Dr. Berning’s Experience With Tongue Ties

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Dr. Kristen Berning's personal experience breastfeeding tongue-tied babies

By Dr. Kristen Berning

I thought breastfeeding would come naturally.  I had successfully breastfed my first two children.  When our son Ted joined the family, I thought my previous experience with breastfeeding would have me well prepared.

However, when Ted was just one day old, something was different.  I felt he was “chewing” instead of “sucking” while breastfeeding.  The hospital International Board Certified Lactation Consultants (IBCLCs) gave suggestions:

  • I was told to use my finger to rub down the middle of his tongue to help his tongue extend.  But he couldn’t stick his tongue out very far.
  • I was told to wait for a wide opening before latching him on.  But over and over, he didn’t open his mouth wide.
  • I was given a nipple shield.  But that made the pain worse since he was “chewing,” and the plastic was digging into sore areas.
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  • When his latch was shallow, I was supposed to break suction and try again.  But the latch-on was terribly painful and I didn’t want to repeat it.  I just wanted it over with.  The toe-curling pain brought me to tears.  I dreaded the next feeding.

I had cracked, bleeding, sore nipples. Lanolin, gel soothies, and salt water soaks weren’t helping. I attended a local breastfeeding support group when he was a couple weeks old. I was sitting by a nice mom named Jessi. Jessi suggested Ted could have a tongue-tie. She experienced it with her daughter and had her daughter's tongue tie clipped by a local ENT physician. The lactation consultants took a look at his tongue, but were not sure. At Ted’s 3-week well child appointment, his pediatrician was also not sure if it was a tongue tie.

I called the ENT physician, and scheduled an appointment for the next week.

The next day, I felt frequent shooting pains, like lightning bolts, in my chest between feedings. It was different than any pain I had before. With one arm clutched across my chest, and my free hand used to search the internet, I read it might be thrush. I looked inside Ted’s cheeks and saw small white patches. I went to the pediatrician’s night clinic to confirm the diagnosis of thrush, a yeast infection. I drove to the pharmacy in tears, to get our prescriptions. The pain, the frustration, the thrush —were pushing me over the edge. I didn’t want to stop breastfeeding. Looking back, I may have quit if he was my first breastfed baby.

I called the ENT doctor’s office the following day, and asked if there was any way they could see us sooner due to my severe pain. They squeezed us in that day, and I was SO thankful.

At our appointment, I explained to the doctor how I knew Ted’s latch was drastically different than my first two kids. We discussed the procedure, and were ready to proceed. Three-week-old Ted’s little body was placed onto the patient chair, he was stabilized by a few nurses, and the ENT clipped Ted’s lingual frenulum with a surgical scissors. Ted was immediately returned to me. His latch was instantly deeper and less painful. I was so relieved. My nipples healed over the next week. It took some time until the thrush was completely managed, but the frenotomy saved our breastfeeding relationship.

Fast forward to when our fourth child was born. Clara latched on well in the hospital and her weight gain was excellent, so I thought we were in the clear.

However, a few months passed and breastfeeding was still painful.  Her latch was often shallow, but not as bad as Teddy’s.  She popped on and off the breast frequently and was very gassy.  Nipples were often sore and cracked, causing me to dread the next feeding.  I was pumping some feedings so my husband could bottle feed her, and I could take a break.  I tried different nursing positions, used prescription APNO (Jack Newman’s all purpose nipple ointment), and tried to improve her shallow latch.  I also developed clogged ducts and mastitis, and was in the doctor’s office again, in tears.

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I noticed Clara’s upper lip was often tucked in tight while breastfeeding, and it did not flange. In our local private Facebook support group for breastfeeding mothers, a mom named Tricia mentioned difficulties due to a lip tie. I was aware of tongue-ties, but I was unsure how lip ties affected breastfeeding. I needed to find out more. I learned that when a definite lip tie was present, a posterior tongue-tie was often present. A medical practitioner is often familiar with anterior tongue ties, however, posterior tongue-ties are not as visible to the untrained eye.

Lip and Tongue Tie Laser Revision

I immersed myself in learning about lip ties and tongue-ties.  I felt there was a need in my community to understand this better.  Let me emphasize, I deeply appreciate and respect my local lactation consultants and pediatricians.  They are amazing, brilliant, and talented people who help so many of us!   They just were not (at that time) familiar enough the effect of lip ties and posterior tongue-ties on breastfeeding.

I learned there were dentists, both pediatric and general dentists, releasing infant ties with lasers.  I was using a laser almost daily in our dental practice and had done many laser frenectomies on older children and adults when needed for orthodontic or periodontal concerns.  Dr. Mindy Hochgesang became my mentor and allowed me to observe the procedure on an infant.

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I also spent a day observing Dr. Fred Margolis, a pediatric laser dentist in Chicago. I attended a course by Dr. Larry Kotlow, another pediatric laser dentist who has been doing this procedure for many years and has many published articles on the topic.  I participated in a tongue-tie hands on workshop led by Dr. Alison Hazelbaker, PhD, IBCLC where we observed normal and restricted tongue function in many babies.   I read articles written by Dr. Bobby Ghaheri, an ENT in Portland, and soaked up as much information as I could from all of these tongue-tie experts. I also attended tongue-tie courses by Dr. Bobby Ghaheri, Dr. Soroush Zaghi with The Breathe Institute, and Dr. Richard Baxter with The Alabama Tongue-Tie Center.

As a passionate supporter of breastfeeding, this opened a door for me.  It was mom-to-mom support that sent me on this journey when I was having pain nursing.  I could now give mom-to-mom support and provider-to-mom support for breastfeeding dyads struggling with tongue and lip ties themselves.

My daughter, Clara, was my first infant patient. I released her lip tie and posterior tongue-tie, we did post-frenotomy exercises, we healed, and we finally achieved a great breastfeeding relationship.

Our dental office has helped hundreds of moms and babies improve their breastfeeding relationship when lip and tongue-ties are present.  We have become passionate about helping identify lip ties and tongue-ties, treating them when needed, and providing ongoing support and resources.

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In the Tri-State area, we are lucky to have awesome lactation support in our local support groups and from our local IBCLCs.

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Dr. Kristen Berning provides support for breastfeeding moms dealing with lip and tongue ties.  She uses a LightScalpel CO2 laser to perform lip and tongue tie revision, including posterior tongue ties. She also treats children, teens and adults with lip and tongue ties.  Her office is located at 4200 Asbury Road, Dubuque, IA 52002.  Many patients travel from Iowa, Illinois, and Wisconsin to her office for tongue tie assessments and treatment.  To schedule an exam or ask questions about the lip and tongue tie procedure with Dr. Kristen Berning please call us at 563-556-2711 or contact us online.

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