Experiences of tongue tie when breastfeeding twins: A qualitative study

Abstract

Problem: Tongue tie is an added complication when breastfeeding, but little is known about the role tongue tie might play when breastfeeding twins.

Background: Twins are much less likely to be breastfed than singleton babies due to added complications regarding pregnancy, birth and ongoing care. Tongue tie can cause breastfeeding barriers including poor latch, inefficient milk transfer and nipple pain.

Aim: The aim of this study was to conduct an in-depth exploration of the experiences of mothers who have breastfeed twins with suspected or diagnosed tongue tie.

Methods: Interview and qualitative survey data exploring the experience of breastfeeding twins and multiples were analysed with a focus on the experiences of participants reporting on suspected or diagnosed tongue tie. Data were analysed using reflexive thematic analysis.

Findings: Three themes were developed. These were: 1) feeling disempowered by tongue tie denial; which illustrated the experience of dismissal by healthcare professionals, 2) the avoidable impact of diagnostic delay; highlighting the practical, physical and psychological impact of tongue tie, and 3) improvements following intervention; illustrating the immediate improvements experienced following frenotomy.

Discussion: Mothers who suspect tongue tie find themselves disempowered by denial of their experiences and needing to fight for intervention. Long delays lead to distress for both mother and child while intervention often leads to instant improvement.

Conclusion: Improved healthcare professional training and healthcare policy changes are needed to improve tongue tie support and intervention for parents of twins and reduce the threat to mother and child health and wellbeing.

Statement of significance: Problem or Issue: Breastfeeding rates for twins are much lower than for singleton babies. For some infants tongue tie may be an additional barrier to breastfeeding success.

What is already known: Research with parents of singleton babies has shown that tongue tie can cause distress, frustration and physical pain for mothers who report dismissal by healthcare professionals and a need to fight for support.

What this paper adds: The voices of parents of infants with tongue tie who have successfully breastfed twins are presented. Like parents of singleton infants, they experienced diagnostic delays and psychological and physical impacts of tongue tie. Intervention was often sought privately when NHS support was lacking. Regardless of source, tongue tie intervention often led to immediate improvement highlighting how the added stresses and challenges created by tongue tie for twin parents could be prevented with appropriate support and intervention following birth.

Keywords: Breastfeeding; Interviews; Qualitative; Tongue tie; Twins.