GUEST POST BY CAIT AHERN, of Soleil Lune https://www.soleillune.me/
When I tell people that I’m in training to become an IBCLC, they often ask what led me to this work. I usually say something like “I struggled with my firstborn and needed a team of support to get breastfeeding started, so I want to be that help for others.” Quick, simple, and true enough.
But the reality is that there are more honest answers I usually avoid.
Yep. You read that right: spiders. Don’t worry, I’ll explain.
My sweet, darling little boy struggled from minute one. He was colicky and wouldn’t latch. We spent about 5 days where I would pump (and cry) while he screamed, so that we could get enough colostrum to feed him with a syringe. We were back and forth to the hospital lactation consultant’s office multiple times before we could finally latch him with a nipple shield. Even with an oversupply and a nipple shield, my baby screamed as if he was starving, and I fed him around the clock. He never slept more than an hour and a half, even at night… for months.
This is where the spiders come in. When I would wake up at night to feed the baby, I would see spiders crawling all over the walls and ceilings. Shadowy, skittering spiders.
Terrified and confused, I would yell at my partner to help, he would jump up to turn on the light, and there would be nothing there but a disoriented me and a crying baby. After a few occasions of this middle-of-the-night confusion, we realized that there was something concerning going on. I was being sleep deprived into hallucinating.
While the spiders were unsettling, it was an obvious manifestation of the sleep deprivation, which made it easy to manage. The less obvious issue was my postpartum depression. The hallucinations boiled over, but the PPD, that simmered.
The breastfeeding pain, the sleeplessness, the emotional exhaustion. It wasn’t long before these all had me feeling hopeless and burnt out. I was angry when my baby needed to eat YET AGAIN. I didn’t want to go out in public where he might cry and I might be unable to calm him. I was sad that this wasn’t anything like I thought it would be. And I kept that all to myself.
At some point we acclimated, he started sleeping for slightly longer stretches, and we were able to ditch the nipple shield, but it was still hard. Even though I nursed my baby for two years, it was a struggle for the entire two years. And somewhere along the way, I decided that my work to do in this world is to help other parents like me. I don’t want anyone to struggle like we did for as long as we did.
The truly sad thing is that my story is not unique. Sleep deprived and depressed moms have been a common occurrence in my clinical experience.
The real tragedy is that there’s usually a single cause and a simple solution: tongue tie and its release. Undiagnosed tongue ties are very common, and it doesn’t have to be this way!
My son was living with an undiagnosed tongue tie, and it wasn’t until I received my lactation training that our experiences began to make sense. The inability to latch, the sleepy feeds, the frequent feeds, the gas and colic- these are all signs of a tie.
So what is a tongue tie?
Tongue tie, or ankyloglossia, is a midline defect of the frenulum classified by excessive or restrictive connective tissue under the tongue.
Babies who have extra midline tissue under the tongue have a limited range of motion and cannot elevate in the middle to create the negative pressure necessary to remove milk (basically, they push things out instead of drawing them in). This leads them to engage other muscles as compensations, which is an exhausting and inefficient process. The tied baby will often click or gulp while eating because their tongue is not strong enough to stay latched. The clicking and gulping leads to air swallowing and a distention of the belly, as well as excess gas and colic symptoms. Pain from the gas and stress from incomplete feeds can release cortisol which then affects sleep.
Who knew that a tiny string of tissue under the tongue could affect so much? Certainly not me as a new parent!
There is a lot of misconception about ties out there, and it can prevent families from seeking the support they need.
Have you ever heard that if your baby can stick their tongue out they aren’t tied? Or it’s only a tie if it goes all the way to the tip of the tongue? Or tongue ties only affect speech later on? Or if baby is gaining weight they can’t be tied? These are just a few of the many myths parents hear surrounding ties. The reality is that any baby or mom who is having symptoms should be evaluated for a tongue tie.
These symptoms can include:
- Nipple pain or damage
- Plugged ducts, thrush, or mastitis
- Low milk supply
- Misshapen nipples after feeds
- Sleepy feeds
- Long feeds
- Gas or colic
- Reflux or spitting up
- Frustration at the breast
- Choking, clicking, or gulping
- Mouth breathing
So, baby is tongue tied. Now what?
The greatest resolution of symptoms occurs when a simple procedure called a frenectomy is performed. A dentist or ENT with specified tongue tie training will use a laser or scissors to release the connective tissue under the tongue. For infants, this procedure can be performed without general anesthesia. A topical anesthetic is used for pain management during the procedure, which only takes a few minutes to complete.
The parents are asked to stretch the wound site for a few weeks after the procedure to keep the tongue from reattaching and symptoms from returning. It is critically important that parents follow up with the provider or a lactation consultant with tongue tie training in the weeks after the procedure to ensure that the wound is healing appropriately and all is well with feeding.
You might be asking yourself whether it’s worth the trouble to address. What if my baby is bottle-fed? What if my baby is gaining weight fine? What if mom’s pain is the only symptom?
Those are all great questions. But here's the thing, ties aren’t just about breastfeeding. It’s not even just about being a baby. Having a functional tongue is necessary for life long health. Babies with ties are more likely to grow into children who have issues swallowing solid foods, oral malocclusions, speech disorders, increased incidence of illness, and sleep disturbances. Disruptions to normal sleep patterns can be rough on the developing brain, so we often see focus and behavior difficulties in children who struggle to sleep well. Children with ties are more likely to grow into adults with autoimmune diseases, migraines, food intolerances, and sleep apnea.
I wasn’t kidding when I said ‘life long health!’
Where to get help:
As a mom, I wish someone would have offered this procedure to our family when my son was an infant. When I see babes in the clinic who find relief and peace after this procedure because their bodies are finally functioning properly, it’s hard not to wonder what our lives would have been like if my baby had been given that chance.
But here is my greatest wish: that no other family has to hold that same ‘what-if’ in their heart.
So, as a lactation care provider, my goal is to give parents comprehensive care and resources to resolve issues like tongue tie. I help clients make a plan of care for their personal needs, learn skills and tools to help mom and babe feel better, and provide referrals to clinicians in other areas of treatment. Treating these kinds of issues is usually a team sport, so this can include a release provider for a frenectomy, postpartum mental health support, body workers, or sleep specialists like Callie.
If any of this has sounded like you and your baby, please get in touch. Let’s make a plan to find your peace.
*Cait Ahern is the Certified Breastfeeding Specialist behind Soleil Lune Lactation Care, is training to be an International Board Certified Lactation Consultant, and anticipates certification in Spring 2021. She provides lactation consults in the Treasure Valley area of Idaho through telehealth, home visits, and office visits. For scheduling and more information on tongue tie please visit www.soleillune.me