When you’re brand new to breastfeeding, it can take some time to figure everything out—the right hold, the proper latch, and the timing just to name a few. But for some moms and babies, breastfeeding may continue to be a challenge. And sometimes there’s a sneaky culprit that could be causing breastfeeding issues: tongue ties. Here’s what to know about how tongue ties can affect breastfeeding.
What Is a Tongue Tie?
A tongue tie, or ankyloglossia, occurs when the membrane that holds the tongue to the floor of the mouth is tight or short. When this membrane, called the frenulum, is too short, thick, or tight, it prevents the tongue from moving through its full range of motion. This can directly impact baby’s ability to breastfeed successfully. Tongue ties can occur at the tip of the tongue (anterior) or the back of the tongue (posterior), and may be passed down genetically.
What Are the Signs of Tongue Ties in Babies?
A baby with a tongue tie may have a tongue that appears misshapen, very short, or even heart-shaped when they try to lift or move their tongue forward. You may also notice that the center of the tongue seems to be pulled down, or that movement is restricted. However, it can be hard to tell whether baby has a tongue tie simply by sight.
There are several other feeding-related signs that your baby might have a tongue tie. Signs can include:
- Difficulty latching deeply, or an inability to latch at all
- Problems staying on the breast or bottle to feed, or milk leaking out of the corners of their mouth
- Clicking noises as baby loses suction on the breast as they feed
- Breastfeeding constantly to get enough milk
- Poor weight gain
- Lack of wet or dirty diapers
- Choking on fast-flowing milk
- Gassiness or colic symptoms from swallowing extra air during feedings
- Gumming or chewing at the breast rather than rhythmic sucking
Things that a breastfeeding mother might experience that could indicate a tongue tie include:
- Nipple pain at latch and throughout a breastfeeding session
- lDamaged, blistered, or bleeding nipples
- The nipple appearing distorted into a wedge shape (like a tube of lipstick) after feeding, sometimes with a line at the tip
- Frequent engorgement, clogged ducts, or mastitis
- Low milk production due to ineffective milk removal
- Oversupply due to baby constantly nursing
Does a Tongue Tie Need To Be Treated Or Corrected?
If you suspect your little one has a tongue tie, the first step is to see their provider as soon as possible for an evaluation. If they do have a tongue tie, there are several steps available to help you and your little one improve breastfeeding:
- Work on your latch: For mild tongue ties, a consultation with a lactation consultant can sometimes be useful to help you learn how to latch in a more effective way, and prevent engorgement.
- Try laid-back breastfeeding: Breastfeeding while reclining with baby’s belly on your belly can be useful for babies with tongue ties. Gravity helps draw your little one’s tongue down and forward, which can help them latch and feed more successfully.
- Surgery: Research shows that a surgical tongue-tie revision, known as a frenotomy, can help breastfeeding mamas maintain and improve breastfeeding. A frenotomy is a quick and simple procedure where a specialist or other provider lifts the tongue, and cuts the frenulum with sterile scissors or by cauterizing it. For very young babies, no anesthesia is needed, and it heals within two days. The best treatment following a frenotomy is to continue breastfeeding, as it helps keep the wound clean, encourages tongue mobility, and — perhaps most importantly — helps to comfort your baby.
If you have any questions or concerns about a possible tongue tie or difficulty feeding, it’s important to schedule time with baby’s provider as soon as possible. Lactation consultants can also be a wonderful resource to help breastfeeding mamas and babies feel comfortable nursing successfully.