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Tongue-tie (ankyloglossia) is a condition in which a thin piece of tissue under the baby’s tongue (the lingual frenulum) is abnormally short and may restrict the movement of the tongue, often leading to problems with breast-feeding.
Tongue-tie occurs in about 3% of babies and is a condition that can run in families. It is also more common in boys.
IMPACT OF TONGUE-TIE
It may interfere with a baby’s ability to latch and suckle at the breast leading to:
- Nipple pain and trauma for mum, during breast-feeding
- Poor breast milk intake, which in turn leads to
- A decrease in milk supply over time.
Tongue-tie may also have an effect on oral hygiene (the tongue cleanses the teeth inside the mouth).
It may also affect speech development (this remains controversial).
Breastfeeding is one of the first independent pleasurable activities that a new baby experiences. It is widely recognised to be important both for the baby’s health and nourishment, and for bonding to take place between mother and baby.
A baby with a tongue-tie often cannot make the necessary movements that allow feeding to be satisfying for both mother and baby. Instead, the experience becomes a frustrating experience for the baby, and often leading to pain, a sense of guilt and failure for the mother.
At Top Health Doctors, we have doctors that have done many tongue-tie release procedures through past surgical training. We also have a private room in our treatment room area where you can spend some time with your baby, before and after the procedure. In addition, we have support nurses that understand your condition.
SIGNS OF A TONGUE-TIE
To tell if your baby is tongue-tied, look at your baby and stick out your tongue. Even tiny babies will imitate you. If your baby is unable to extend the tongue fully, beyond the lips, your baby likely has tongue-tie.
In addition, you may find that with your baby,
The tongue cannot be moved sideways.
The tongue tip may be notched or heart-shaped, and
When the tongue is extended, the tongue tip may look flat or square instead of appearing pointed.
There is usually breastfeeding problems such as:
- Nipple pain and damage
- A misshapen nipple after breastfeeding
- A compression/stripe mark on the nipple after breastfeeding
- The baby often loses suction on the breast whilst feeding
- A clicking sound may be heard while the baby is feeding
- Associated poor weight gain
Before performing this procedure, clinicians (including midwife, lactation consultants / nurses, paediatrician, and others) who work with breastfeeding mothers usually have assessed the baby, and recommended your baby to have a procedure called lingual frenotomy (or simply called tongue tie release).
This is usually in the setting of painful breastfeeding, with poor milk transfer associated with your baby’s tongue-tie. A tongue-tie release in this case, will likely improve your baby’s ability to breastfeed.
However, sometimes a tongue-tie causes no problems with breastfeeding and this requires no action.
At Top Health Doctors, we conduct a thorough history and assessment of breastfeeding and baby’s tongue mobility to determine if release is required.
If the frenulum is thin and the baby is less than around four months of age, the tongue-tie release can be performed at Top Health Doctors without any anesthesia.
Tongue-tie release is considered only after your baby has had Vitamin K, usually at birth (or at least 2 oral doses).
If baby who is older than 4 months of age or who has a tongue-tie that is thick, your baby may need to be referred to have it done in a hospital setting.
TONGUE-TIE RELEASE PROCEDURE
It is preferable for the tongue-tie to be released before a feed. If your baby is due to have this procedure please try not to feed your baby for at least one hour before your appointment.
The release of a tongue-tie involves our doctors placing a finger and thumb under the baby’s tongue to gain clear access to the frenulum. The frenulum is released with a small pair of sterile scissors.
A drop or two of blood at the release site is normal and is rarely a problem. Some babies may be unhappy at being held still and having fingers placed in their mouth. Occasionally a baby will startle when the release is performed but will settle quickly once comforted. Following the procedure, the mother will be encouraged to breastfeed straight away.
Possible complications of the procedure are bleeding (usually minimal) or infection (rare). There is usually no need for painkillers, with most babies settling very quickly with breastfeeding and cuddles.
Occasionally, during the healing process a small white patch may be seen under the tongue of some babies. This is normal and should resolve within two weeks of the release.
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