An infant struggling to latch or breastfeed can be difficult for everyone. For some babies, a nursing issue may be due to a little band of skin that is too tight or thick under the tip of the tongue.
Tongue tie, also known as ankyloglossia, can be very troublesome for babies and nursing moms. The little band can keep the tongue from moving as it should and can inhibit a good latch on the breast to nurse or cause a very painful latch for mom.
Symptoms for baby can include prolonged feeding and poor weight gain, notching at the tip of the tongue or a “heart-shaped” tongue, gassiness and irritability. Babies with tongue tie and feeding issues will usually be seen in their first days or weeks of life by their pediatrician, a pediatric Ear, Nose and Throat doctor, or a pediatric dentist to help identify the problem and treat it.
Lactation specialists are also helpful with identifying tongue tie and latching issues.
If the baby is found to have a significant or tight tongue tie, the band can often be easily treated in the office with a simple procedure to divide it called frenulectomy. There are a variety of ways to divide the band under the tongue without injuring any other surrounding tissues. Most commonly the band is cut with surgical scissors but at times a laser may be used. Rarely it may require anesthesia if the tie is posterior.
The band is located near the floor of mouth where the salivary or spit glands drain, and care must be taken to avoid these openings. Once the procedure is completed, the baby is allowed to feed right away. Nursing moms frequently notice an immediate improvement in latching and decreased pain with feeds.
It is important to keep in mind there are many different factors that can affect a baby’s ability to nurse and tongue tie is only one of them. Many babies will take a bottle of pumped milk or formula without issue and this is an option as well if a mom does not wish to direct. This can be a very personal decision for each family as they care for their child.
Occasionally frenulectomy will be performed even if a baby is feeding well to help prevent future issues.
Tongue tie can also affect the way an older child eats, speaks or swallows. In an older child, tongue tie may affect some of the sounds of speech such as “t,” “th,” “r,” “d,” “z,” “s,” and “l.” It will not cause speech delay or difficulty learning to talk.
It can affect a child’s ability to stick their tongue past their lower teeth and lick an ice cream cone, for example, or play a wind instrument. Tongue tie can be addressed at any age, but older children may need a slightly different procedure that will need anesthesia. therefore, it is often prudent to fix the issue early on as an infant.
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About the Author: Dr. Trowbridge specializes in the medical and surgical treatment of Ears, Nose and Throat disorders of children and adolescents. Special areas of interest include: airway reconstruction, pediatric sleep issues, Cochlear implants, tumors of the head and neck, chronic ear diseases and ear surgery, chronic sinus disease and sinus surgery, and pediatric allergy issues.