Breastfeeding a baby with a tongue-tie can be a difficult situation. A tongue-tie is when the tongue is restricted from a full range of motion. Medically it is called ankyloglossia and is sometimes referred to as a short frenulum or tongue mobility restriction. Most new moms would not know that their baby is tongue-tied unless formally diagnosed by a pediatrician or lactation consultant, which can make trying to breastfeed even more frustrating.
Symptoms of a Baby with a Tongue-Tie
A tongue-tie prevents babies from effectively latching, sucking and swallowing during feedings. As you can imagine, this makes breastfeeding very difficult. Often babies will not be able to latch or stay latched, or will stay on the breast but not suckle enough breast milk for satisfaction. These situations result in fussy, hungry babies and very frustrated mamas.
Besides not latching, a baby who does not gain weight or who doesn’t have frequent wet and soiled diapers may have a tongue-tie. Other signs of tongue-tie include choking during feedings and making clicking sounds with the mouth. When babies aren’t consuming enough milk, it can cause a low milk supply for mothers or oversupply that can lead to plugged ducts and mastitis.
Lactation consultants and pediatricians look for several factors when diagnosing tongue-tie. Usually the baby cannot lift his tongue to the roof of his mouth and cannot stick out his tongue past his lower gums. Experts examine elevation, lateralization and extension of the tongue to help determine tongue-tie. However, it’s important to note, however, that tongue-tie is diagnosed by function, or lack thereof, not by the appearance of the tongue or frenulum.
A lip tie is similar to a tongue-tie but the tight membrane connects the upper lip to the gums in this case. Many babies who have tongue-tie also have lip-tie. Lip-tie can further complicate feedings because babies cannot wrap their upper lip around the breast properly and may make the baby take in excess air.
Causes of Tongue-Tie
The impeded mobility in babies with tongue-tie is caused by a membrane under the tongue connecting the floor of the mouth known as the lingual frenulum. If this membrane is too short or too thick, it can restrict the tongue’s movement for proper breastfeeding. Usually the issue resolves in utero by the end of the first trimester but approximately 15% of babies are left tongue-tied at birth. Statistics show more boys than girls have tongue-tie and it may be genetic.
Overcoming a Tongue-Tie
Some babies with tongue-tie find ways to work around their feeding issues on their own. They compensate for their restricted tongue mobility in other ways and can get enough milk to thrive.
Other times medical experts recommend a frenotomy or frenectomy where the membrane is cut to allow more range of motion. This can be done with lasers or surgical scissors with local anesthesia and a sedative.
A tongue-tie may not present itself as an issue immediately after birth. Some tongue-tied babies succeed at breastfeeding when their mother’s milk supply is high and let-downs are forceful and frequent. As milk supply settles and steadies, these babies may have a harder time getting milk because they cannot latch, suck and swallow as necessary.
Breastfeeding isn’t the only complication with a tongue-tied baby. Speech, eating and dental care may impact the child as he grows up. Certain sounds and actions may be limited by a tongue-tie and food may get stuck in hard-to-reach teeth causing tooth decay.
Breastfeeding a baby with tongue-tie is challenging. If you suspect your baby has a tongue-tie, visit your pediatrician to get a formal diagnosis and discuss options for correcting it.