Infant Tongue-Tie - Not Your Typical Tongue Twister...

For many women breastfeeding is a time of bonding with their baby. Providing nourishment, comfort, and security, they grow their relationship with their infant in these special moments. Though, like any part of birth and parenting, it does not start out so enjoyable for everyone. Some mothers experience frustration at their baby’s struggle to latch. They endure painful feedings, all while feeling something is not quite right with what they are experiencing.

If your baby suffers from ankyloglossia, more commonly known as “tongue-tie”, you know this struggle all too well. Let’s start with some basic oral anatomy. You are probably familiar with that paper-thin bit of oral tissue that attaches your tongue to the floor of your mouth. What about the piece that attaches your lip to your gums? Run your tongue along the outside of your teeth, down in the cavity between your lip and your gums. It probably got caught on your frenum. You may have one on the top and the bottom that you can feel. Your tongue will be a bit harder. You get the idea now, though!

When this tissue is too tight or attached too deeply, it can create an issue with your baby

moving their tongue or their lips to get a deep latch. The tissue restricts the mobility of the

baby’s tongue and lips. As a result, your baby will try to compensate for this loss of attachment

with increased suction. This shallow latch can lead to:

- Nipple damage and pain

- Inability to fully drain the breast (causing supply issues)

- Digestive problems (like colic and reflux)

- Misalignment of the baby’s future teeth

- Infant weight loss or failure to gain weight

- Frustration for both mom and baby

The great news is you are not alone. Many babies have this issue, and it is easy to remedy. Your first step would be to seek the assistance of a lactation consultant in your area to assess your baby’s latch. A trained lactation consultant can determine whether a tongue or lip tie is genuinely the cause. Once the LC has determined what the challenge is they can make a recommendation or referral.

If it is due to tongue or lip tie the tissue will need to be released. This is done in a very simple, short and relatively painless procedure either by a pediatric dentist, oral surgeon or ENT. The procedure is done in office and is a simple clipping of this tissue to loosen it and allow greater range of movement. You will then return to your LC, who will help you with exercises so that your baby can relearn the most effective way to latch and feed. A blind study published in the Journal of Neonatal Surgery in 2012 conducted on 58 newborns (average 6 days old) found that the group of newborns treated with tongue tie release procedures (30 of the 58) saw pain scores in the mothers decrease and an improvement in feeding. Infants who undergo tongue-tie release procedures can nurse immediately, and mothers will often notice a deeper latch as soon as the first feeding. It is usual for there to be an adjustment period as the soreness subsides from the tongue-tie release.

Surgical intervention is not always necessary, though. In a study published in JAMA -

Otolaryngology-Head & Neck Surgery (2019) a team of providers found that 63% of babies who were diagnosed with tongue-tie were able to overcome feeding difficulties without surgery with the help of a certified lactation consultant. Your lactation consultant can work with you on non-surgical interventions to try to get a deeper, more comfortable latch and allow your baby a satisfying feeding.

It is important to have support during this time, you might have nipple pain, your baby might not be gaining weight properly and you are stressed out because you have to supplement. No matter your situation you should join a breastfeeding support group. Facebook is a great way to connect with other moms who go through similar experiences and can give you insights and provide some support when needed. Please join our Luscious Letdown Facebook Breastfeeding Support Group for more great content on alleviating breastfeeding discomfort, improving feedings, and how we can help you and your baby get the most out of breastfeeding.

Citations:

Caloway, C., Hersh, C. J., Baars, R., Sally, S., Diercks, G., & Hartnick, C. J. (2019). Jama Otolaryngology-Head & Neck Surgery. doi: 10.1001/jamaoto.2019.1696

Raveenthiran, V. (2012). Release of tongue-tie in neonates. Journal of Neonatal Surgery, 1(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420317/