The phone call came about a week after her baby’s tongue-tie release.
She wasn’t calling to celebrate. She was calling because feeding was still hard. And nobody had told her why.
This is one of those stories I carry with me, because it captures something I see more often than I’d like. A mama does everything right. She notices the signs. She finds a provider. She gets the release. And then she goes home.
And nothing changes.
What Happened Before She Called Me
This little one was born at 9 pounds, a beautiful, healthy baby. But from the start, feeding was a struggle. Eventually, a tongue-tie was identified and a release was completed by a pediatric dentist.
Here’s what I want you to understand about that step. Pediatric dentists are skilled at the procedure itself. But a tongue-tie release is a structural correction. It removes the restriction. What it cannot do is teach the tongue how to move differently afterward.
That part requires someone who specializes in oral motor function and feeding. And this mama didn’t have that.
At her week follow-up with the dentist, she was shown a deep stretch. That was the extent of the post-release guidance.
No oral motor exercises. No feeding reassessment. No help with the nipple shield she was still using. No plan for the triple feeding schedule that had taken over her life.
She had found a free lactation class in the area and was attending. But when she asked that lactation consultant about oral motor exercises, the response was honest: “I have no idea.”
Tongue-tie is a specialty. Not every lactation consultant has trained in it, and that is not a criticism. It is just the truth. And this mama needed someone who had.
What I Found at Our First Visit
She reached out to me and we met when her baby was about six weeks old.
When I arrived, I learned that baby had been given a 2-ounce bottle at 7am. Our visit started at 9:30am. I weighed baby before we began: 10 pounds, 6 ounces.
The first thing I noticed when I looked at this baby was tension. She was tight throughout her body and only comfortable looking to the right. Mama had noticed the same thing without having the words for it. She told me she always started feeds on the right side and had a really hard time getting baby to latch on the left.
This was not a coincidence. When a baby has been working hard to eat for weeks, especially with a restricted tongue, they develop compensatory tension patterns in their neck, jaw, and upper body. This baby had been doing that. She needed bodywork alongside feeding support, and chiropractic care was going to be part of the plan.
Mama was also still using a nipple shield. The latch was getting better but they hadn’t been able to move away from it yet, and she was not sure how or when to try.
We worked on positioning, latch, and some initial oral motor guidance. After feeding on the right side, I weighed baby again: 10 pounds, 7.5 ounces. She had transferred about 1.5 ounces in that session. For a baby who had been struggling since birth, we were building from here.
The Conversation About Triple Feeding
Triple feeding is a protocol sometimes recommended when a baby isn’t transferring enough milk. The idea is to nurse, then give a pumped bottle, then pump again to protect supply. All of that, every feeding, around the clock.
This mama was doing it. And she had been doing it for weeks with no guidance on how or when to stop.
She was exhausted. Her husband and her mom were each taking one bottle feeding a day to give her a break. But there was no end in sight. And she was going back to work in August with daycare starting in July.
No one had told her that triple feeding is a short-term tool, not a long-term plan.
How We Approached Stepping Down from Triple Feeding
Triple feeding serves a purpose in the early days, but it is not sustainable. Here is the general framework I walked her through:
Start by dropping the pump session first. Once baby is transferring well at the breast and weight gain is appropriate, you can begin eliminating the pumping session after feeds. Nurse, offer the bottle if needed, but skip the pump.
Then reduce the bottle supplement gradually. As nursing gets stronger and more efficient, you can begin offering the breast first for a full feeding before offering a top-off bottle. Watch weight gain closely as you do this.
Keep one bottle per day intentionally. With daycare starting soon and a return to work coming, keeping one bottle in the daily routine is actually a smart move. It keeps baby comfortable taking a bottle from another caregiver, which makes the transition much smoother. For this family, dad or grandma was already giving that bottle. That was a good rhythm to keep.
Wean the nipple shield slowly. Once latch improves and nursing feels more comfortable, you can begin trying without the shield at the start of a feed when baby is calm and not deeply hungry. Some sessions will work. Some won’t. That is normal. Patience here matters more than speed.
The goal is never to stop overnight. The goal is to move in a direction, one feeding at a time.
What I Found at Our Second Visit
We met again one week later, when baby was about seven weeks old.
I want to note something important about this visit. Baby had nursed about an hour before they arrived, which meant she wasn’t at her hungriest. That matters when we look at the numbers.
Pre-feed weight: 10 pounds, 12 ounces.
This time, we worked on the left side. The side mama had struggled with since the beginning. The side baby had resisted because of the tension she was carrying in her neck.
After that feed, baby weighed 10 pounds, 13 ounces. One ounce transferred, with a full feed just an hour before.
Here is what else I noticed. The latch had no pain. Mama said it herself. Something that had felt impossible for weeks was starting to shift.
She had tried nursing without the nipple shield a few times on her own and had some success. Baby was clicking occasionally and coughing a little, which told me the oral motor work wasn’t finished, but the trajectory had changed. Baby was now taking 3 ounces in 30 minutes on a good feeding. That is efficient. That is progress.
She was still triple feeding and still didn’t have a clear plan for stopping. We worked through that together.
What This Case Teaches Us
The tongue-tie release was the right call for this baby. But the release alone was never going to be enough.
The tongue had been restricted for six weeks. It had learned to compensate. The body had learned to hold tension. The mama had learned to protect herself with a nipple shield and to manage with triple feeding just to keep her baby fed. None of those things disappear the moment a frenulum is released.
Post-release care is not optional. It is where the real work happens.
If your baby has had a tongue-tie release and feeding still feels hard, that is not a sign that something is wrong with you or that the release didn’t work. It may simply mean that the tongue needs help learning how to move in its new freedom. And that is exactly what oral motor work and feeding support are for.
This mama called me because she trusted her gut. She knew something was still missing. She was right.
And by week two, she was feeding without pain on both sides, beginning to move away from the nipple shield, and finally had a real plan for stepping down from triple feeding before daycare started.
That is what follow-up care is supposed to look like.
Frequently Asked Questions
Why wasn’t I given oral motor exercises after my baby’s tongue-tie release?
Most pediatric dentists who perform tongue-tie releases are highly skilled at the procedure itself. However, oral motor exercises and feeding therapy are outside their scope of practice. That is not a criticism. It simply means that post-release feeding support requires a specialist, typically a lactation consultant or speech-language pathologist with specific tongue-tie training.
How long does it take for breastfeeding to improve after a tongue-tie release?
It varies. Some babies show improvement within days. Others take several weeks as they learn new movement patterns with their tongue. Babies who receive oral motor exercises and skilled feeding support before and after the release tend to progress more quickly. Without that support, old compensatory patterns can persist even after the restriction is gone.
What is triple feeding and when should it stop?
Triple feeding is a protocol that involves nursing, then offering a pumped bottle, then pumping to protect supply. It is sometimes recommended when a baby is not transferring enough milk. It is a short-term tool, not a long-term solution. Most families need a clear, guided plan for stepping down from triple feeding as nursing improves. If you are triple feeding and no one has given you a plan for stopping, reach out to a lactation consultant who specializes in tongue-tie.
Can a baby still have feeding difficulties after a tongue-tie release?
Yes, and this is more common than most families are told. The release addresses the structural restriction, but the tongue still has to learn how to move differently. Tension patterns in the body, compensatory habits at the breast, and oral motor weaknesses can all persist after a release without proper follow-up support.
My baby only looks to one side. Is that related to the tongue-tie?
It can be. Babies with tongue-ties often develop tension in their neck, jaw, and upper body from the effort of feeding with a restricted tongue. This can cause them to strongly prefer one side. A pediatric chiropractor who works with infants can help release that tension, and many families see feeding improvement after bodywork alongside oral motor and lactation support.
If This Sounds Like Your Story
If your baby has had a tongue-tie release and something still feels off, you are not imagining it. And you do not have to keep guessing.
I work with families in Brownsburg, Avon, Plainfield, Zionsville, and the westside of Indianapolis. I come to your home so you do not have to load up a baby and go anywhere.
👉 Book a free consult to talk through where you are
👉 Learn more about tongue-tie support packages
