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The low down on ‘Tongue Tie’

Many people will never have even heard of tongue tie so here’s a summary as to exactly what it is and how it can be treated:

What is a tongue tie?

A tongue tie is an extra piece of skin that goes from underneath the tongue to the floor of the mouth or lower gum and restricts the tongue’s movement. Sometimes it is attached to the tip of the tongue, sometimes further back under the tongue.

How does tongue tie affect feeding?

Recent research has suggested that some babies with tongue tie may experience feeding difficulties. This is because a free moving tongue is vital to enable baby to attach effectively onto the breast and to remove an adequate amount of milk during feeding. Babies who are bottle feeding can also experience problems including dribbling and inability to create a seal around the teat so baby takes in air and becomes colicky and windy. However, all mums and babies are different and some will be more affected by a tongue tie than others.

Problems which may be due to a tongue-tie:                     

Mother:

  • Sore/damaged nipples
  • Nipples which look misshapen or blanched after feeds
  • Mastitis
  • Low milk supply
  • Exhaustion from frequent/constant feeding
  • Distress from failing to establish breastfeeding

Baby:

  • Restricted tongue movement
  • Small gape resulting in biting/grinding behaviour
  • Unsettled behaviour during feeds
  • Difficulty staying attached to the breast or bottle
  • Frequent or very long feeds
  • Excessive early weight loss/ poor weight gain/faltering growth
  • Clicking noises and/ or dribbling during feeds
  • Colic, wind, hiccoughs
  • Reflux (vomiting after feeds)

Research suggests that approximately 1 in 10 babies may be born with some membrane under the tongue. But only about half of those babies display significantly reduced tongue function, making breast or bottle feeding difficult.

These babies are likely to benefit from treatment to release the restriction that the membrane is having on the tongue and enable to baby to feed effectively.

Assessment

Assessment for tongue-tie requires training and skill.

The decision on whether or not a tongue-tie is impacting on feeding and whether it is appropriate to offer to divide it should be made after a detailed feeding history has been taken. This will usually include information about the pregnancy and birth and the medical history of both mum and baby. The baby is usually observed at the breast. This may be done by the person who divides tongue-ties or by someone who has been supporting you with feeding, prior to you being referred for division, such as a MW, HV or breastfeeding counsellor/lactation consultant. The function of the tongue will also be assessed to establish if the baby is tongue-tied and if this is impacting on feeding.

How is tongue tie divided?

Tongue tie division (frenulotomy) is a very simple procedure in young babies that should only be carried out by fully trained professionals. It takes only a minute or so, your baby may be wrapped up to prevent wriggling and the tongue tie divided with scissors. Babies don’t always like being wrapped up and some will cry at that point. The baby does not require any anaesthetic or medication because the frenulum is poorly supplied with nerves and blood vessels.

Tongue tie services at CBH

Carmelle is a registered midwife and infant feeding specialist. She is setting up a donation based tongue tie clinic that will be student led and supervised by herself or another tongue tie practitioner.  Parents can also book in with Carmelle personally if they prefer.

Please email [email protected] or call Rosie on +44 7519 096129 to book in to the clinic.

Sources: Carmelle’s website and Association of Tongue-tie Practitioners.