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Dealing With Tongue-Tie

What do I need to know about caring for my tongue-tied baby?

As an IBCLC (International Board Certified Lactation Consultant) who has worked extensively with many infants with tongue-tie, I feel the need to point out that both of my biological sons had tongue-tie. This lead me to specialize in tongue-tie and structural issues, and advocate for breastfeeding families facing this situation. After pursuing extensive continuing education on Tongue-tie, I have provided continuing education seminars to other colleagues and healthcare professionals throughout the years.

What is “tongue-tie?”

The medical term for tongue-tie is ankyloglossia. Some cutting edge researchers are even calling it “partial ankyloglossia.” We use the term “tongue-tie” when the piece of tissue that attaches to the underside of the tongue and the floor of the mouth (called the lingual frenulum) limits the tongue’s mobility and full range of motion. Lip-tie and a high arched upper palate are also associated with tongue-tie a majority of the time.

Tongue/lip-tie may not always affect breastfeeding, but that doesn’t mean it won’t cause issues later on in life. The tongue has over 57 muscles (intrinsic and extrinsic). This means the tongue is classified as an organ, not a muscle! The consequences of having an organ that is not fully functioning may include more serious health issues such as:

  • Difficulty with solid foods and navigating textures of foods.
  • Issues with palatal and sinus development (resulting in ear infections, adenoid issues, etc.)
  • Speech Impairment
  • Teeth and jaw formation
  • Orthodontic issues
  • GI issues
  • Sleeping issues
  • Behavioral and/or social issues

 

Things to remember while breastfeeding the tongue-tied baby:

  • Aim for the deepest latch possible
  • Positioning is key! Consider using our favorite nursing pillow, “My Brest Friend.”
  • Understand that a tongue-tied baby may tire quickly at the breast. This is because they are using jaw and neck muscles to help them feed, since they have restricted tongue muscles.
  • Since these other muscles are being used, tongue-tied babies typically have a VERY strong suck.
  • Sore, damaged nipples and low milk supply are major issues for mothers whose babies are tongue-tied. Many moms choose to pump and bottle feed a few times a day to boost supply and to give their nipples a break from nursing.

 

Should I get my baby’s tongue-tie corrected?

Treatment of a tongue/lip-tie is a personal choice for each family. Usually, a procedure is done to cut or laser the frenulum so the tongue and/or lip can have full range of motion. This may be called a frenotomy, frenectomy or frenulectomy. Resources and providers may not be available to each family due to geographical or financial reasons. Some parents choose to correct the tongue-tie when and if it becomes an issue.

My personal opinion is that it is best to correct the restriction as soon as possible so that proper tongue function can begin. The longer you wait to correct it, the longer it will take for the effects of tongue-tie to resolve. Also, it is much easier to correct the tongue tie when the child is younger. I’ve known some offices that required that an older infant/toddler be given mild sedation in order to do the most thorough revision and to ensure the patient can remain still.

What is the best way to get tongue-tie corrected?

This is a complicated answer. You will first need to find a provider that you trust and comes highly recommended. This referral may come from your pediatrician or IBCLC. There are many methods to correct a tie: scissors, laser, electrocautery, scalpel, etc. So what’s the “best” method? It depends on the provider. If the provider is a master and confident in his/her tool, then they will do the best job. Whether scissors or scalpel are used, it’s the person behind the tool that matters.

A good provider will also have great bedside manner. They should treat you and your family with compassion, respect, and understanding. They should be patient, explain the procedure to you and never make you feel rushed or pressured. Before I make a referral to a new provider, I personally interview them and even observe their procedure multiple times so I feel confident sending patients to them.

What happens after tongue-tie is corrected?

Often after the procedure, you will be asked to nurse the baby if you are breastfeeding. Be sure to bring your nursing pillow or any supplies you may need. Once you are settled at home, it’s a good idea to follow up with an IBCLC to get a feeding plan in place. Many families expect that the procedure will solve all their nursing issues immediately. I’ve seen this happen only a handful of times. Correcting the tongue-tie is not a magic cure. It may not make all your nursing issues go away immediately.

Nursing issues will often dissipate gradually after working on latch, sucking skills and bodywork. Keep in mind, your baby has had a restricted tongue even in utero, so it will take time for him/her to learn how to use it properly and to retrain it to move properly. Mother’s may need to heal their damaged nipples and increase milk supply as well. During this healing and re-learning time, it is important to have your team ready to help. Your IBCLC, pediatrician and your support network can give you reassurance and guidance when you need it most.

Looking for more support dealing with your baby’s tongue-tie or other structural issues? Send us a message and one of the healthcare professionals on our team can offer personalized care for you and your baby.

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