthebloglove

    Nicole | The Professional Mom Project

    1. Thanks Nicole. I’m so glad your son’s tie was discovered and took action so quickly!

  23. Thank you so much for this post! When my baby was born, my midwife told me he wasn’t tongue tied, but my health visitor (about 3 weeks later) told me he was. I had no idea, and breast feeding was so painful it actually made me depressed. I still don’t know whether he is, but judging by what you have said, he is, and so is my other half. I had absolutely no idea it was genetic.

    I love this.

    x

    1. Oh no breastfeeding with tongue you’re really does suck and I totally agree it’s depressing. So pleased if this post has helped you. I was bottle fed so there was no reason for me to know I was tongue tied, maybe the same as your other half. Unfortunately even some midwives don’t know how to correctly check for tongue tie!

  24. rightroyalmother says:

    This is so informative and I’m sure will help loads of parents. I didn’t realise how difficult it must be to breastfeed with tongue tie until I met a woman who was doing so at a group with NC last winter. It’s really important to be able to identify it – thank you for this again. #bloggerclubuk

    1. I wish I knew about it before having my first. It would have saved a lot of heartache and pain. Thank you!

  25. Kerry says:

    Breastfeeding was such an horrendous experience for me, so painful, and my daughter wasn’t getting anything from me at all, so much so that she dropped weight and was dehydrated. I gave her a bottle after 3 days and I still feel guilty over it now. I wonder if a tongue tie was the problem?! It was never mentioned to me or checked by the midwives/health visitors. #bestandworst

    1. It sounds very familiar Kerry so it could well be she had a tie…there are off course other reasons but it’s worth having a quick check!

  26. helen gandy says:

    Very interesting post, lots of useful info here, thanks for sharing with the #bestandworst hope you’ll stop by again!

    1. Thanks for your comment!

  27. This is really interesting. My newborn niece who is just over a week old was tongue tied but luckily it was discovered within a few hours post birth and she had it snipped and is now feeding fine! Great post
    Thanks for linking to #ablogginggoodtime

    1. Thanks, so glad to hear and positive experience and that your nieces tie was fixed straight away!

  28. Such a helpful post! Thanks for sharing!
    Lx
    http://workingmumy.blogspot.com
    #ablogginggoodtime

    1. Thanks for stopping by to comment!

  29. This is such an important post for new mums to read – as you say, even though there is the support there, sometimes you need the knowledge upfront to explain what is happening. It must have been such a hard time for you, and glad you found a way in the end. Thanks so much for linking up to #dreamteam Great to have you x

    1. Thank you so much for your lovely comment. I do think all new mums who want to breastfeed know about tongue ties just in case. It’s hard to rely on others is you are let down by the system!

  30. Oh bless you, that sounds so painful. I volunteer as a peer supporter so give up my spare time to help other mums and often see babies who we suspect have tongue tie. Assessing it requires specialist training which we don’t get but we worked hard in our area to push for better support and now have trained health visitors at several of our drop ins and once diagnosed the referal and snip is done really quickly, usually no longer than a week. A year ago it was such a battle to get the referal for mums! Thanks for linking up to #SundayBest x

    1. Thanks Sian, so glad to hear that you are helping mums to achieve a quick diagnosis. Let’s hope things continue to improve and are easier for tongue-tied babies and their mums.

  31. I’m so angry with the lack of tongue tie training in the NHS. Why the bloody hell isn’t it standard training for all midwives/health visitors?! I reckon a massive percentage of women that give up breastfeeding

  32. That give up breastfeeding have tongue tie issues. I had to ask to get my son assessed otherwise I wouldn’t never have got help. I just kept being offered the same advice of positioning over and over again!!

    1. Thank you for your comment. It’s so true, so called ‘experts’ haven’t got a clue and push the positioning advice over and over. It really shouldn’t be up to ‘mum’ to diagnose their own babies ties!

  33. Cassie says:

    So sorry you and your little one had to go through this. I had heard of tongue-tie but not PTT. It’s interesting to know it can grow back too.

    Thanks for linking up.
    #KCACOLS

  34. what a fantastic post and you explain it all really well. Great advice for new mums out there who are struggling and need some help #KCACOLS
    lisa (mumdadplus4) recently posted…Gluten Free Banana Pancakes – Healthy and Easy to MakeMy Profile

  35. Maria says:

    This is a really interesting and informative post. My youngest was tongue tied and had to have it snipped when he was a couple of weeks old because it wasn’t picked up by the midwives . I’m glad you managed to find your way eventually. #KCACOLS
    Maria recently posted…20 Facts About MeMy Profile

  36. Dani says:

    Thank you for sharing and enlightening me on how to identify tounge tie. I’m pretty sure I have this myself as I’m forever biting my tounge too. #KCACOLS

  37. Amy says:

    My son had tongue tie, it was picked up quickly and snipped no trouble. He does have trouble with speech now, I wonder if it is related. #kcacols

  38. Bread says:

    Wow, I didn’t even know this was a thing. Glad you finally got some answers. #kcacols
    Bread recently posted…Poem: AffirmationMy Profile

  39. Tim says:

    Our first child had a slight issue with this too. Thankfully we managed to get it identified within a couple of weeks but it was a horrible time initially when we didn’t realise how much it was contributing to him having trouble feeding. As a first-time mother, my wife assumed she had been doing something wrong herself, which is a horrible feeling for any mum but particularly a first-time one. #KCACOLS

Leave a Reply

Your email address will not be published. Required fields are marked *

CommentLuv badge