A tongue-tie (ankyloglossia) is a condition in which the thin piece of skin under the baby’s tongue (the lingual frenulum) is abnormally short and may restrict the movement of the tongue.
Tongue-tie occurs in about 3% of babies and is a condition that can run in families. Interestingly it is more commonly found in boys.
What Is The Impact Of A Tongue-tie?
The most immediate impact of a tongue-tie is on a baby’s ability to breastfeed effectively. It may interfere with a baby’s ability to latch and suckle at the breast.
As Midwives we most often see the impact of a tongue-tie through the following:
Nipple pain and trauma
Poor breast milk intake
A decrease in milk supply over time
What Can Be Done For A Tongue-tie?
A procedure to release a tongue-tie may be recommended if it is impacting on breastfeeding.
The procedure is called a lingual frenotomy. Before performing this procedure Midwives/Lactation Consultants who work with breastfeeding mothers and their babies will assess the baby’s mouth, how the breastfeeding is going and the mother’s comfort.
If you find breastfeeding to be painful, there is poor milk supply, and there is significant tongue-tie, a release procedure will improve the baby’s ability to breastfeed and overall improve the mother’s and baby’s breastfeeding experience.
Sometimes a tongue-tie causes no problems with breastfeeding and requires no action, however a majority of the time it does seem to cause problems in the beginning few days post birth when you are trying to establish breastfeeding.
Signs Of A Significant Tongue-tie
Tongue cannot extend beyond the baby’s lips
Tongue cannot be moved sideways
Tongue tip may be notched or heart-shaped
When the tongue is extended, the tongue tip may look flat or square instead of pointed.
What Are The Breastfeeding Problems?
Nipple pain and damage
A misshapen nipple after breastfeeding
A compression/stripe mark on the nipple after breastfeeding
The baby often loses suction on the breast whilst feeding
A clicking sound may be heard while the baby is feeding
Poor weight gain
How Is It Assessed??
A lactation consultant or a paediatrician will conduct a thorough assessment of your breastfeeding and your baby’s tongue mobility to determine if a release is required.
If the frenulum is thin and the baby is less than around four months of age, the frenulum can be released as an outpatient procedure without any anaesthesia. A baby who is older or who has a tongue-tie that is thick, may need to be referred to an appropriate specialist like a paediatric surgeon.
What Is A Tongue-tie Release?
Babies should have had Vitamin K injection at birth (or at least 2 oral doses) before the tongue-tie release is considered. Find out more about Vitamin K here.
The release of a tongue-tie involves the Doctor placing a finger and thumb under the baby’s tongue to gain clear access to the frenulum. The frenulum is released with a small pair of sterile scissors.
A drop or two of blood at the release site is normal and is rarely a problem. Some babies may be unhappy at being held still and having fingers placed in their mouth. Occasionally a baby will startle when the release is performed but will settle quickly once comforted. Following the procedure, you will be encouraged to breastfeed straight away and comfort your baby.
Possible complications of the procedure are bleeding (usually minimal) or infection (extremely rare). There is no special care required following the procedure.
If your baby has a tongue-tie release and you have any concerns following the procedure, please contact your lactation consultant, maternal and child health nurse, paediatrician or your GP.
As a mother it is always important to ask as many questions as you need to feel comfortable with any procedure that may be performed on your baby. Ensure you feel comfortable with the procedure before you allow it to go ahead.
(This article contains general information only and is not intended to replace advice from a qualified health professional. All information is written from the experience and knowledge of the person writing the post).
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