Tongue Tie

Article provided by Eirini Vounatsou- Ozohili, Phd Candidate, MSc, BSc, RM, RN
Senior Midwifery Lecturer 
Infant Feeding & Tongue Tie Division Specialist 

Tongue Tie or Ankyloglossia

What is it?

It is a congenital anomaly of the oral cavity that can reduce the mobility of the tip of the tongue and is caused by an unusually short, thick lingual frenulum, that is, a membrane that connects the underside of the tongue with the base of the oral cavity.

Why does tongue function matter?

The way the tongue works is a key component for nutrition, food, swallowing, speaking and breathing, as well as for the development of the craniofacial complex.

Symptoms for the baby

• Difficulty latching to the breast and/or difficulty remaining on the breast (appears to “slip from the nipple”)
• Frequent breastfeeding for long periods due to inefficient milk transfer
• Your baby may be very agitated and appear hungry most of the day
• Weight gain can be slow or static due to ineffective breastfeeding
• Weaning
• A click is heard during feeding
• Cough, vomiting and reflux during breastfeeding/bottle feeding
• Dripping milk from the side of their mouth when feeding
• Upset baby on the breast, hitting the breast and shaking the head left and right
• Symptoms of colic or reflux

Symptoms for the mother

• Deformed nipples. Lipstick-shaped, flattened, ribbed or elongated
• Reduced milk production
• Mastitis – frequent occurrence due to the stasis of milk in the breast (ineffective emptying of the breast).
• Feeling exhausted/depressed/or like a failure due to continuous/frequent feeding
• Pain and sore nipples due to the baby’s tightening their latch on the nipple to hold it in the mouth 
• Compression of the nipple into the hard palate by the tongue of the newborn
• Fear of the next breastfeed (because of the pain)

Is a short frenulum always a problem?

The frenulum is part of the normal anatomy. However, there may be increased muscle tension around the head, neck and jaw which can occur with identical symptoms that may occur with the presence of a short frenulum. 

The role of the qualified professional is to thoroughly assess your baby so that they can support you in the best way for you and your family.

• Especially after  a caesarean section or use of forceps/ventouse
• Breech position (The fetus has a position with the hips or legs down)
• Long labour/Induction of childbirth
• Abrupt/violent exit of the fetal head

Tongue Tie Division

• Tongue tie division involves cutting the short, tight piece of skin that connects the underside of the tongue to the bottom of the mouth. 
• It is a quick, simple and almost painless procedure that usually improves feeding immediately.
• Encourage feeding the infant immediately after.

Advice

Tongue tie division is only one aspect of the riddle of the function of the tongue. Patience, consistency and constant support from qualified healthcare professionals is the perfect combination to achieve the most positive results on your journey.

If you think your baby has a tongue tie let us know and we can offer support and guidance to you online or face to face on how to manage it.