Author Nancy Mohrbacher, IBCLC, recently wrote a thought-provoking blog post about mothers who self-diagnose tongue ties in their babies and seek revisions. This is a trend that is having a significant impact on the work of many La Leche League Leaders.
Mohrbacher thinks that is because, even though there may be a tongue tie present and possibly causing a problem, these mothers are not getting help with the most basic issues of latch and positioning. Therefore, they are not solving the whole problem. She encourages mothers to seek help from volunteer mother-to-mother support groups such as LLL or from an IBCLC before self-diagnosing tongue or lip ties.
What does that mean for us as Leaders? If a mother calls or comes to a meeting complaining of nipple pain that she is attributing to a tongue or lip tie, according to Mohrbacher, we should first try to help her improve her positioning to get a deeper latch. Mohrbacher quotes several lactation consultants who say that helping mothers get a deeper latch improves the comfort and effectiveness of breastfeeding for a large percentage of their patients.
In addition to the telephone and in-person help that Leaders provide, sharing videos and pictures can be incredibly helpful. As Christina Smillie has said, “If a picture is worth a thousand words, a video is worth one million.” Leaders can continue to follow up to offer support and to ascertain that an improved latch has helped ease the mother’s pain.
If the pain or poor transfer of milk hasn’t resolved with a deeper latch, then pointing out the possibility of a tongue tie might be appropriate. Remember, though, that other causes of pain, including bacterial and yeast infections and skin conditions, may be present. In any case, Leaders best serve the mother-baby dyad by encouraging contact with a health care provider to have the condition evaluated.
While Leaders can offer a lot of information, we are also sought out for our empathetic responses that help mothers get through difficult breastfeeding situations and challenges. As a wise Leader once reminded me, “The difference a Leader makes lies in how she shares information.” As Leaders, our role is to share information and support, never to give advice.
We need to develop the communication skills necessary to couch our knowledge as information, rather than as instruction. When it comes to tongue tie, it’s the difference between saying “You should have your baby’s tongue clipped,” versus—at the end of much empathetic listening and latch assistance—mentioning that “some mothers have found having a qualified health care provider evaluate their babies’ tongues can help improve breastfeeding.”
Haham, Alon, et al. 2014. Prevalence of Breastfeeding Difficulties in Newborns with a Lingual Frenulum: A Prospective Cohort Series. Breastfeeding Medicine 9:9.
Mohrbacher, Nancy, "Tongue and Lip Ties: Root Causes or Red Herrings?" Breastfeeding Reporter (blog), November 16, 2014. http://www.nancymohrbacher.com/articles/2014/11/16/tongue-and-lip-ties-root-causes-or-red-herrings.html.
IMGP1686 – Celeste Burke
Perfecting the Latch – Roshnii Rose
Mom with grandmother and baby – U.S. Department of Agriculture