What is a tongue tie - and how does it affect breastfeeding?
We are hearing more and more about tongue tie, both in the press and on social media groups. Why is that? Is it because it’s now in vogue? Or we have a glut of babies with tied tongues?
Is it because it’s now in vogue? Or we have a glut of babies with tied tongues? Neither, but it is actually a good sign. Why? Well it is a good indication that more babies are being breastfed. And the fact that it is being highlighted by medical research and caregivers is a pretty good indication of this. Bottle-fed babies don’t seem to have as many problems in early years with a tied tongue.
What is tongue tie?
There are various types of tongue tie but it is basically a restriction caused by the piece of skin attaching the tongue to the floor of the mouth - called the frenulum. Sometimes this piece of skin is very tight causing the tongue to be restricted in its movements. It can be restricted at the front of the tongue or at the back. To the untrained eye, a tongue with tongue tie can look entirely normal. The major problem we are finding is that although tongue tie can cause a plethora of problems, many of our health professionals are not trained in recognising them. And to complicate matters ties can also occur in upper and lower lips, gums and cheeks.
How can you spot a tie?
There are some ties that look pretty obvious. And there are those that are not. My best advice is that if your baby is experiencing some of the problems listed below, that you contact a lactation consultant and ask if they are experienced in tongue tie and get a professional to diagnose if there is a problem. Not your doctor, paediatricion, health nurse or a midwife at the hospital. They have most probably not been trained to identify them. Many mothers I know have been to their GP with a query about tongue tie to be told that it’s not an issue when it has been. Here is a directory of Irish Lactation Consultants ask if they have a lot of experience with tongue tie (some already state it on their bio).
What are the more obvious pointers to tongue tie?
After my harping on about experts here, I truly believe mothers are the experts of their children. Have a look for these more obvious physical signs which can help you build a picture of a tongue tie problem:
- The first thing to look for is - can your baby stick out their tongue?
- Touch your baby's lips and they will probably open their mouth
- Touch their gums and they will probably stick out their tongue
- Look for the baby's tongue coming out flat over their lip. Not pointing down or drooping downwards
- Can your baby lift their tongue to the roof of their mouth? They should be able to do this
- Does your babies tongue have a heart shape when it sticks out? This can indicate a tie
- Can they only stick their tongue out with their mouth closed? This may mean a tie at the back of the tongue
There is a fantastic site showing tongue ties and how they look. Use this for a basic reference.
How will a tongue tie affect feeding?
Your baby's tongue is instrumental in feeding. It is the vigourous sucking and action of their tongue that empties your breast helping your milk supply maintain a level sufficient for your baby. The photo above shows a baby with a great latch but this can be very difficult to achieve with a tie. The tie can affect feeding in many ways:
- The baby's mouth may not be able to open wide enough causing a poor latch to your breast. This can result in severe pain and eventually nipple damage with sore and cracked nipples. If you experience continous pain or see a blanching (whitening of your nipple), a tie may be causing this. Please note though that tongue tie does not always cause pain with feeding.
- Your nipple may not lengthen towards the back of the baby's upper palate. This can cause your milk to be directed incorrectly with accompanying chocking, gagging or vomiting.
- Your supply may dwindle due to an incorrect latch and your breast not being emptied during feeds.
- Your baby may not be able to make a good seal around your breast causing milk to leak during the feed. This can also indicate upper or lower lip ties too.
- You may notice noisy sucking with slapping noises during the feed.
- Severe nipple pain can cause milk supply to reduce as the milk ejection reflex can be disturbed.
- Babies can often become equally distressed with wind, reflux, hunger, insufficient weight gain, inabilty to settle and continous crying.
Okay. Now take a deep breath. If this sounds like what you are experiencing, you need to get to see one of the professionals I mentioned as soon as possible.
How to treat a tongue tie?
It’s simple - you get it snipped. A frenulotomy is where the tissue is snipped before the baby is put back to the breast. The antiviral and anti-inflammatory properties of breast milk will help to sooth and clean the area, while your baby is feeding with more freedom for the first time. A study in 2005 found that 97% of babies fed better after the procedure.
What happens if the tongue tie is left?
Leaving a tongue tie will probably result in ongoing issues with breastfeeding. But, even beyond that, children can experience dental issues, speech issues, eating issues, jaw pain and much more.
My recommendation would be to have it fixed. Your lactation consultant can recommend a doctor to perform this procedure.