Does my baby have a tongue tie?

By Carrie Bruno

November 20, 2018

Carrie is the founder of The Mama Coach. She is a RN, IBCLC lactation consultant, sleep consultant and mama of two little guys. She leads the nationwide team of Mama Coaches and is committed to making motherhood easier.

For the modern Mama, tongue ties have been in the forefront of conversations surrounding their new baby. Tongue ties can still be controversial, and different healthcare providers may have different stances on their prevalence and how they affect feeding. Receiving mixed messages from your care providers can be frustrating and confusing, and parents often struggle to feel supported if they are worried their baby may have a tongue tie. The Mama Coach offers evidence-based education and support, to help you navigate the waters of motherhood. If you are curious about tongue ties or wonder if your baby may have one, read below, and then contact The Mama Coach in your area for breastfeeding support.

 

What is a tongue tie?

The lingual frenulum is a piece of connective tissue that attaches the bottom of the tongue to the floor of the mouth. Presence of a frenulum is NORMAL, but in approximately 3-10% of infants this frenulum is restrictive of proper tongue movement and function. The medical term for this is Ankyloglossia. Proper tongue mobility is essential to a baby’s ability to breastfeed. Proper assessment, diagnosis, and management of tongue ties is crucial to the breastfeeding relationship. Even if baby is not breastfeeding, a restrictive tie can have implications on baby’s overall health and well being.

                             (Photo Credit: Dr. Nicholas Blackwell)     (Photo Credit: Dr. Laurence Kotlow)

Who can assess for a tongue tie?

Mama Coaches are all Registered Nurses qualified to assess for tongue ties. As Lactation Counsellors and IBCLCs, we have additional education and experience assessing moms and babies and utilizing the many assessment tools available. We will do a digital oral examination, where our clean, gloved finger will be gently placed in your baby’s mouth to feel for abnormal attachment of the tissue. We will also assess the function and mobility of baby’s tongue using standardized assessment tools. In combination with these digital oral assessments, we will also ask a variety of questions about your baby and watch a breast or bottle-feeding session. Registered Nurses and IBCLCs can provide comprehensive assessments and make a referral to a diagnosing health professional, but do not diagnose. It is also important to note that pictures alone CAN NOT provide a diagnosis.

Signs and Symptoms of a tongue tie:

Particularly for breastfeeding moms and babies, there can be many distressing signs and symptoms that will leave moms looking for a diagnosis explaining the struggles they are experiencing.

Moms may experience:

  • Severe pain with latching
  • Creased, pinched, or “lipstick” shaped nipples after unlatching
  • Nipple damage including cracking, blistering, and bleeding
  • Nipple shield dependence
  • Clogged ducts and Mastitis
  • Low milk supply

Signs in baby:

  • Shallow latch or slipping off the nipple
  • Poor milk transfer and weight gain
  • Breast/bottle refusal
  • Breaking of latch seal – clicking and smacking sounds that can result in vomiting, reflux, gassiness, and colic from excessive air swallowing
  • Prolonged sessions of non-nutritive sucking (sucking without drinking)
  • Chomping or chewing at the breast
  • Frequent feeds without satisfying baby
  • Falling asleep at the breast
  • Nasal congestion or abnormal breathing

 

Example of a suboptimal latch (Photo Credit: Shutterstock)

 

If you are breastfeeding your baby and continue to have any of the signs and symptoms listed above despite being told that your latch looks good, an additional assessment is warranted. It is important to note that you and your baby may not have ALL of these symptoms.

What can be done about tongue ties?  

The Mama Coach will develop an individualized plan for you and your baby to help you meet your goals. This plan may include latch and positioning adjustments, suck training exercises, and/or evaluation and treatment by a Dentist, Doctor, or Nurse Practitioner to see if your baby may benefit from a frenotomy.

If you are a breastfeeding Mama, it is important for you to know that we will support you through this. We will help you maintain your milk supply while working on the functional issues baby is experiencing.

What is a Frenotomy?

Frenotomies are simple procedures used to release abnormally tight or short frenulums. They can be done in clinics or dentist offices, using either scissors or a laser to make a cut in the tissue to improve the mobility and function of the tongue. Anesthesia is usually not required and is quick and usually painless. After the procedure is over, mom is able to breastfeed immediately, and will usually notice improvement in symptoms. After care instructions will be provided by the care provider that did the frenotomy, or by your Mama Coach. It is important that you continue to receive follow up from your Mama Coach to ensure that breastfeeding is going well.

Like all breastfeeding issues, it is imperative to have the right team on your side. We want to ensure your baby thrives and you meet your goals. Let The Mama Coach support you!

 

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