Tongue Ties Can Affect Breastfeeding

Ankyloglossia or tongue-tie is when an infant’s tongue is tethered with a band of tissue (frenulum) to the floor of the mouth, making it unable to move in a normal way.

Tongue-tie is a congenital condition of unknown cause with potentially significant implications.   It is the subject of ongoing research and is a hot topic among healthcare providers and lactation consultants. Although there is controversy around the significance of the condition, tongue-tie can negatively impact both infants and the nursing mother.

Lip-ties most often accompany tongue-ties.  The shorter and tighter the upper lip frenulum is, the more uncomfortable it is for the baby to flange the lip outward and latch properly while nursing.

Breastfeeding mothers of tongue-tied and/or lip-tied infants may suffer from low milk supply, nipple soreness that extends past the first minute of nursing, raw nipples, plugged ducts, and mastitis.

If you are experiencing breastfeeding difficulties, you should first see a lactation consultant (IBCLC) determine the cause of the problem.  You may need advice on positioning, latching, or other feeding techniques.  If a tongue tie or lip tie is noted, the IBCLC may recommend that you see a provider who specializes in treating infants with tongue ties such as a pediatric ENT, a pediatric dentist, an oral surgeon, and/or a pediatrician.

Tongue-tied infants may exhibit:

• Weight loss or inability to gain weight
• Reflux or colic symptoms including excessive gas
• A heart-shaped tongue
• Inability to latch on or stay attached to the breast
• Inability to stick tongue out past the lower gum
• Blanching of the tongue when the frenulum is stretched

Long term symptoms of a tongue tie may include:

• Speech delays or inability to speak clearly
• The gap between upper or lower front teeth
• Teeth coming in crooked
• Cavities due to inability to clean teeth effectively
• Inability to lick lips, suck on candy, drink from a straw properly, kiss, or play a wind instrument

Treatment options include:

• Frenectomy- a simple snip of the frenulum usually done in the office
• Tongue exercises- exercises may be recommended for a looser tie or after a frenectomy, to promote healing and prevent scar tissue.
• Do nothing- choosing a wait and see approach is always an option. Some frenulum will stretch over time.

There are four types of tongue ties:

Type 1- The frenulum is attached to the tip of the tongue, the baby appears to have a heart-shaped tongue when extended, and the tongue is 100% attached.

Type 2- The frenulum is anchored 4mm behind the tongue, just behind the alveolar ridge, and usually the tongue has a 75% attachment.

Type 3- The frenulum is attached at mid-tongue, noting a 50% attachment.

Type 4- The frenulum is attached to the base of the tongue. It appears thick, shiny & riddled. This is a tricky attachment as it is often overlooked by providers as 0% attached.

Photos of both Lip Ties and Tongue Ties can be found at http://tonguetie.net/photo-gallery/

If you would like to learn more or see images click here:  http://tonguetie.net/

This information is shared for educational purposes only. Please do not self-diagnose. Instead, remember to see a board-certified lactation consultant or pediatrician for diagnosis prior to treatment.