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What Is Tongue Tie And What Should I Do About It?

What Is Tongue Tie And What Should I Do About It?

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Do you have a fussy baby who isn’t breastfeeding like they should? Perhaps your infant has acid reflux symptoms. Or maybe you’ve reached a stage where breastfeeding just isn’t working. 


These issues may have something in common: tongue tie. Infant tongue tie can cause a host of problems for both you and your baby. It affects how your baby latches on, which can cause sore and cracked nipples, and could be why your infant is swallowing excessive air, resulting in reflux. 


No wonder your little one’s fussy – for babies with tongue tie, the struggle is real! Fortunately, there are ways to deal with it. Read on to see if you have a tongue-tied baby and how to resolve it. 

 

baby looks over mother's shoulder

 

What Is Tongue Tie?

We all have a small fold of tissue beneath the tongue called the lingual frenulum. This loosely connects the tongue to the floor of the mouth.


Up to 10% of us are born with tongue tie, when the frenulum connects too tightly to the mouth. This limits how much the tongue can move around. Most tongue tie is mild and stretches as the baby grows.


Some infants also have lip tie, where the tissue between the upper lip and the gum connects too tightly.  

 

How Does Tongue Tie Affect Breastfeeding?

Infants with tongue tie may make breastfeeding extremely challenging. Research undertaken in Spain shows well over half (57%) of 302 infants with breastfeeding difficulties studied had tongue tie.


If your baby’s tongue or lips don’t have full range of motion, it can be much harder for them to form a seal around the nipple to draw in milk. 


This means they may be unable to suck properly and fail to take in enough milk to gain weight and thrive. 


A poor latch results in painful, sore and cracked nipples. An inability to feed means breasts can become engorged, leading to blocked ducts, mastitis and an end to breastfeeding well before you’re ready. 


Babies with tongue tie may also struggle to form a seal around the teat of a bottle. When the tongue and lips don’t create a perfect seal around the teat or nipple, your baby may swallow large amounts of air. 


This is called aerophagia, or air-induced reflux. The air will bubble up from little one’s tummy later, making them feel uncomfortable and bringing up their milk. The symptoms are similar, and often mistaken for, acid reflux. 


Here are some natural ways to help you cope in the meantime:

  • Use a nipple salve on the nipples and areola between feedings. 
  • Pump and give your baby a bottle (if they’ll take it) if your breasts are very sore and the pain is too much.
  • Give your baby a BIBS Supreme pacifier to soothe them. Made with a flat nipple, this pacifier has a valve which means that it can be flattened and the air pressed out so the pressure against palate and gum are reduced. This means that your baby doesn’t need to suck as hard. The shield and teat are symmetrical, so the pacifier always lies correctly in your little one’s mouth.
  • Try a nursing pillow. We love the Boppy Anywhere Pillow. It offers ergonomic feeding support and is easy to move around.
baby with bibs supereme pacifier

 

What Else Can Tongue Tie Affect?

Even if your baby is nursing fine now with a tongue tie, speech issues may arise later in life. If your child reaches the age of three and those outside your immediate family still have trouble understanding their speech, consult a speech language therapist


An uncorrected tongue tie may also cause tooth decay in a baby’s molars. This is because your baby can’t move their tongue to efficiently sweep their mouth clean, causing milk to puddle.

 

What Does A Tongue Tie Look Like? 

Tongue and lip tie are sometimes diagnosed at routine check-ups. However, unless it’s severe, it can often be missed, even by your pediatrician. 


Here’s how to tell if your baby is tongue tied:

  • They struggle to lift their tongue up to the roof of their mouth.
  • They find it hard to move their tongue from side to side.
  • The tip of their tongue looks heart shaped when they stick it out.
  • They can’t stick their tongue out further than their lower lip.
  • More milk drips out of their mouth than is swallowed while feeding.
  • They seem uncomfortable and can’t settle down.
  • They frequently spit up their milk.
  • They ‘fall off’ or pull off the bottle or breast while nursing and may cry or hit out. 
  • They make very noisy sucking sounds.
  • They try to bite down or chew on your nipple.
  • You may have sore, cracked or bleeding nipples. 
  • Your nipples appear squashed, lipstick shaped, and are white in color.
  • It hurts when you breastfeed.
  • You’re suffering frequent bouts of mastitis.
  • You have problems with your milk supply. 

 

woman rubs baby's back

 

How Do You Fix A Tongue Tie? 

A tongue tie is corrected by snipping the frenulum – the piece of skin that attaches the tongue to the bottom of the mouth. The procedure is quick and only requires a topical anesthetic, but does carry some risks, such as infection, bleeding and swelling.


And because there are often multiple factors at play when a newborn has trouble feeding, some experts say that a tongue-tie revision may be unnecessary. Not all breastfeeding issues are the same and a tongue-tie procedure may simply be a quick fix rather than exploring other non-surgical treatment options.


You may feel pressure to decide quickly about whether your child should undergo a tongue-tie surgery. It’s important to take a moment to think about whether there is another way. For example, is it a short frenulum or could it be a muscular control issue? Perhaps it’s low milk supply, reflux or shallow latching that’s the real problem.

 

How to Get Baby’s Tongue Tie Diagnosed

Your first port of call is to establish whether it is in fact the tongue tie that’s affecting your baby’s feeding. You can receive support from several different providers. It’s a great idea to check in with all these experts to get a holistic opinion. 

Lactation consultant

Lactation consultants are experts in the positioning and latching issues that might be keeping your baby from feeding effectively.

Pediatrician

Your baby’s doctor will be able to troubleshoot any feeding and growth concerns. They can look at your baby’s mouth to check for tongue tie. Bear in mind that some doctors are not trained at diagnosing a tongue tie, however. Depending on their experience and what your baby needs, your doctor may refer you to a speech therapist.

Speech therapist

These experts can recommend stretching exercises to help coordinate the tongue, jaw and cheek muscles. They essentially retrain your baby’s mouth to feed.


Some babies simply have trouble latching right away, but with ongoing lactation support, they will improve. However, if your baby doesn’t latch, even with the help of a lactation consultant, seek help sooner rather than later. The earlier your baby’s tongue tie and feeding issue is detected, the easier it will be to correct it. 

 

What Happens During a Tongue Tie Revision?

There are two widely used techniques for performing frenotomy: cold steel and laser. Thanks to this technology, the procedure is less painful, more accurate, reduces bleeding and is less traumatic for your baby.


The surgery only takes a few minutes. Here’s what to expect:

  • You hold your child.
  • In very young babies, no general anesthetic is used but a local numbing agent may be applied.
  • Your baby’s head is held securely, while sharp, sterile scissors with blunt ends (or a small handheld laser) cut the tongue-tie.  
  • You can nurse or comfort your baby straight away.
  • Your baby may develop a white patch under their tongue, but this should heal in a day or two.

 

How to Help Baby Heal Naturally After Tongue Tie Surgery

You’ll be relieved to know that the mouth is one of the body's quickest healers and your baby should be back to normal within 48 hours. Some babies will need more comfort than others. Here are some ways to help your baby:

  • Nurse or feed your little one immediately to comfort and reassure them.
  • Hold your baby skin to skin.
  • Apply a small dab of refrigerated coconut oil to the area.

 

smiling baby

A tongue tie can cause a lot of stress for you and your baby, particularly if it isn’t diagnosed right away. Don’t suffer in silence – get your baby checked by your pediatrician, a lactation consultant or speech therapist as soon as you start to struggle. 


About to embark on your breastfeeding journey? Read our guide to breastfeeding: everything you need to know.

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