When we think of tongue tie, we often think of a nervous speaker stumbling over their words, or mixing up our words during a conversation. However, many people don’t realise that tongue tie is a medical condition found in some babies, also known in medical terminology as ankyloglossia. From how common it is, to the implications for your child, here’s everything you need to know about tongue tie in babies.
Tongue tie occurs when a baby’s’ frenulum (the strip of tissue connecting the tongue to the floor of the mouth) is shorter than usual. This is a relatively common condition, affecting between 4%-11% of babies, but studies have shown it’s actually slightly more common in baby boys. Tongue tie is present at birth, and some studies have shown that it can be hereditary (passed from parent to baby), so if you know that you suffered from this then make sure to tell your doctor or midwife.
How To Tell If Your Baby Has Tongue Tie
Caregivers may notice that their baby with tongue tie or lip tie does not meet appropriate feeding milestones or has atypical feeding behaviours. Possible symptoms for this condition include:
- Difficulty latching and feeding when babies breastfeed or bottle feed; they lift their lower jaw during suckling, and use their top gum and the tip of the tongue (which lies on the lower gum) to keep the nipple / bottle in place. Tongue tie and lip tie can prevent the baby from taking enough breast tissue into the mouth to latch properly for feeding and the latch is often very shallow. Many babies may be able to latch but are unable to get the correct movements for sucking. Tongue tie may also result in a poor suck, breath pattern or swallow.
- Mother experiences pain while nursing due to restricted and atypical tongue movements or improper latching. While the infant nurses, the mother may experience additional friction. This can lead to pain, bruising and bleeding.
- Frequent feeding patterns occur because during each feed, the infant consumes less milk than typical infants. Shortly after feeding, the infant may also show signs of hunger.
- Fatigue during or directly after feeding; the stressful experience of feeding means that the child expends more time and effort when feeding. During feedings, she might become irritated or fall asleep within one to two minutes.
- Dimpling of cheeks or clicking sounds when feeding; this is tongue tie-specific and is caused by atypical latching and sucking movements. There may also be jaw tremor here. Children with tongue tie are sometimes fussy and / or often pull away from the breast or bottle.
Some babies with tongue tie have no problems stemming from the condition at all; bottle fed babies are usually fine, as the teat from the bottle doesn’t require the same tongue action as breastfeeding. However, tongue tie can cause difficulty when breastfeeding, as the baby’s tongue is essential for proper suction to the breast.
A baby with tongue tie may end up compressing mum’s breast tissue during feeding, which can lead to nipple soreness and damage. This inability to feed correctly can lead to low weight gain and fussiness. A tell-tale sign of a baby with tongue tie is a clicking sound when feeding, but this can also be a sign that you need support with the positioning and attachment of the baby at your breast, so check to make sure.
How might an upper lip-tie impact feeding?
The impact of the upper lip-tie can vary - as the fullness of the upper lip can come into play. According to Melanie Potock, MA, CCC-SLP, you should consider these key points:
Breastfeeding and Bottle Feeding with Tongue Tie
- Breast – Inadequate latch: An infant has to flange his lips to establish ample suction and a proper seal of the nipple and surrounding tissue. It is important for babies to take in sufficient breast tissue to activate the suckling reflex, stimulating both the touch receptors in the lips and in the posterior oral cavity in order to obtain enough milk without fatigue. One (not always present) sign is a callus on the upper lip of the infant, immediately at midline.
- Bottle – Inadequate Seal: Since bottles and nipple shapes are interchangeable, and modifications can be made, a weak lip seal can be compensated. These compensatory measures are often adopted, however, because all attempts at breastfeeding have become too difficult, too exhausting, or result in poor weight gain ... and the culprit has been the upper lip-tie all along.
It can be difficult to tell if a baby has tongue tie, but if your baby struggles to extend his tongue out beyond his lips or if his tongue has a heart shaped appearance at the tip, it might be worthwhile getting him evaluated by a doctor.
Can Tongue Tie Go Away By Itself?
In most cases, the frenulum will recede by itself over the baby's first year, but in some cases a small surgical procedure may be required. This is a very simple operation known as a frenotomy, which is a safe and uncomplicated procedure, usually performed in office at the GP’s surgery. No anaesthesia or stitches are needed; it’s a very easy and painless procedure.
However, needing this procedure is rare, and only required in cases where the baby is struggling to feed or when mum is very uncomfortable. The baby can feed with ease straight after the procedure, and many mums note that comfort during breastfeeding improves almost instantly!