Babies with posterior tongue tie have limited mobility of their tongue. This often results in problems with breastfeeding, which in turn can negatively affect mom and baby. If you’re a mom whose baby is suffering from this condition, you are most probably looking for ways to make breastfeeding a better experience for you and your baby until you receive professional help and advise. That’s exactly why I did some research about certain breastfeeding positions and techniques for babies with a posterior tongue tie.
What breastfeeding positions are helpful for a baby with a posterior tongue tie. Breastfeeding positions in which the mother has her palm behind the baby’s shoulders and can exert gentle pressure throughout feedings will assist with improving a breastfeeding session. This includes the cross cradle hold and the football hold. The laidback breastfeeding position is also helpful when feeding a baby with a posterior tongue tie.
I will talk about these positions in more detail and how they could specifically help you breastfeed your baby with a posterior tongue tie. But first, let us have a quick discussion about what a posterior tongue tie means and the possible breastfeeding problems that may be encountered in relation to this condition.
What is Posterior Tongue Tie
When we think of tongue tie, we imagine a baby with a very noticeable membrane also called the frenulum when they cry or open their mouth. Known as anterior tongue tie, this can be easily diagnosed and treated. Posterior tongue tie in babies, however, is a lot less visible and harder to spot. It is located beneath the mucous membrane or the surface layer of the skin. The frenulum or membrane attaching the tongue to the base of the mouth may or may not look abnormal. It may also be present along with an anterior tongue tie. In addition to this, the frenulum is mostly made up of collagen instead of elastin. This abnormality impedes the normal movements of the tongue within the mouth.
Effect on Breastfeeding
For breastfeeding to be effective, a baby should be able to move his tongue freely to get a good latch. This makes it a problem for babies suffering from a posterior tongue tie. Posterior tongue tie mostly results in them being unable to elevate their tongue upwards towards the palate. This movement is crucial when breastfeeding. The lack of a strong upward movement results in your baby not being able to suckle effectively. Most often, babies with this condition resort to nipple feeding rather than breastfeeding. This becomes very uncomfortable and painful for the mother and will not satisfy baby even if he feeds frequently.
Here’s a list of some of the breastfeeding problems that may be associated with posterior tongue tie:
For the baby:
- Latch difficulties (completely unable or shallow latch)
- Losing suction while breastfeeding (you may hear a clicking sound indicating suction was lost)
- Breastfeeds often but not getting enough milk
- Difficulty coping with the fast flow of breast milk and may subsequently refuse feeds
- Poor weight gain
- May develop jaundice because of insufficient milk intake
- May develop colic and reflux due to excess air swallowed from nipple feeding
- May have sucking blisters on his lips
For the mother:
- Pain due to baby’s poor latch and sucking
- Sored and distorted nipples (right after feeding, it may appear wedge-shaped, with a stripe at the tip)
- Blocked ducts, engorgement or mastitis because breasts aren’t effectively emptied.
- Ineffective milk removal and inadequate stimulation mat decrease milk supply.
- Frustration that may lead to weaning baby prematurely.
Breastfeeding Positions and Techniques
As mentioned above, breastfeeding will become harder for you and your baby if posterior tongue tie is present. If you are experiencing any of these difficulties it’s important you contact your health care provider or more specifically a lactation consultant. In the meantime, before you receive profession help there are a few things you can do to make breastfeeding a little easier for you and your baby. Below I have described three breastfeeding positions that can help with latching your baby to the breast and to give some more comfort to both mom and baby when feeding.
Babies with posterior tongue tie have difficulty latching on to mom’s breast. Experts suggest that with a laid back position, the baby is given the opportunity to get into his most comfortable position. Eventually, he will latch on to his mother’s breast more effectively. This position also promotes the use of gravity in helping the baby’s tongue to be pulled forward and feed more efficiently. In addition, skin-to-skin contact initiates baby’s instinctive reflexes to latch and feed unto her mom’s breast. This breastfeeding position is ideal when you are sitting comfortably at home. It may be more difficult to nurse in this position in public places.
Here’s how to do the laid back breastfeeding position:
- Recline with several pillows behind your back, neck, and shoulders. Position as if you were about to relax and read a book.
- With your baby facing you, place him on top such that you are tummy-tummy with your baby.
- Allow a few minutes for your baby to adjust his head and mouth and latch on your breast.
- Nurse while one of your hands is gently supporting your baby’s back.
Cross Cradle Hold
This breastfeeding position is a variation from the classic cradle hold. In this position, one arm will need to cross over and support baby’s head and back, the reason why it is also called the cross- over hold. With your arms switching roles, you can promote close proximity to your baby and help him latch more effectively, making it very beneficial if your baby has a posterior tongue tie.
Here’s how to assume this breastfeeding position:
- Sit comfortably in your chair, sofa or bed.
- If you are breastfeeding with your right breast, use your left arm and hand to hold and position your baby.
- Your baby’s head and body should be aligned and facing towards you.
- Position your left thumb and fingers just under your baby’s ears for support.
- Guide his mouth to your breast, wait until he got a good latch and nurse.
As its name suggests, this is a position similar to someone holding a football. Others may also call it the clutch hold since it also assumes the position when you are holding a clutch bag. This breastfeeding position is ideal for babies who are having troubles latching on, like babies with a posterior tongue tie. This position also offers more comfort if the breastfeeding mom just had a Cesarean section, has large breasts or flat nipples.
Here are the steps on how to do a football hold:
- Place your baby at your side and under your arm.
- Your baby must be facing you.
- Position your baby such that his nose is right under your nipple and his feet is pointing at your back.
- With your free hand, place a small pillow across your lap or just beside you. Use this pillow as additional support for your baby’s back and head.
- Use your free hand to support your breast in a “C hold”. Assume a letter C, with your thumb on top and fingers below the breast.
- Guide baby’s chin first to your nipple and offer him time to latch on.
- Be careful not to push your breasts unto your baby too much in such a way that he’ll struggle. One common sign that you’re putting in too much pressure is when your baby is arching his back and resists to feed.
Can tongue tie resolve by itself?
In mild cases tongue tie does not present any problems to mom or baby and breastfeeding is not a problem. However, in most cases, treatment with a frenotomy is usually the best course of action. This will ensure breastfeeding can continue. Other problems associated with tongue tie such as speech development will never become an issue. It is important in particular, to be aware of posterior tongue tie as many cases are often left undiagnosed. Many moms may not be aware their baby has this condition.
Can tongue tie affect speech development?
Language and articulation involve tongue movements so if a baby has a tongue tie, it is possible for him to encounter speech problems as he gets older. According to experts, tongue ties usually cause difficulty in articulating words with “t”, “d”, “z”, “s” and “r” because pronouncing these letters involves retro-flexing the tongue. However, it is also important to note that not all babies having a tongue tie will have speech problems later on in their life.
Is tongue tie procedure painful?
The younger the baby is, the less nerve and blood supply is present in the frenulum. This means the sooner your baby undergoes the procedure, the less likely it will hurt.
Some doctors introduce anesthetic to babies 4 months and older because of their hypersensitivity and ability to resist. For younger babies, the procedure is often done without anesthetic. Experts say the procedure causes a minor sting and the baby can usually go on breastfeeding immediately after the procedure to soothe.
Overall, a posterior tongue tie may impact your breastfeeding experience but there are ways to make it better for you and your baby. If you think your baby has a tongue tie of any kind, it is always best to have him checked by a pediatrician or lactation consultantfor appropriate evaluation.
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