Life with a newborn baby is so beautiful, isn't it? But sometimes, little problems come along with it. Especially when it comes to breastfeeding your baby. Does your baby not like to drink milk? Is he not gaining weight? Or do you feel pain when breastfeeding? One reason for this could be a small problem with your baby's tongue. We are talking about something like that today.
What is Tongue-Tie?
Simply put, tongue tie , or as doctors call it , ``Ankyloglossia,'' is a condition in which a baby's tongue is restricted in its movement. This is because a band of tissue under the baby's tongue – called the ``Lingual Frenulum'' – is either shorter or tighter than normal. Think about it, there's a small band of tissue under our tongue that connects our tongue to the floor of our mouth. Babies have one like that too.
Every baby has this `(Lingual Frenulum)` under their tongue, and it is normal. It does not cause any harm. But sometimes problems arise when this becomes too tight, or when it is too close to the tip of the tongue. Then the baby cannot move his tongue properly, it becomes difficult to lift it up and put it out. Especially when breastfeeding, he cannot make the necessary movements with his tongue properly.
Tongue-tie can sometimes be a big challenge when breastfeeding . Babies with tongue-tie may have difficulty latching on to the breast properly or sucking milk. This can prevent them from getting the nutrition they need . Also, since the baby is not latching on properly, you may feel pain and discomfort while breastfeeding. Some mothers even feel like stopping breastfeeding because of this.
If you have experienced this, don't despair . Often, lactation consultants can help you overcome these problems by changing your breastfeeding position or the way your baby latches on to the breast. If these methods don't work, your baby can have a very safe and quick surgery called a frenotomy . This involves cutting and releasing the lingual frenulum. This allows your baby's tongue to move freely. Your lactation consultant and pediatrician will work together to find the best solution for both you and your baby.
How common is this?
Now you're probably thinking, "Oh, is this just my baby?" Don't worry. According to the American Academy of Pediatrics, between 1% and 11% of newborns have symptoms of this condition (Ankyloglossia). That means it's quite common . It's also said to be slightly more common in male babies. So this isn't something you're alone in facing.
What are the symptoms that the baby and mother experience?
Well, how do we know if we have tongue-tie? There can be symptoms that affect both the baby and the breastfeeding mother.
Symptoms that a newborn baby may have:
See if your little one has these things:
- The baby may not latch on properly or latch deeply: The baby may not latch on at all, or may cry when trying to latch on. The baby may make a clicking sound when sucking, or may pull away from the breast.
- It feels like the milk is not going down properly when breastfeeding: This may be why the baby is not gaining weight properly . They may be asking for milk frequently (frequent feedings), but as soon as they finish drinking, they feel hungry again. They may not even be able to hear the sound of milk being swallowed.
Symptoms you may experience while breastfeeding:
As a mother, you may also experience things like this:
- Cracked, sore nipples.
- I feel unbearable pain while breastfeeding.
- Insufficient milk supply: Because the baby is not sucking properly, milk production may decrease over time.
But here's something to keep in mind: These symptoms aren't specific to tongue-tie. Doctors call them 'nonspecific' symptoms . That means they can be caused by other things, too. That's why it's important to see a doctor or a lactation consultant who's experienced in breastfeeding issues to find the exact cause. They can help you figure out the cause of your symptoms (whether it's tongue-tie or something else) and help you find a solution.
How do you see this tongue twister?
Your baby's tongue may look heart-shaped , or it may have a small notch at the tip of the tongue. This is because the lingual frenulum, which I mentioned earlier, is attached to the tip of the tongue and restricts its movement. But sometimes this is not so noticeable, it can be barely noticeable. Doctors pay attention to this during the physical examination of the baby after birth.
What are the causes of `(Ankyloglossia)`?
Tongue-tiedness is congenital . This means that a baby is born with the condition. Researchers still don't know exactly why some babies develop it. However, they think there may be a genetic component . Some research suggests that it can run in families, possibly as an X-linked pattern of inheritance.
How do doctors recognize this as ankyloglossia?
Pediatricians usually look at this as soon as the baby is born. They work closely with lactation consultants, who can tell you exactly whether these changes in the baby's tongue will affect breastfeeding.
The important thing is that just because a baby's tongue is a little tight or short, it doesn't mean they have a ``tongue-tie'' or need treatment. Doctors only diagnose this condition if the tongue tie is actually restricting the tongue's function and making breastfeeding difficult.
Doctors will do the following to determine if your baby has tongue-tie:
- They will ask about your breastfeeding history: If you have had previous babies, what your experience was like with them. If your baby has a tongue tie, they may feel differently when you suckle than other babies. They will also ask how long you breastfeed, how many times a day you breastfeed, and whether you pump or formula feed.
- Asking how you feel while breastfeeding: If you are constantly experiencing pain or discomfort, you should tell your doctor . This does not mean that your baby has ``(Tongue-Tie)``, as there can be many other reasons for painful breastfeeding. But the discomfort you are feeling can help them figure out what the problem is.
- Consider the baby's medical history: Many things can affect a baby's ability to breastfeed, such as neurological disorders, heart conditions, and nasal or airway obstructions. If there are other problems, treating just the tongue tie won't help.
- Physical examination of the baby: In this, the pediatrician will carefully examine the baby's tongue and other parts of the mouth. They will check for signs of tongue-tie or other medical conditions.
- Direct observation of breastfeeding: A lactation consultant will watch you and your baby while you breastfeed. They will look at things like how you hold your baby (breastfeeding position) and how your baby latches on to your breast (latch). Sometimes, just a little change in the way you hold and latch on your baby can help a baby with tongue-tie get through the feeding without any problems.
Are there special tests to diagnose tongue-tie?
The baby doesn't need any special tests for this. Some doctors use different grading systems or assessment tools to see how well the baby's tongue moves inside the mouth. But the only way they can get the information they need is by looking at the baby's tongue and feeling the lingual frenulum. These grading systems help doctors describe the appearance and function of the baby's tongue. That information helps in diagnosis.
What are the treatments for this?
Okay, now let's see what can be done to treat this `(Tongue-Tie)` condition. Doctors mainly do two things for this:
1. Helping you develop a breastfeeding position and latch: This helps many babies with tongue-tied latches to breastfeed successfully without any difficulty. Your lactation consultant will support you every step of the way and will regularly check in on your progress.
2. In some cases, a small, quick surgery can be done right in the doctor's office: This involves cutting and removing the ``Lingual Frenulum'' under the baby's tongue. This allows the baby's tongue to move freely.
Does my baby definitely need a frenotomy?
Most of the time, not all babies with tongue-tie need surgery. And, even if your baby does need treatment, you can rest assured that it won't be a major surgery. In fact, doctors can perform this procedure called a frenotomy, which is a quick in-office procedure.
Most babies with tongue-tie do not need a frenotomy at all. Doctors only recommend this if your breastfeeding position and latching don't improve your symptoms.
This is a very safe procedure and is considered the gold standard for treating babies with tongue-tie. Before performing a frenotomy, doctors will rule out or treat other possible causes of breastfeeding difficulties. If a frenotomy is necessary, it is usually best to do it within the first month of a baby's life . This will help your baby learn to latch on properly from the start.
Are there any disadvantages to cutting the membrane under the tongue?
Frenotomy is generally a very safe surgery, and the risk of complications is very low. However, very rarely, the following can happen to your baby:
- Bleeding
- Infection
- Scarring
- Feeding aversion (baby not wanting to eat)
- Damage to the salivary glands (saliva ducts) in the mouth.
Can tongue-tie be prevented?
There is no known way to prevent tongue-tie. It is a congenital condition, so it is difficult for us to control it. However, in severe cases, early diagnosis and treatment can prevent problems with breastfeeding.
What to expect when having a tongue-tied baby?
Tongue-tie is usually nothing to worry about . It's common and can often be managed without surgery. The most important thing is to get help early . Don't just assume, 'If I just work a little harder, it'll be okay.' Breastfeeding difficulties are not your fault, and they're very common. Even experienced mothers sometimes need expert advice to help them deal with the problems that arise.
Does tongue tie affect bottle feeding?
Tongue-tied babies rarely have problems with bottle feeding. The baby uses his tongue to suckle milk from a bottle in a different way than he does from the breast. If necessary, a breastfeeding consultant can help by adjusting the bottle nipple or the speed of milk flow. If your baby is still having trouble getting the milk to come out of the bottle, there may be other reasons. Your consultant and pediatrician will work together to find the cause.
When should I see a doctor?
If your baby is having trouble latching on, definitely see a doctor or a lactation consultant . Whether the cause is tongue-tie or not, they can provide you with the support you need. The sooner you talk about it, the sooner both you and your baby will feel better.
Other related matters
Now let's look at a few other small questions related to this.
Does tongue-tie cause sleep apnea?
According to a clinical consensus statement published in 2020, there is currently no evidence that tongue-tie in children causes sleep apnea.
Does tongue tie affect speaking?
Experts agree that tongue-tie usually does not affect a child's speech. Therefore, there is no need to perform a frenotomy on a baby in the hope of preventing speech disorders in the future.
What is `(Posterior Tongue-Tie)`?
The term ``Posterior Tongue-Tie'' refers to the part of the ``Lingual Frenulum'' under the tongue that is located posterior to the tongue, rather than near the tip of the tongue. However, this is a somewhat controversial term. Some doctors say that this is not anatomically correct, and therefore suggest that the term should be removed. They prefer to use the term ``Tongue-Tie'', regardless of where the ``Lingual Frenulum'' is located.
What is `(Lip Tie)`?
`(Lip Tie)` usually refers to the membrane that connects the baby's upper lip to the upper gum. This membrane, called the `(Maxillary Labial Frenulum)` , can have many variations as normal. Whether it is a lip that is attached to the bottom of the baby's gum, or a lip that seems a little too big, it cannot be said that it will cause problems.
However, lip ties are a controversial topic among doctors. Some believe that lip ties can cause breastfeeding problems or dental problems later in life. Others say that there is not enough evidence to prove these links.
When it comes to breastfeeding, the latest research suggests that surgery is not necessary to treat a ``Lip Tie.`` There is no evidence to suggest that removing a ``Lip Tie`` improves milk flow or reduces nipple pain. However, if you have any questions about how to latch your baby on, talk to a lactation consultant.
Do adults also have tongue-tie?
Tongue-tied teeth can affect some adults, but it is usually diagnosed and treated in infancy. The lingual frenulum, located under the tongue, is just one of the frenulums inside your mouth. Other frenulums, such as the buccal frenulum, located in the cheek, provide support to other parts of your mouth. Depending on their size or location, they can make it difficult to properly clean your teeth and gums. Your dentist can examine all the structures inside your mouth and tell you if there is anything wrong.
The first month of your baby's life is a time of wonder and discovery for both of you. But it can also be tiring and frustrating, especially if breastfeeding isn't going as planned. Tongue-tie can be one cause of breastfeeding difficulties. But it's not the only one. If your baby is having trouble feeding, don't hesitate to see a breastfeeding consultant. They can work with your pediatrician to find the cause and come up with a solution that suits your needs.
What are the most important points we should take home from this story?
Okay, so, here are some things you need to remember from what we've talked about with regard to tongue-tie:
- Tongue-tied teeth are common: they're not something unique to your baby. Most babies can have them.
- Not all tongue-tie cases require surgery (`frenotomy`): In many cases, these problems can be resolved by changing the breastfeeding position and the way the baby latches on to the breast.
- Be aware of symptoms: If your baby doesn't want to breastfeed, isn't gaining weight, or has pain while breastfeeding, talk to your doctor about this.
- Get help early: See a pediatrician or a breastfeeding consultant as soon as you notice a problem. This will help both you and your baby get relief quickly.
- It's not your fault: It's normal to have problems with breastfeeding. Don't feel bad or blame yourself for it.
- Frenotomy is safe (if necessary): If surgery is necessary, it is usually very simple, quick, and safe. Don't be too afraid of it.
As a mother, it's best to talk to a doctor and resolve any doubts you may have. Because a happy mother means a happy baby!
` Tongue Tie, Ankyloglossia, Lingual Frenulum, Breastfeeding, Baby, Frenotomy, Child Health
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