What is tongue-tie?

Photo source

Tongue-tie in newborns. Heard of it before? I bet most of you don't. I didn't, until I gave birth to my son almost nine months ago.

Here's my experience of coping with my newborn at that time: Behind the scenes: First 4 weeks of motherhood

What is tongue-tie?

Tongue-tie (ankyloglossia) occurs when a baby's frenulum (the piece of skin between the underside of the tongue and the floor of the mouth) is short and tight. This causes the baby's tongue movement to be restricted, making it hard to latch effectively to his mother's breast.

Tongue-tie is a birth defect that runs in families and affects 3-10% of newborn babies. It is more common in boys than girls.

To breastfeed successfully, the baby needs to latch on to both breast tissue and nipple, and the baby's tongue needs to cover the lower gum so the nipple is protected from damage.

Babies with tongue-tie are not able to open their mouths wide enough to latch on to their mother's breast properly. They tend to slide off the breast and chomp on the nipple with their gums. This is very painful and the mother's nipples can become sore, with ulcers and bleeding. Some babies feed poorly and get tired, but they soon become hungry and want to feed again. In most cases, these feeding difficulties mean the baby fails to gain much weight.

[Source: http://www.nhs.uk/conditions/tongue-tie/Pages/Introduction.aspx]

Symptoms

The whole list of symptoms can be found on http://milkmatters.org.uk/2011/04/15/hidden-cause-of-feeding-problems-however-you-feed-your-baby/

For my case, the following symptoms are the ones that prompted me to contact a lactation consultant and pediatrician to check on my boy's tongue at that time:

• Persistent very sore or damaged/blistered nipples
• Compressed nipples (change in shape) after feeding
• Very frequent feeds
• Baby wants to feed/suck very frequently
• Baby swallows infrequently/sporadic
• Baby doesn't seem satisfied after feeding
• Low milk supply
• Mastitis/blocked ducts
• Baby rarely settles to a deep restful sleep
• Latch trouble, i.e. as though struggling to remain attached
• Clicking sound when feeding and may pop on and off
• Restricted tongue elevation when crying 
• Slow weight gain

Frenotomy

The following video reminds me of what my boy went through when he was 14 days old.

He had frenotomy (also called a frenectomy or frenulectomy), i.e. snipping, dividing or clipping of the frenulum (which has few nerve endings and blood vessels) with a pair of blunt ended sterilized scissors done by a trained pediatrician.

Post by Gina's Place : The Breastfeeding Postnatal Centre.