Breastfeeding and Identifying Posterior Tongue-Tie

Breastfeeding and How to Identify 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

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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 4) 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.   The La Leche League were fantastic, it was this supportive group and their very informative leaders who finally agreed with me that my baby had a tongue-tie.  Do read their amazingly informative book too, The Womanly Art of Breastfeeding which is a wonderful resource for any breastfeeding mum.

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.  It took me 8 long and painful weeks to research for myself and find out about tongue-tie, way too long!  You can read more about my breastfeeding journey here.

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 products, resources, websites and groups invaluable:



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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 successfully breastfed my second until he was two and a half years old…and yes he still has a tongue tie.

Most of all be kind to yourself and your baby and good luck on your journey.

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?

Affiliate links are included in this post, if you purchase any of the products via amazon through a link on my page I will receive a small commission. Thank you!

71 Replies to “Breastfeeding and Identifying Posterior Tongue-Tie”

  • 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

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

    • 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!

  • 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

  • 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

    • 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!

  • 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

    • 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!

  • 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

  • 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 ( 🙂

  • 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

  • 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

  • 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

    • 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.

  • 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

  • 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

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