The Modern and Decontextualized Lens of Tongue Ties

This could be a 10,000 word post, but I will keep my thoughts brief and to-the-point. I have been working with mothers for over a decade. I knew nothing about breastfeeding when I first started working in an OB surgery unit ten years ago. I almost remember being disturbed by breastfeeding when I saw it (rarely) - thanks a lot society and mom!! But the reality was, I could not stop thinking about the biology and human design of breastfeeding. I knew intuitively it was what was best for babies. So, as my fascination grew, so did my curiosity. If it was as simple as more support, than would we just do that and more women would breastfeed?

The issues with breastfeeding are SO complex at this point and society is completely plagued by misinformation, inappropriate expectations of infant biology, and an unaligned “mother first” approach to care (which intends to separate mother and baby). In reality, when we support the mother-baby dyad, when we have appropriate expectations, and when we are given GOOD information, breastfeeding comes naturally. I know we are not supposed to say that for fear of disturbing the formula mamas here, but the facts are this, when women know, we know. And we cannot unknow. We know. So once you know, you know that breastfeeding really does come easily.

Which leads me to the issue. The modern tongue tie world. The issue with taking women out of the leadership role and separating the mother-baby dyad. Taking the focus and putting it right on baby’s mouth. That’s it. Just their mouth. Meanwhile, we have an entire system that is mother and baby and environment. Can you see what I mean about decontextualization?

Time and time again, women end up in my office saying someone said they “have” to get their baby released “or else.” Usually the or else is that they won’t breastfeed, but when providers see baby doing reasonably well breastfeeding, they cannot help but make the “or else” something else scary down the line. They won’t breathe well, they’ll struggle with sleep, they’ll end up on the airway train. Unfortunately, they aren’t wrong. But their view is too narrow and their mission is to scare into submission. Rather than taking a much wider view of the family ecology, the relationship between mother and baby, the birth, the environment, the support etc. Then, when we clean that up, and we put the power back in mom’s hands, we often find no need for a release and then symptoms magically improve. Baby comes off the “train” so-to-speak. They end up thriving.

If it’s so simple, then why are more providers not offering these options to moms? Because they cannot see it. They have too narrow of a lense. They have completely and disgracefully decontextualized the infant’s mouth. They do not see how the mouth interacts with the body and how the body interacts with the environment and how the mother is the leader of the entire operation. They truly cannot see it and it’s disappointing.

When I was early in my carrier, I saw the most amazing new family. Their son had arguably one of the worst appearing tongue ties I had ever seen (even to this day). AND his function was completely bear minimum. BUT what he did have was an extremely grounded mother and father which is quite honestly very rare in this space. Normally, what I see, is a mother who is a complete anxious mess. (No offense and soooo much love to the mamas I see!) The problem with that is, they are so much more susceptible to being led astray because they are in fight or flight. Not only that, the baby picks up on the anxiety and further clamps down. Further retreats. Further tightens up. Can we expect babies to unwind and unleash the tight tethered frenulum when mom is so anxious? Anyway, I told them quite honestly that the tongue tie looked “bad” (a term I would never use now more seasoned in my career). I told them they might want to consider the frenectomy. Mom looked at dad (a leader) they both were calm and quiet. Dad made a slight shake of the head. Calmly, but firmly leading his family through a stressful situation. Then almost at the same time they said “that is not for us, can you please give us some other options.” Amazing. Cool as cucumbers. Meanwhile her nipples HURT! And they can see clearly the potential risks of avoiding the release. Yet, here they are, sticking to their gut. So I gave them some bodywork, some oral exercises, and sent them on their way. I did not know so much at the time how important the environment was for this situation, but that mama was intuitive. She sent me pictures of her newborn face down in the grass. She told me the pain was improving. She later told me he slept great and night weaned so she could easily get pregnant again. They were an inspiration. Grounded. Unwavered. United. Calm.

It is next to impossible to teach this to women. But storytelling is the best way to start. I tell many, many of my clients this story. I am not saying snap your fingers and become unanxious, oh and change your entire family dynamic overnight. But I am saying to try. Try. Take the journey. Because here’s what I truly believe in the bottom of my heart:

our babies with these “tongue ties” are actually here to do just that - take us on a journey to devout motherhood, unwavering and unshakable in our decisions, united and committed to our partner, protected and aligned. Only then do we find we need to do very little to unwind the ties. But try teaching that to the medicalized tongue tie industry.