Breastfeeding With A Lip Tie or Tongue Tie

The severity of complications from a lip- or tongue-tied latch can range from clear and frustrating to hardly noticeable. In generations past, wise women, midwives, and mothers knew to check the lips and tongues of babies at birth when they first learned to breastfeed. We lost some of that wisdom in the middle of the past century, so the most recent generation of care providers have fallen out of the habit of checking and correcting ties when helping a mama breastfeed. If you are struggling with your baby’s latch, your milk supply, or their weight gain, a lip tie or tongue tie could be at the root of the problem.

Identifying a Lip Tie or Tongue Tie

The baby’s instincts and reflexes for breastfeeding are beautiful. Tickle a newborn’s chin, and you’ll likely see him open wide to nurse with his top lip receding over his gums. When his mouth is open, the tongue will thrust forward over the gums. The tongue does the heavy lifting while breastfeeding, so he’s looking to latch on and enjoy a meal. If the tongue doesn’t cover the gums, his reflex will be to chomp down as he would on the foods he’ll be ready for in a year or so.

These reflexes are present even when the anatomy of the baby’s mouth isn’t helpful.

• Lip tie describes a tight upper frenulum – the skin connecting baby’s upper lip to her gums – which may force her top lip to suck under instead of flanging open.

• Tongue tie refers to the lower frenulum – the skin connecting the underside of baby’s tongue to the inside of her mouth – which can restrict her suckling movements and potentially keep her tongue from covering her gums or moving milk efficiently.

Signs of a lip tie might include, but not limited to:

• Baby’s top lip keeps pulling in
• You latch and unlatch to get it right but can’t keep it that way
• Baby might get frustrated and shorten nursing sessions
• You have to manually pull the top lip out
• Baby doesn’t open her mouth wide

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Signs of a tongue tie might include, but not limited to:

• When his mouth is opened, the tongue doesn’t cover the gums (this can vary based on the severity, so have a professional evaluate before ruling it out based on a visual assessment)
• The tongue does not stick out past the lips
• The tongue is pulled in at the tip, creating a heart shape
• The tongue does not reach the soft pallet of the roof of the mouth
• Baby breastfeeds with a chomping motion rather than suckling
• The baby makes a clicking sound when nursing
• The nipple is compressed after breastfeeding, shaped like a lipstick tube
• Nipple pain such as, cracked nipples and or blisters on the top of the nipple
• Baby “falls off” frequently
• Colic gassy baby with acid reflux
• Sleeping problems
• Slow weight gain

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If your little one is not latching, you’re experiencing pain or infections, or they latch but aren’t gaining weight well, have a professional check for a lip tie or tongue tie. You may be able to spot visible signs, but it’s best to have someone assess for you. Even a small tie might be creating big problems.

Breastfeeding with a Lip Tie or Tongue Tie 

Usually, pain is our first indicator of a problem. Sharp, shooting pains when you latch. Chomping, sudden pain while nursing. Sore to the touch all the time when blisters and cracks appear. Breastfeeding pain is difficult to work through and a good indicator that something needs to change.

While you are working to identify a lip tie or tongue tie and get it resolved, you have to take care of yourself, too. Soothing the pain ensures your ability to keep nourishing your little one without dreading a painful latch.

• Nipple Salve after breastfeeding sessions can ease the pain as well as soften hardened nipple tissue, blisters, and cracks

You might also find that your supply is lower than expected while you work to stretch or resolve the lip tie or tongue tie. This is because the baby isn’t as efficient. Remember your milk flows with supply and demand. When the tongue can’t stretch to massage the areola or the lip can’t stretch to provide proper suction, your body is missing the “make more milk” signals that a strong latch gives.

• Both my Let There Be Milk! tincture and Nursing Nectar tea work together to support your milk supply. Together, they tackle all angles of milk supply: digestion, relaxation, hydration, and direct milk production.

You might also be able to meet baby halfway by changing nursing positions or the way that you latch.

• For a baby who sucks their top lip under with a potential lip tie, try rocking their head as you move them onto the breast, bottom lip to top lip. This might help them position first before they get a chance to suck that top lip in.

• The football hold might give more control over the baby’s head and latch when a tie keeps them from managing it on their own.

• If the baby’s latch leads to sputtering and choking at the let down, try leaning back so that baby is almost laying face down on the breast.

• Be patient! Baby will probably need longer or more frequent nursing sessions since their latch is not as efficient as it could be.

• Work with your midwife, La Leche League leader, IBCLC consultant, or other support professionals to see if you can work out a latch that works with your baby and helps him to stretch and draw milk in spite of the lip tie or tongue tie.

• If needed, consult with a professional who can resolve the tie to free the baby’s lip or tongue to latch properly.

• Get gentle chiropractic adjustments or Crainio Sacral Therapy.

It’s not easy to breastfeed with a lip tie or tongue tie, but once you’ve identified the problem and soothed any pain, it is possible. Reach out to your local support network, check in with professionals, and let your love and milk flow -- even if it does take a bit of work to get there!