A tongue tie is also know as an ‘Ankloglossia’ or ‘short frenum’. It refers to the cord that stretches from under the tongue to the floor of the mouth. Tongue tie is characterised by an abnormally short lingual frenulum, which may restrict the mobility of the tongue during breastfeeding.
A normal frenum is elastic and does not interfere with the movement of the tongue in sucking, eating, clearing food off the teeth in preparation for swallowing, and speech. Tongue ties are broadly referred to as an anterior and/or posterior tie. Limited literature would report 3.2%~ 10.7% incidence of tongue tie in babies. However, lactation consultants would consider this number to be significantly higher. As more studies are completed, the number of tongue ties is likely to be much higher. Research has also suggested tongue tie to be more common in boys 2:1.
Tongue ties can be asymptomatic and cause no breastfeeding problems. All babies are different and need to be assessed and treated individually, by an experienced trained Lactation Consultant (IBCLC). If tongue tie is causing breastfeeding problems, it should be assessed, managed and treated (if necessary), as early as possible to minimise breastfeeding problems. All tongue ties do not look alike; this can also make them difficult to diagnose.
Anterior tongue tie characteristics:
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A frenulum that is attached toward the front of the tongue, often visible and easy to identity.
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It is easy to see when looking in your baby’s mouth.
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Often the tongue is pulled into a heart shape when extended.
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The baby may not be able to put their tongue out past their lower gum line.
Posterior tongue tie characteristics:
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Tongue tie is normally hidden under the skin.
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It is hard to see when looking into baby’s mouth.
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Assessment by a trained professional is required to determine posterior tongue tie
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Baby can often stick their tongue out past their lower gum line.
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Due to the restriction of the tongue, it can effect tongue motion and movement when breastfeeding.
Lip tie characteristics:
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Lip tie is also known as Upper labial maxillary tie.
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It is a thickness or shortness of the upper labial maxillary.
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It can affect the ability to flange the upper lip outwards, thereby affecting the latch.
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There is growing evidence to suggest lip tie restriction impacts breastfeeding.
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Lip tie is associated with posterior tongue tie.
Baby signs and symptoms can include:
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Poor sucking technique.
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Ineffective sucking (not getting enough milk).
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Trouble remaining latched on throughout a feed.
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Long feeding/ short breaks in between feeding.
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Poor weight gain, failure to thrive.
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Making sounds while feeding; clicking, smacking.
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Windy/ colicky & reflux baby.
Mother signs and symptoms can include:
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Sore nipples.
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Damaged nipples - cracked, blistered, bleeding.
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Leaking milk while baby is feeding.
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Reduced suppleness, due to poor removal of breast milk.
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Long feeding times.
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Plugged ducts.
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Thrush/ mastitis or recurrent mastitis.
If you think your baby has a tongue tie or lip tie and it is affecting breastfeeding, you can seek an experienced practitioner to assess your baby’s tongue function and breastfeeding. A Lactation Consultant (IBCLC) can also refer your baby for a frenotomy procedure, if required, a frenotomy is a procedure in which the lingual frenulum is cut. Research has suggested, when a frenotomy procedure is performed for significant tongue tie, there was an immediate improvement in nipple pain and babies ability to breastfeed.
If you need additional breastfeeding support you can contact a Lactation Consultant (IBCLC), your health care professional or attend a breastfeeding support group in your area.
