Tongue Tie Overview

Tongue tie or ankyloglossia, refers to one’s tongue movement being restricted by a short or thick band of tissue that is connected to the lower jaw and called the frenum or frenulum. Although everyone has a frenum, not all are tongue tied. Tongue tie is often hereditary and can easily be fixed, but is often left undiagnosed so many adults are tongue tied but unaware. A tongue tied child may have no noticeable problems, however many times the children will have trouble breastfeeding, sticking their tongue out, speaking, swallowing, and orthodontic problems.  

The correction of tongue tie has increased in the last several years. This is not because more people are tongue tied, but due to the increasing trend toward breastfeeding. For many years, parents were advised to bottle feed their children, but we have seen a trend back to breastfeeding. Breastfeeding is not only more natural but also provides many benefits to mother and baby. Furthermore as our society has changed so have medical practices, and back in the day midwives had one long nail that they used to clip a tongue tied child. You may have been horrified that midwives used to snip a tongue tie with their fingernails, but the procedure is a very quick and the snipping, is not done through muscle but rather through a skin like webbing, hence the reasons nurses were able to use their nails. This is not to say it doesn’t hurt, but it should serve to reassure you that your child will feel minor pain and they may cry. Most children will not need any help in the way of pain relief, but if they do ask the provider what they recommend.

So now you may be wondering how can you tell if your child has a tongue tie. With babies, one indicator of a tongue tie may be problems breastfeeding. These problems may include a baby having trouble latching, not latching at all, or they may simply come on and off the breast multiple times. You may also hear a clicking sound, they may have trouble gaining weight, or mom could have nipple pain. Since tongue tie may present itself in a range of different ways, it is important to work with an IBCLC if you have any problems related to breastfeeding. Often, the evidence may not lie with the baby. A tongue tied baby will overcompensate by increasing their suction which can lead to a mom having very sore and often damaged nipples. Many of these symptoms of a tongue tie can be attribute to other causes, so often babies are not diagnosed straight away. Furthermore, as we as a society moved away from diagnosing tongue ties, we have lost the knowledge necessary that allows many practitioners to be comfortable diagnosing tongue ties that are not extreme, or immediately obvious. For these reasons, it is important that you not only seek an experienced Lactation Consultant, but also that they recommend you to a pediatric ENT who has experience dealing with children who are tongue tied. Now that we know what tongue tie is, let us have a quick look at the different types of tongue ties and go over some of the myths and facts associated with tongue ties.

If you think that your child may have a tongue-tie, make sure that you have your baby checked by someone, who is familiar and has worked with them before. You should book an appointment with a pediatric ENT, and once they have determined your baby has tongue tie, they  will release it. To release a tongue tie, the ENT or pediatric dentist will use scissors or a laser. The procedure will be over in a few seconds and there will be minimal bleeding. Once the procedure is complete, most babies will be able to nurse immediately, some may be a little fussy and sore. Some babies may not feed immediately, but don’t worry, this will not last long and does not happen in the majority of cases. Once your baby’s tongue tie has been released it is imperative to see your IBCLC for another consultation, because while some mothers will immediately see a difference in the way their baby nurses, many mothers will not. For the mothers who do not see an immediate difference, your baby may need a helping hand while learning to adjust to the new way of nursing. After the release of your baby’s tongue tie your IBCLC will work with you to gently encourage tongue movement. These are very simple and gentle exercise to ensure that the tongue tie does not reattach. Please do not worry if you think your baby has a tongue tie, your IBCLC should be familiar with tongue ties, they will be able to answer your questions, and know that this is something that is easily revised.

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