Tongue-tie is a condition in which an unusually short, thick or tight band of tissue (frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. Often it goes unnoticed and causes no problems in life but rarely it can affect how a child eats and how they sound when they speak, and can sometimes interfere with breastfeeding because baby’s tongue may not have enough range of motion to attach to the breast, suck and swallow effectively. Sometimes tongue-tied babies can’t maintain a latch for long enough to take in a full feeding, and others remain attached to the breast for long periods of time without taking in enough milk. Sometimes babies with tight frenulums make it miserable for mom to feed because of the way they attach and latch. When a newborn has a tight frenulum breastfeeding moms may have nipple pain, mom may hear clicking sound while the baby feeds, or mom may feel it’s inefficient. Sometimes a parent will notice a heart shape to the tip of the tongue as the band of tissue pulls on the tongue where it’s attached.
What to do about tongue-tie can be controversial. Not all pediatricians, Ear, Nose and Throat surgeons, lactation consultants and occupational therapists always agree. However, every baby deserves the chance to be evaluated by both a physician and a board certified lactation consultant if there is concern! Awareness about a newborn’s challenges with breastfeeding increases diagnosis in the newborn period but decisions to clip a tongue-tie come about from a variety of factors. The American Academy of Pediatrics states: “surgery, called frenotomy, should be considered if the tongue-tie appears to restrict tongue movement, such as inability to latch on with breastfeeding. It is a simple, safe, and effective procedure—general anesthesia is not required.” It takes only a few seconds and many pediatricians can perform the clip in their office.
In the podcast here, I had the grand pleasure to talk with Lynn Wolf, an occupational therapist and lactation consultant with decades and decades of experience helping new parents and new babies (and older infants!) with nursing and associated challenges that sometimes comes with tongue-tie. She’s a guru and even wrote the book, “Feeding and Swallowing Disorders In Infancy: Assessment and Management.” She explains what tongue-tie is, how to identify it, the ways babies need to show they can breastfeed, and what to do about tongue-tie if suspected in the newborn period or at older ages.
More resources here on breastfeeding and tongue-tie at KellyMom. And here’s a nice video, Tongue-Tie In Infants And Young Children, from an ENT surgeon, Dr. Anna Meyer, in San Francisco, on tongue-tie in infants and young children.