Missed Ties: Why It’s Not Always You (And How to Advocate for Better Support)
It’s heartbreaking to hear stories from parents whose babies have struggled to breastfeed, only to have their concerns dismissed or misdiagnosed. One of the most common issues I see in my practice? Tongue and lip ties that are very obvious to trained eyes but somehow missed by pediatricians, and yes, sometimes even by untrained lactation consultants.
Let me break this down:
Breastfeeding Is the Biological Norm
Our bodies are designed to feed our babies. It’s a system millions of years in the making. Babies come into the world with the reflexes and tools they need to feed effectively—and our breasts are designed to meet their needs. When breastfeeding isn’t working, the question we should ask isn’t if you’re capable, but why it’s not happening as it should.
It’s Not Always You, Mama
Yes, modern life can throw curveballs into the breastfeeding journey. Hormonal imbalances, thyroid disorders, and even certain medications can affect milk supply. But here’s the kicker: when there’s pain, damage, or low milk supply after birth, the issue is often not your body—it’s the baby’s ability to nurse effectively.
Tongue and Lip Ties Are Often Missed
If breastfeeding is a struggle, and your baby isn’t transferring milk well or causing you pain, it’s not enough for a pediatrician to just glance inside their mouth. Here’s what a thorough tie assessment should include:
• A Functional Exam: The provider should gently manipulate your baby’s tongue to assess its ability to move in all directions (up, down, side-to-side, and forward).
• Observation of a Feeding: Watching how baby latches, sucks, and swallows provides critical clues about what’s going on.
• Nipple Assessment: Checking your nipples before and after a feed can reveal if baby’s latch is causing damage or isn’t deep enough.
• Symptom History: You and your baby’s feeding challenges are part of the puzzle—this context matters.
If this didn’t happen, your baby wasn’t really assessed for ties.
What Pediatricians (and Some Providers) Get Wrong
Many pediatricians are incredible at their jobs—but infant oral function isn’t their specialty. If they tell you low milk supply is simply “your fault” or that formula or pumping is your only solution without addressing the underlying why, they’re not being breastfeeding supportive.
And if you’re pumping enough milk to feed your baby, but they still can’t latch or transfer milk well from the breast? That’s a BABY issue—not a YOU issue.
How to Advocate for Your Feeding Journey
• Trust Your Gut: If something feels off, keep pushing for answers. You know your baby best.
• Seek Specialists: Work with a trained lactation consultant (IBCLC) who has experience assessing oral ties and feeding issues.
• Comprehensive Care: Ask for a full feeding evaluation, not just a quick “look in the mouth.”
• Get to the Root Cause: Don’t settle for Band-Aid fixes like pumping-only solutions or being told to “wait it out.” Resolving the underlying issue is key to breastfeeding success.
You Deserve Real Support
Your baby’s challenges are not a reflection of your ability to provide for them. You’re doing an incredible job by seeking answers and fighting for your feeding journey. If breastfeeding isn’t going as planned, there is a reason—and with the right support, you can find it.
Because here’s the truth: Breastfeeding is natural, but it’s not always easy. And when it’s hard, you deserve care that addresses the real problem, not just the symptoms.
You’ve got this—and you’re not alone.