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The ties that bind - when your baby is tongue-tied


Sophie White with her baby son, Rufus.. Photo: Tony Gavin.

Sophie White with her baby son, Rufus.. Photo: Tony Gavin.

Sophie White with her baby son, Rufus.. Photo: Tony Gavin.

My breasts were always a great source of disappointment to me. In my teens, they were barely there. As I was plagued by puppy fat, I thought it grossly unfair that I didn't at least have some compensation in the boob department.

In my 20s, I made peace with my mini mammaries. I flung off my (admittedly, unnecessary) bras and embraced the minis as an asset that enabled me to pull off high-necked shirts and sheer tops without looking slutty. Hurrah! What I didn't realise was that my greatest boob struggle was just around the corner.

When my baby arrived, the boobs decided, once more, to disappoint me. I just could not seem to breastfeed him. I experienced the baby blues, the sleep deprivation was crippling and I hated my life most of the time, but, with hindsight, I genuinely believe the struggle was largely driven by my apparent inability to feed my son.

Remarks like "every mother is capable of feeding their baby" and "there's always milk for baby" haunted my internal monologue of self-beration.

I had been warned that breastfeeding was very difficult for some women, but that if I just pushed on, I'd make it. There is a bit of a culture of judgment when it comes to breastfeeding and, 
let's face it, parenting in general. And maybe it's just me, but I was actually more embarrassed to be seen to 
bottle-feed my baby in public than I 
was to whip out a tit.

I endured eight weeks of nipple pain, crying in the shower, hating my son and trying to pretend I was fine. Believe me, I don't think that I am unique in any of this, nor that I was in particular need of psychiatric attention. I was just hitting breaking point and I introduced the bottle out of necessity, but breast is best, after all. I was convinced that I was already failing at motherhood and I just couldn't seem to let go of the breastfeeding.

My mother and my husband were begging me to give it up. My baby boy was, seemingly, starving. He fed continuously and never appeared sated. He cried and cried, and so did I.

To boost my milk supply, I was taking six tablets of Motilium, plus nine capsules of fenugreek each day, and 
OD-ing on fennel tea. I could usually be found attached to either a baby or a double breast pump.

I returned to the maternity hospital's lactation consultants on four separate occasions for private appointments. My 
baby was about six weeks old when 
I was finally referred to a private lactation consultant, who spent two hours at home with me, observing my son feeding. She examined his mouth and diagnosed him with tongue-tie. It was the first time I had heard the expression. The medical name for the condition is ankyloglossia.

Tongue-tie is when the frenulum under the baby's tongue is too tight or too short and hinders tongue function. I learned that tongue-tie could affect breastfeeding, because the baby is unable to extend the tongue to cup the mother's nipple. The condition is linked to breastfeeding issues like nipple pain, poor milk supply, inefficient feeding, continuous feeding, recurrent mastitis and a failure to thrive in the infant.

Undiagnosed, tongue-tie could be contributing to our low national breastfeeding rates. A baby with 
tongue-tie can often appear to have 
a good latch, yet the breastfeeding 
will be, as I can confirm, torturous. Fiona Rae, my private lactation consultant, recommended a frenulotomy to snip my baby's frenulum and increase his tongue function.

When I told people about the diagnosis, I detected scepticism from some corners, which didn't surprise Rae one bit: "I've heard that a paediatrician told a mum, 'it is a fad in babies'. It's the new thrush, or the new whatever."

I researched the procedure extensively online and found a lot of other mothers who said that a frenulotomy improved their baby's breastfeeding ability immeasurably. I found it difficult to believe that an apparently straightforward intervention, which 
could have such a positive result, 
was not being highlighted in the 
current pro-breastfeeding climate.

I have a healthy distrust of the internet and was loath to do anything so permanent to my baby. I hesitated a further two weeks before booking 
an appointment with Dr Alan O'Reilly, the only doctor performing the procedure (at the time) in Dublin.

Fiona Rae laments the lack of information concerning the procedure: "The HSE has an information page on tongue-tie, but they don't have a list of where to go for treatment. And, because it's not easy to find, it makes it very difficult for a new mother to get any confidence in the procedure".

Dr O'Reilly began his frenulotomy clinic in August 2013 because, he says, "it was only being performed by four people in the country at the time. Families were avoiding having the procedure done because the option was to drive hours with their newborns." He added, "between September and January, I did 40 procedures, and it was 87pc successful, in terms of the mother continuing to breastfeed."

Tongue-tie is most definitely not a fad. Holles St lactation consultant, Catherine McCann, says, "If you go back to the 1900s, after the birth, the midwife would examine the baby's mouth and, if that baby had a tight frenulum, it was snipped immediately.

"But it went out of vogue in the 
1940s and 1950s because babies could bottle-feed. It's only now, with the emphasis on breastfeeding, that it 
is coming back to being an issue again."

I stayed in the room while the procedure was performed on my baby. This was difficult, as a frenulotomy can seem like an aggressive procedure to perform on such a young child without anaesthetic.

But, as Dr O'Reilly says, "a look at recent evidence shows it's almost zero 
in terms of complications. We quote 
a one-in-300 risk of a small bleed, and 
a one-in-10,000 risk of infection."

My baby cried during the frenulotomy, but I was able to comfort him with a bit of boob immediately after, and, within the next 24 hours, I noticed a radical difference in our feeding.

The procedure is by no means a 
cure-all and there are feeding problems not related to tongue-tie but, after 
first-hand experience, I'd tell parents 
not to hesitate, if the procedure has 
been recommended by a health professional.

Thankfully, for other families, the HSE are now working towards setting up a national policy on tongue-tie, led by Siobhan Hourigan, the national breastfeeding coordinator.

Dr Alan O'Reilly, Meath Primary 
Care Centre, Heytesbury Street, D8, 
tel: (01) 453-6636.

Fiona Rae, private lactation consultant, tel: (087) 632-4967

Sunday Independent