WHAT IS TONGUE TIE?
A tongue tie is a membrane that is too tight under the tongue called a frenulum, this tight membrane can restrict tongue movement, and anchor the tongue down to the floor of the mouth, this can lead to breastfeeding difficulties.
Tongue tie can affect as many as 10% of babies born, maybe more.
HOW CAN A TONGUE TIE AFFECT BREASTFEEDING?
Often a baby with tongue tie is unable to open the mouth wide to have a deep enough latch to breastfeed efficiently. If the tongue is restricted, the mouth may not create a good seal during a feed, and so the baby often chomps down on the nipple with its jaws in order to keep the breast in place. This can be extremely painful for the mother, and this method does not transfer milk efficiently. The nipple is also often damaged from this shallow latch. Without a good seal the baby can swallow air during the feed, which can also cause him or her much discomfort and irritation. To accommodate for this, the baby may feed a lot more frequently or for very long periods of time, which can be exhausting for both mother and baby.
- Nipple damage
- Painful feeds
- Blanched or flattened nipple in ‘lipstick’ shape
- Blocked ducts
- Reoccurring candida
- Difficult to latch
- Small or narrow latch
- Constant feeds
- Clicking sound during feeds
- Seems unsatisfied after feed
- Gumming or chomping on the nipple
- Leaking milk from corners of mouth during feeds
- Gasping, coughing and releasing when milk comes
- Slow to put on weight
If a tongue tie release is appropriate, this can be done during the same visit as the assessment. The assessment is done by evaluating the following:
- Asking about your breastfeeding so far and your breastfeeding goals
- Observing how the baby feeds
- Looking inside the baby’s mouth
- Feeling the frenulum under the tongue
- Evaluating tongues movement, lift, restriction, cupping and extension
If we feel there is a tongue tie causing difficulty, we will offer to release. We will explain the procedure, and if you would like to go ahead with the tongue tie release, we will ask you to sign a consent form.
First, the baby is swaddled, then the tight membrane under the tongue, known as the frenulum, is snipped. This is called a tongue tie release, or frenotomy. This minimally invasive procedure takes seconds, and there may be just a few drops of blood, which usually stops as soon as the baby is latched on the breast, or by compression with a sterile gauze. If a lip tie is causing difficulties, this too can be released easily. Often, there is an immediate improvement with breastfeeding, latch, suck, and relief in nipple pain. In other cases, improvements can be more gradual, from 3-4 days to a few weeks later.
AFTER THE PROCEDURE
We encourage gentle exercises and active wound care to encourage optimum tongue function and reduce risk of reattachment. This is done in a very gentle and kind way, and should not upset the baby at all.
The baby should be encouraged to make a deep latch at every feed (even at night when you’re really tired!), to use his/her new freedom in the tongue effectively, otherwise he or she may be inclined to continue making a shallow latch, and problems may persist.
Clear and easy instructions will be given after the procedure in order to:
- Encourage effective tongue function and wound healing
- Optimise positions for a deep latch
- Reduce or eliminate nipple pain
- Promote optimal milk transfer for breastfeeding success
Deirdre offers a follow-up consultation one week post-procedure, to assess the healing, maximise breastfeeding results, and release any significant reattachment of the frenulum if this has occurred (between 3-10% of cases). This follow-up is free of charge.
Book an appointment to see Deirdre below.