Forgotten Knowledge

The Forgotten Knowledge / Blog by Laurie Reinke of Birth In Berlin

My pain was so bad. I went to my gynecologist. He said it’s up to me to decide to endure the pain or stop breastfeeding as he can’t do anything more about it. He said my body could not manage to breastfeed because I have a small body and bigger breasts.
Ella, mother of a 3-month-old.

Forgotten Knowledge

Ella received this less-than-scientific diagnosis from her trusted doctor after suffering from painful breasts and nipples. Her milk ducts clogged, she developed white blebs in her nipples and experienced throbbing pain in her breasts and nipples after breastfeeding.
Unfortunately, when doctors reach their capacity to heal, they sometimes blame the mother, the woman’s body.  
This doctor missed her baby’s Ankyloglossia, also known as “tongue-tie”. Her baby’s tongue was tethered to the bottom of its jaw by a hidden band of skin. Most pediatricians, gynecologists, and midwives have unfortunately lost the ability to diagnose and treat Ankyloglossia.
Now only able to recognize an anterior tongue-tie, when the tongue is tethered to the bottom jaw by a visible band of skin at the front of the tongue, the POSTERIOR tongue-tie is continuously overlooked. Most dentists do not trust their knowledge and skill to release a POSTERIOR tongue-tie.
Symptoms of both anterior and posterior tongue-tie in a baby include,

  • trouble latching on to the breast
  • agitation during and after breastfeeding
  • never settling
  • clicking sounds while feeding
  • lack of suck–swallow–respiration rhythm
  • constant hunger
  • needing 40 minutes or more to complete a feed
  • slow weight gain or lack of weight gain
  • extreme gas
  • extremely sleepy, falling asleep at the breast
  • thick milk film on the tongue
  • bowl shaped tongue when crying, heart shaped tongue
  • blisters on the baby’s lips
Symptoms in the mother can look like

  • sore nipples
  • nipples that crack or bleed
  • decreasing milk supply
  • mastitis
  • low milk supply

One wonders how doctors and midwives could miss a physiological abnormality, which, when including anterior Ankyloglossia, occurs up to approximately 30% of the population.

The answer;  breastfeeding is no longer essential to survival. 
Breast milk substitutes have been used for infant nutrition in the mid-1800s, alongside the practice of a wet-nurse service.
Through the decades, substitute breast milk changed from animal-based milk mixtures, raw milk mixtures (animal mixed with milk, sugar, cream, flour), evaporated milk mixtures, and consumer milk products still used today. The popularity of modern-day “formula” increased in the 1920s and reached a peak in the 1970s, with nearly 75% of all American babies being formula-fed. For various reasons, the late 1970s experienced a resurgence of mothers breastfeeding their babies and decreased reliance on synthetic baby milk products.
But by then, the awareness and ability to diagnose Ankylolossia had suffered much.
The result is seen today in the inability of medical professionals to diagnose and treat Ankyloglossia correctly. Sometimes the blame for failed breastfeeding is shifted to the mother. Common comments thrown around are;
  • “you don’t have enough milk,”
  • “the latch looks good, and there is no problem,”
  • “the baby can stick it’s tongue out, and there is no tongue-tie,”

and from visual evaluation only –

  • “I can’t see any tongue-tie, that is not the reason you are having trouble breastfeeding.”
These are all very incorrect and misleading evaluations.  
Without correct assessment and support, many new mothers decide to stop breastfeeding. Feel frustrated, guilty, and angry that breastfeeding failed, thoughts that they are inadequate, that they “did not try hard enough,” linger. Of course, this has the potential of coloring the mother’s confidence, trust in her body, and the ability to handle future parenting situations.
The baby’s long-term development is also at risk when a tongue-tie is missed. The impact can carry on into adulthood, for example;
  • underdeveloped jaw bone and muscle structure
  • reflux, heartburn
  • ADHD like symptoms, false diagnosis
  • difficulty swallowing and chewing
  • speech and breathing issues (obstructive sleep apnoea)
  • temporomandibular joint (TMJsyndrome
Because a POSTERIOR tongue-tie is hidden by the sub-mucosal structures of the tongue and jaw, the tethering piece of skin is often only visible when challenged. One can test the tongue by lifting it gently upward with one finger on each side of the baby’s tongue. If the lingual frenulum is visible in this position, your baby may have a tongue-tie.
This is exactly what I did when visiting Ella and her baby.  It was clear to me that she needed to visit a Dentist specializing in Ankyloglossia as soon as possible. The doctor confirmed my suspicion.  With a three-second procedure, little crying involved, a very little bleeding, the tongue of Ella’s baby was released.  Immediately after the procedure, her baby drank from her breast.  After only a few days, breastfeeding became a completely different experience for Ella and her baby, and Ella’s breasts are fully healed.
If breastfeeding is a painful experience or if a mother has the feeling something is not “right,” I encourage them to pursue more information. If they see the baby is not thoroughly examined, or they are told that it is “simply how it is,” I enhearten them to seek out informed caregivers. The inner voice and gut instinct are never wrong.
Enjoy watching.
See you soon, Goddesses!
Laurie Reinke
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