Tips for Breastfeeding a Baby With a Tongue Tie

When my daughter was born we had issues establishing breastfeeding. Feeding her was painful, and her weight gain was slow because she was tongue-tied. My memories of the early days of motherhood are still a haze to me, but by far one of my clearest (and saddest) memories was of looking at my perfect baby girl, willing her not to wake up. I couldn’t bear to feed her again. My nipples were bruised and cracked. I was on strong painkillers, because I had an emergency C-section, yet even with those, the pain far outweighed the wound I was recovering from. For various reasons, I was feeding my daughter for seven weeks before her tie was fully released and feeding started along the slow path to improvement. I won’t dwell too much on my story, perhaps I will tell it more fully one day on another blog. The purpose of this one is to share a few things I found helped me during the long weeks, plus a few things I have learned during my training in breastfeeding support.

There may be many reasons you are waiting to have a tongue tie division or indeed you may have decided the procedure isn’t the right decision for your family. Here are a few ideas and tips for you to consider.

Seek experienced feeding support whatever position you find yourself in. Find a lovely boob group too. Whatever happens on your breastfeeding journey, remember it is a journey. Sometimes a division isn’t an instant fix. Ongoing experienced support and moral support can be really helpful. Find a breastfeeding group here.

A breastfeeding counsellor or IBCLC can help you experiment with different positions. Some positions which work well for tied babies include laidback breastfeeding, the rugby hold, the straddle hold. Pay particular attention to the fundamentals of good attachment as this may be a harder to achieve with a tongue tied baby.

Get skin to skin! Skin to skin feeding can really help encourage a baby’s natural latching reflexes and has the added bonus of removing layers which separate you and the baby. It may just make that bit of difference.

Experiment with exaggerated latch techniques. These can be really helpful to encourage a deeper attachment. Options include tilting the nipple (“flipple”) or shaping the breast (“breast sandwich”).

It can be really helpful to use a couple of different positions while feeding when feeding is painful. This is because it stops the same part of the nipple being hurt and potentially damaged at every feed.

If baby struggles to transfer milk effectively while feeding

If feeds are very lengthy, painful or your breasts don’t feel relieved afterwards- there are a couple of things you can try. Breast compressions can improve milk transfer. Switch nursing can keep an ineffective feeder from falling asleep too soon at the breast and maximise milk intake. Combining both techniques can be particularly effective. Using both techniques during a feed might look like this; offer boob one, when the baby looks like their sucking is slowing (fluttering) or getting sleepy use compressions to speed up the milk flow again. You might find that sleepy baby springs awake again because babies often respond to milk flow! Once compressions become less effective, switch baby to side two and repeat. Once the same thing happens, then offer the first side again, and continue switching until baby signals they are done. You will ideally offer 4 sides minimum per feed.

Patience and support are important when feeding tied babies. Feeds may take longer than average and babies may feed more frequently to compensate. It can be helpful to reflect on your wider support network. Can someone help around the house or with other children while this is going on? Can your partner/family/friends offer any extra support?

Keep a close eye on nappy output and weight gain, and keep in contact with that experienced breastfeeding support I talked about earlier. An experienced supporter can help you to decide if your baby needs additional supplements of expressed milk and give you information about how best to do this while protecting your milk supply.

Sometimes the baby may be doing well but you may be struggling with engorged breasts, blocked ducts and even bouts of mastitis. If this is the case, firstly ouch, I am so sorry! One thing to consider may be expressing milk for a short amount of time after feeds to soften the breasts. This may also protect your long-term milk supply. If you need support with blocked ducts this factsheet might be useful.

“I can’t carry on! Feeding is too painful!”

Nipple shields are often considered by mothers in this situation. There can be some pitfalls to using shields, but if it is a choice between a shield or a bottle, a shield might be the better option. Ideally, shields need to be used with support from experienced breastfeeding support. Attention still needs paying to try to achieve a deep latch. Here is some more information to consider while using a shield.

I can empathise when mothers decide to use a bottle because they have tried so many options, and feeding is just too painful. Sometimes a mother may have nipple damage and just can’t bear feeding on demand at that time. I know how tough it is. If this is you remember to talk to your breastfeeding support person. In an ideal world you will still offer the breast for at least some feeds in a 24 hour period. As babies get bigger often latching can improve. It may also help with transition back to fully breastfeeding if this is what you want to do. Continuing to offer the breast, even if it is only a small amount to practise breastfeeding, protects your options down the line. If mixing breast with bottle, paced feeding techniques can be helpful to reduce the risks of bottle flow preferences. There are also alternatives to bottles, for example syringe or cup feeding.

If your baby is not breastfeeding much, or not at all, you may find the following information links useful:

Information on expressing: https://www.laleche.org.uk/expressing-your-milk/

Maintaining milk supply if the baby is not directly breastfeeding: https://kellymom.com/bf/got-milk/basics/maintainsupply-pump/

If using bottles or formula continuing to express when baby has a bottle can help support your milk production. Remember skin to skin is not only great for supply, but does good things for both of you, so keep baby close however you feed them. If you are using some formula it is important to prepare it safely.

Nipple damage

If you have sore nipples but no open wounds, there is no evidence a cream is more helpful than using your own milk rubbed into the nipple.

If you have bruising, the usual treatment for bruising can be helpful such as cold compresses after feeds.

If you have open wounds, moist wound healing may be helpful. This is essentially treating a cracked nipple like a cracked lip and not allowing it to dry out. Cracks in nipples that dry out may split open again at every feed, and this can be very painful. Keeping the crack soft can help healing from the inside out. There is no evidence any one cream is better than another, some mums prefer a lanolin based cream but soft white paraffin (Vaseline) can be just as effective and cheaper. Do use a new pot though and not something that’s been knocking about in the medicine cabinet for donkeys years! Both of these options are safe to breastfeed with, no need to wash off. Just wipe any excess off before feeds.

While we are on the subject of washing, if you have cracked nipples it is essential the wound is kept clean to prevent infections. Some mums use a fragrance-free soap (some babies can be bothered by strong perfumes), others prefer a salt water rinse like the one suggested here.

It might be helpful to start feeds on the least sore or damaged side, babies tend to suck more vigorously at the start of a feed. If you do this, listen to your body to make sure the other breast is still adequately having milk removed, via expression if necessary, to help avoid any engorgement or loss of supply.

If you are in a lot of pain feeding here is information on analgesics which you can use to help.

When you have a long wait for a tongue tie division, I know it can feel impossible. Like an eternity. Those early weeks can feel like months even when things go smoothly. I can totally empathise how overwhelming it might feel. I can’t tell you whether to stick it out, or what is best for you but I can tell you that you are stronger than you know you are.

I remember one day being asked why I had persevered with breastfeeding for so many weeks despite painful challenges. This is something I’ve considered a lot because on that day I couldn’t give an answer.  One thing I have come to understand is often it isn’t really about “the milk”, it is about an inner desire for this connection to our babies. Focusing on that can be more motivating than anything else. Try to remember why you started breastfeeding and why it is important to you. Encourage your partner to remind you of this. Hold on to any moments that are positive. Remember any breastfeeding you can do is significant. Setting small goals can be helpful- try to think about making it to the next day, or next week rather than longer term. This will all pass someday. By setting small goals one day you might suddenly realise you have stopped setting goals to get to next week and will know that the worst is behind you.

Whatever you decide to do, make sure you have support so you can talk it through and feel empowered to make decisions you feel at peace with. Finally, remember, there are lots of us out there to support you. You got this mama💚.

For more information and support:

Association of Tongue-tie Practioners for information about tongue tie

If you need support or someone to talk to fast about the issues you are having try the National Breastfeeding Helpline

Facebook tongue tie support group

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Parenting with Social Anxiety

social anxiety and parenting 2

Confession time. This is a scary blog to put out there. I’ve dithered posting it and re-drafted it a million times because it is so personal. But here goes. I struggle with social anxiety. Some close friends and family already know this about me. Some people might be surprised I guess. It is something I have lived with to varying degrees since I was a child. Over the years I have developed coping strategies, and mostly, I get by. I can usually play the part of a functional adult. However, still, on very bad days the idea of the smallest interaction with someone else can make me feel pretty stressed.

My anxiety was probably worst during my pre-teen years and adolescence. At its peak, during my first year at secondary school, I barely talked to another person, aside from my teachers, or family. Not an exaggeration. It was a really unhappy time for me. I am amazed now, that not a single teacher spoke to my parents about it. This was during the ’90s. I hope social anxiety is more recognised now, that young people get more support than I did.

What is social anxiety?

Social anxiety isn’t simply shyness. It’s intense fear that can affect everyday life. Lots of people feel uneasy in social situations. However, for someone with social anxiety, those feelings can be very difficult to manage.

According to the NHS, you may have social anxiety if you:

  • dread everyday activities, such as meeting strangers, starting conversations, speaking on the phone, working or shopping
  • avoid or worry a lot about social activities, such as group conversations, eating with company, and parties
  • always worry about doing something you think is embarrassing
  • find it difficult to do things when others are watching – you may feel like you’re being watched and judged all the time
  • fear criticism, avoid eye contact or have low self-esteem
  • often have symptoms such as feeling sick, sweating, trembling or a pounding heartbeat (palpitations)
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Personally, my anxiety manifests in a few ways. Much of the above is very familiar to me. For example, in a conversation with another person, I am often half listening, wondering how I am coming across to the other person. What are they thinking? Do they like me? What should I say next? Did they just give me a funny look? Am I boring them!? This distraction isn’t a lot of fun for the other person either to be fair. On bad days this internal narrative is so overwhelming my mind goes blank, and I cannot think of a thing to say. Sometimes, I respond almost defensively to the most innocuous of questions. A simple, “How are things with you guys?” can send me into a panic. I desperately try to think of something interesting to say, and fail, awkwardly shrugging “Oh well, you know, nothing really”. Then I spend the rest of the day (even days) berating myself.

I apologise to all my friends who have endured these painful interactions with me. Thank you for seeing past it all and being kind. In truth, I am luckier than some. I have a loving husband and family, I have had help, my anxiety is always there, but mostly under control. I can go to a party where I don’t know people well. I have some good friends. Held down a career in freelance design. I do volunteer work that I love. You see, I do actually want to be around people. People think socially anxious people don’t want to socialise, and that’s just not true, at least not for me. It is just we also find it incredibly difficult.

Parties or gatherings of large people can be most difficult for me to navigate. I  make sure these days, that I don’t allow my anxiety to control whether or not I go. I used to just turn down invitations to parties. I still get that white-hot fear though, when I walk into a room full of people even if I know most of them. How I feel the event went can have a profound impact on my mood. If I think I managed to navigate it with more ease than usual, I am happy. If I have an awkward moment, not only am I anxious about how that must have looked, but it descends into this horrible feeling of shame and embarrassment about who I am as a person later. The self-loathing sometimes lasts for days. Regardless of how the event went, I am often exhausted afterwards.

At 35, when I had my baby, I was thrown into a new world. I suddenly had to have adult conversations in a room full of parents I didn’t know, a situation which scares the pants off me. I didn’t do many classes and groups. I often found myself making an excuse to avoid them. “Those classes more stress than they are worth” (true, but not entirely the truth). I went to one baby group where not one person spoke to or made eye contact with me. It was such a triggering experience, I didn’t ever try another local village group. Despite tons of breastfeeding issues, I think my daughter was months old before I managed to get to a breastfeeding support group without a friend. The kindness of peer supporters and mothers there made that group my lifeline really. Thank goodness for boob group, NCT friends and Facebook because I think these things actually saved me from acute loneliness in the early days of motherhood.

People sometimes don’t believe me when I say I now do volunteer work yet am socially anxious. Especially when I say I also do telephone support and they are familiar with me dithering around, taking a week to call a plumber! However, my support work is so much easier to navigate than a baby group. It is like putting on a costume. I have conversational tools from my training to support women. There are some questions you always have to ask, some issues which are so very common, these things form a kind of familiar script, so I always have something to say. Silences are encouraged so it gives me time to think. I am often asked about specific issues and have a bank of knowledge I can draw from to move the conversation forward. Crucially, I am not focusing on myself, but on someone else. I can largely forget about what people are thinking about me. I don’t have to worry about making the mums I support my friends. In fact, it is actively discouraged. The tools I have gained in training have been immensely helpful to me in ‘real life’ social situations, however, and it has really built my confidence.

As my daughter gets older I now find myself often scrutinising her interactions with other children. My biggest fear is that she ends up like me. The maddening thing is, I know the more anxious I am around people in front of her, the more likely this is. This encourages me to navigate situations I would have previously avoided. My daughter drives me on to be my best self. While she is a little shy as a child and often overwhelmed in busy situations, I have seen how well she interacts with other children at nursery or smaller groups. I try to reassure myself she’s doing fine, and no different to many of her peers. Next year she starts school. I cannot articulate how worried I feel for her. I desperately hope she does ok, that she makes friends and has a “normal” experience.

If you are a parent with social anxiety but you push yourself into situations which make you anxious try to remember this: it takes guts. Finding the courage to go to that group is amazing. Even if you don’t speak to anyone, feel proud. You were brave. Being a parent with social anxiety can be hard. You may lose the “crutches” or coping strategies you had developed pre-children. On top of this, as parents, we may be dealing with a loss of our professional identity and other parts of ourselves. You are navigating a new beginning. Like many new starts, if you lack confidence, it can be even more stressful. So give yourself credit where it is due.

I still remember the girl who finally befriended me at school during my worst period of social anxiety. I don’t think she knows what she did but she made a lifelong impression with her kindness. My appeal to everyone is, please say hello to that quiet mum in the corner of the playgroup if you can. Make eye contact, smile, reach out, be kind. Sometimes, someone is standoffish because they are anxious. Please be forgiving. Engage that scared looking person in a conversation. It might not be the start of a beautiful friendship, but you might be the person who helps them get through the day smiling or encourages them to come to the group again. They may actually make a friend or two eventually. Small gestures count. Make them a cuppa. You never know the difference your kindness might make to someone.

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Social anxiety support:

If you can relate to the issues raised in this blog, first and foremost, seeing your GP might be helpful. You may also have local counselling services you can self-refer to. CBT is considered one of the most effective interventions for social anxiety.

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Before You Tell a Breastfeeding Mother to Cut Out Dairy, Consider THIS

Why supporting a breastfeeding parent with their diet is really important if their child has CMPA

giving up milk

I’ve always felt we need to tread very carefully around suggesting dairy elimination for mothers before basic breastfeeding issues have been worked out, and recently I have had personal experience of why it is so important to be mindful.
I don’t consume any milk products anymore, because my daughter has CMPA and I am currently breastfeeding her. I was keen to keep breastfeeding. Breastfeeding a baby with CMPA is really important, it avoids many of the pitfalls of using dairy free formula (like the bad taste), and it protects and safeguards your child’s nutrition. Mothers should absolutely be supported to do this if they need to. At first, I was amazed at how good I felt when I cut out milk (and I still believe it doesn’t agree with me).
2 years in, I’ve recently discovered the downside. I’m currently taking v high strength vitamin D, calcium and omega 3 oils because despite spending so much of my time supporting others and knowing all the recommendations to supplement and be careful with diet, my levels got low, really low. I actually started to feel quite unwell, mentally and physically.
You see, lots of people like to say dismissively “Pfft, we don’t actually NEED milk”, and this is true, however, our bodies do need the nutrients within it. Fats, Calcium, Iodine, Vitamin D. Some milk also has Omega 3 added to it. Non-dairy milk and dairy substitutes often contain lots of Omega 6 (sunflower oils, nut oils etc) but we need a balance of both Omega 6 and Omega 3 at the very least, and while following a non-dairy diet, if you aren’t careful it can be easy to throw this out of balance. Omega 3 is thought to play an important part in reducing inflammation in the body, inflammation is linked to things like joint pain, chronic illness, weight gain, and depression.
Removing dairy from the diet is a huge dietary change, we need to be mindful of that. In my opinion, breastfeeding parents who need to avoid dairy should be offered support with their diet, rather giving them a blanket recommendation to supplement (NICE guidelines), however, unfortunately, the guidance only discusses dietetic input in regards to the child. I feel this is a huge oversight, when treating breastfeeding parents and children it is surely better to treat the dyad, but that aside, things that can help are:
Sometimes, depending on your diet, considered supplementation may be needed.
It is easy to make light of the impact milk elimination might have on a mother’s body, or to forget about this ourselves, especially when we are busy parents whose primary focus is our child. It is easy to let nutrition slip when you are tired and touched out anyway, let alone if you are avoiding a major food group. So if you have an allergic child, I am sending you so much love, I know it is tough! And what you are doing is so important for your babies, and so wonderful, just make sure to take care of you at the same time.
More information and sources: