Tongue-Tie and Breastfeeding: 5 Things You Need To Know

Ankyloglossia, otherwise known as tongue-tie, is an anatomical anomaly in which a thin piece of tissue called the frenulum connects the bottom of the mouth to the tongue. The location of insertion on the tongue varies. When the frenulum connects close to the tip of the tongue, the baby’s tongue will look indented or heart-shaped. Babies who are unable to protrude their tongue properly may have a hard time breastfeeding. Not every baby with a tongue-tie, however, will have problems breastfeeding.

Frenotomy

Babies with breastfeeding problems and tongue-tie may benefit from a procedure called a frenotomy. A frenotomy is the clipping of the frenulum to release the tongue. Parents should talk to their pediatrician if a frenotomy has been recommended to them. Here are some things to keep in mind before having the procedure.

1. Symptoms: Babies only need the procedure if they are unable to latch properly, have trouble transferring milk and thus poor weight gain, and/or if mom is having nipple pain, cracking or bleeding. You may notice your baby “chomping” instead of sucking and you may hear clicking noises with feedings.
2. Procedure: The procedure is easily done by lifting tongue with a tongue elevator. This protects the base of the tongue and guides the location of the cut. Scissors are used to clip the frenulum. Pressure is applied to stop the bleeding. Babies are encouraged to breastfeed right after. The procedure is best done by your pediatrician or an ear, nose and throat doctor. Many dentists now perform frenotomies using a laser, however often times the laser is not as exact and can cause damage to surrounding tissues.
3. Follow up care: Families should use gauze on their fingers to sweep under the tongue after each feeding for 1 week following the frenotomy. This will keep the frenulum from re-adhering.
4. Risk: The main risks of a frenotomy are bleeding and infection. Babies must have a vitamin K shot to help their blood clot prior to the procedure. Applying pressure and breastfeeding right after also help stop the bleeding.
5. Long term: Babies with a tongue-tie but no issues with feeding do not require frenotomy. Currently, there is not a recommendation to do a frenotomy to prevent future problems with speech, feeding or tongue function.

Overall, frenotomy is a relatively simple and safe procedure that can be helpful for infants having feeding issues related to their tongue-tie. If you have concerns for your baby, speak to your pediatrician.