By Kamie, Contributing Writer
Like many alternative moms, I first started questioning mainstream practices and determining that I wanted to go the natural route during my first pregnancy. As I wrote my birth plan, I researched all the routine baby procedures that a hospital might push and firmly stated what I did and did not want to happen.
Unfortunately, I was a bit naïve and assumed that the birth would be the hardest part of having a new baby (and her natural breech birth was ROUGH). I was terribly unprepared for the transition to motherhood, especially the challenge I never realized breastfeeding could pose. Instead of even remotely resembling the sweet, peaceful moments portrayed in most breastfeeding photos, early nursing sessions always felt a lot like torture.
Once I was home with my new baby, I remember wincing in tears at just the thought of latching her on because it was so intensely painful. We were living internationally, in a culture that did not understand or even value breastfeeding, so my only real support was from online friends. The few ladies I knew personally who had successfully breastfed assured me that nursing was also uncomfortable for them in the early days and that over time, it would get easier.
Over the next several days, however, nothing was getting any better. In fact, things were getting worse as baby and I both became sleep deprived and stressed, and she struggled to gain weight. At two weeks I pulled out my breast pump and started supplementing with a bottle of breastmilk. Still, we were both frustrated. Every time I tried to latch her, she would scream, and I would cry.
When she was 3 months old, I finally decided that our sanity was more important than trying to get her to latch. And though it felt like defeat, I chose to exclusively pump and say goodbye to my nursing goals.
The greatest thing about failure is that it gives you so much valuable experience. A couple years later, when my second and third babies were born, I dug into research and found more resources. Because of that, I was able to nurse my second daughter for two years and my now three-year-old son still nurses a few times a day!
If any of this sounds familiar so far, I urge you to follow your gut.
If your intuition is telling you that something is off with your brand new breastfeeding relationship, listen to it! It’s so important that you find helpful resources early enough to make a difference and support both your growing baby and your milk supply.
Concerning symptoms may include:
- Painful latch for mom – more than just sore/tender nipples
- Mom has damaged, bleeding nipples
- Mom’s nipples look pinched and pale when baby unlatches
- Mom feels like her milk supply is too low or too high
- Mom’s breasts feel engorged or inflamed
- Baby makes a clicking sound when feeding
- Baby pops on and off the breast often
- Baby is fussy at the breast
- Baby feeds extremely often and never seems content
- Baby is slow to gain weight
- Baby is gassy, colicky, and generally unhappy most of the time
Where do I start? Lactation Consultants
If you’re noticing any of the symptoms above, I recommend you look for a professional lactation consultant first. Both CLCs and IBCLCs go through rigorous training programs. They can help you assess your baby’s latch for function (not just appearance) and make sure that baby is actually getting enough milk.
They can support you in finding minor adjustments that may help make nursing more comfortable for you and demonstrate how to properly latch baby (because moms and babies both need practice!). They can do weighted feeds, which means that they weigh baby before and after nursing to calculate exactly how much milk baby is actually consuming.
Learn the difference between a CLC and an IBCLC here: https://www.mamamend.com/postpartum-health/CLC-vs-IBCLC-choose-a-lactation-consultant
Here are some ideas to help find a lactation consultant:
- Ask your healthcare provider, hospital, birthing center, midwife, etc. – they may have recommendations for lactation consultants in your area or support groups.
- Reach out to breastfeeding support organizations – La Leche League has a directory on their websites that allow you to connect with local support here: https://lllusa.org/locator/. The Academy of Lactation Policy and Practice has a directory to find a CLC here: https://findaclc.org/. The US Lactation Consultant Association has a directory to find an IBCLC here: https://uslca.org/resources/find-an-ibclc/
- Talk to other moms – Connect with other breastfeeding mothers in your community or online breastfeeding support groups like Modern Alternative Mamas! or Human Milk for Human Babies. They may be able to recommend lactation consultants they have worked with and had positive experiences with or offer support online.
- Check with your insurance provider – they may be able to provide you with a list of in-network consultants or information.
Once you’ve found a lactation consultant, they can also help you determine if there may be a deeper issue hindering baby from nursing efficiently. That’s when you might need to find additional professionals to join your team.
Could it be Tongue Tie?
This is easily one of the most popular topics of discussion in the breastfeeding world. For anyone who isn’t familiar with oral restrictions or ties, here’s a brief introduction. There are seven natural attachments, or frenums, in the mouth: 1 under the tongue, 3 on the top lip, and 3 on the bottom lip. These frenums help to hold the mouth together and support full range of motion. A tongue tie is present when the tissue holding the tongue to the floor of the mouth (the lingual frenum) does not allow full motion of the tongue.
The lip frenums may be restricted or tied as well. For a newborn baby, this may contribute to a shallow latch, and lead to poor milk intake, while causing (often extreme) discomfort for mom. A frenectomy (also called a revision or release) is the procedure where a frenum is either clipped or lasered, in order to free movement and support proper function.
The presence of frenums is completely normal and natural. It’s when they are tethered or even just too tight that issues arise. To learn more about tongue ties, and when a release may be warranted, check out this blog: https://modernalternativemama.com/2019/07/31/tongue-tie-why-and-when-to-clip/
The important information to glean from that blog post is that there are different levels of restriction with tongue ties and not all of them require revision. This is why careful assessment by someone well versed in oral function is so important.
Here are some ideas to help you find a tongue-tie specialist:
- Check with your care provider, lactation consultant, or ENT (Ear, Nose, and Throat) specialists. They may be knowledgeable about tongue-tie or refer you to a specialist. Do not be discouraged if they are less than supportive about your inquiry. Some just do not like to see things outside of their allopathic approved wheelhouse.
- Find local pediatric dentists – look for ones who specifically mention tongue-tie as an area of expertise on their websites or professional profiles.
- Talk to other moms. Connect with other parents who have gone through a similar experience. Online support groups, local parenting groups, or breastfeeding support communities can be excellent resources for finding recommendations for tongue-tie physicians in your area.
- Utilize online directories: Several online directories can help you find healthcare providers who specialize in tongue-tie treatment. For example, IATP Tongue Tie Professionals
- Verify insurance coverage: If you have health insurance, ask what the requirements are for tongue-tie evaluation and treatment coverage. Many places are great about working with you regardless of insurance situation.
The Missing Piece of the Puzzle – Tension
If frenums are completely normal, why would they cause issues? While the discussion surrounding tongue ties often limits the concept to the tongue itself, in reality the tongue is connected to the rest of the body via the fascial system. The fascial system is part of the nervous system, so hopefully you’re already starting to see some of the complexities at play here.
In order to understand the full picture of breastfeeding difficulty and find a solution that truly addresses the root issues (without creating new ones) we have to look at the body as a whole. Tightness that your baby may feel in the tongue, jaw, mouth, and neck signals tension that runs the entire length of their body, from the head to the hips to the toes. A tight frenum should not be released without prior bodywork to relax this tension. In some cases, bodywork may help the oral frenums relax enough to allow proper function and avoid revision altogether. If surgical release is completed, the tongue then needs to be strengthened and retrained on how to use its full range of motion, otherwise it will simply revert to its default settings and the problems will persist.
Michale Chatham BSN, LMT, OMT is my favorite resource for gaining a full understanding of what is going on with tight or tethered oral tissue and how to best execute a release if necessary. During her career spanning more than 30 years, she has developed a conservative philosophy of tongue ties that allows her to step back, take a holistic approach, and distinguish between an actual tie and just a tight frenum.
Listen to her Freely Rooted Podcast here, where she explains the development of her unique philosophy after her health started to fall apart following her own tongue tie revision as an adult:
https://podcasts.apple.com/us/podcast/the-big-picture-of-tongue-ties/id1558059416?i=1000552167496
And watch her video here, where she explains why tongue tie revision should never be completed without bodywork both before and after:
https://www.youtube.com/watch?v=ciTx4KkerWU&app=desktop
One Common Cause – Birth Trauma
In utero, a baby’s movement is greatly restricted, especially if they are not in an optimal position. Their chin is tucked and their hips are tight. The process of gentle, natural birth is intended to elongate baby, lift their chins, stretch them out, compress their lungs, and prepare them for life on the outside. So bodywork is a great idea for any new baby as they acclimate to their new surroundings.
Today, the natural stress of birth is often compounded because many babies are born under difficult circumstances and exposed to the mainstream “cascade of interventions”. Some are born via C-section. Some require manual help with hands or forceps. Some babies find themselves in less than ideal positioning. They may be breech or posterior. Each of these scenarios is considered traumatic, even if they occur in a home or birth center.
Babies with oral restrictions are at particular risk. The already dense tissue at the base of their tongue and lips becomes even thicker and tighter, holding on to tension from trauma or stress during pregnancy or birth. Bodywork is essential for these babies in order to give them the best opportunity for full health.
Types of Bodywork
There are three main types of bodywork that are commonly used to assist with newborns to achieve the best breastfeeding outcomes: chiropractic, craniosacral therapy, and craniosacral fascial therapy. Each of these modalities focus on the release of tension. Craniosacral therapy and craniosacral fascial therapy work on the soft tissues of the body, while chiropractic care focuses on the hard tissue of the spine. When you have a newborn struggling to nurse, it’s best to find a chiropractor who is looking to the overall state of the nervous system as well. (Some chiropractors use noninvasive neurological scans as an objective gauge of the effectiveness of treatment.)
The best approach for you and your baby will always depend on what resources you have readily available to you. If you live in a city, you may have access to all three! I recommend you use the links below as a springboard to start your own research to find what resonates most with your unique situation.
When my third baby was born, he experienced a difficult posterior delivery (my kids have all insisted on being born in their own way). I was fortunate to have an awesome lactation consultant who also offered craniosacral therapy. She came to our home and did his first therapy session just a few days after birth.
He had a few more sessions over the next several weeks and each time we noticed marked improvement. He was nursing better and I wasn’t in pain anymore. I didn’t learn about the other two types of bodywork included here until a couple years later. Do not feel like you have to do it all or have everything figured out before you can get started. Just start where you can. It will make all the difference on your breastfeeding journey.
If you’re looking to find a bodyworker who specializes in newborns, here are some good steps to consider:
- Seek recommendations from trusted sources like friends, family, or colleagues who have experience with chiropractic care, CST, or CFT.
- Look online. Find more information on each of these modalities at these sites:
Craniosacral Therapy (CST)
https://www.upledger.com/pediatrics/
Neuro-Centered Chiropractic
https://pxdocs.com/navigating-the-challenges-of-tongue-ties-in-newborns/
Craniosacral Fascial Therapy (CFT)
https://www.gillespieapproach.com/tongue-tie-lip-tie-philosophy/
Search engines may find bodyworkers in your area who offer chiropractic care, CST, or CFT. You can search for specific terms like “cranial sacral therapy chiropractor” along with the name of your location. This can help you find professionals who specialize in the specific modality you are looking for.
- Don’t forget to check facebook groups! These facebook groups offer a wealth of information:
Neuro-Centered Chiropractic
https://www.facebook.com/drtonyebel
Craniosacral Fascial Therapy (CFT)
https://www.facebook.com/groups/128162437281535
- Read/ask for reviews and testimonials: Once you’ve identified potential bodyworkers who work with newborns with oral restrictions, take the time to read reviews or testimonials from their clients.
- Contact the bodyworkers: Reach out to the bodyworkers on your list to inquire about their experience with newborns and oral restrictions. Ask questions about their availability, fees, and practices.
