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Tongue Tied Babies

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We’ve all had one of the those moments where we stutter, stammer, or are at a loss for words. “I’m tongue tied,” we might joke. But for some babies, being tongue tied is actually a serious problem. Tongue tie, or Ankyloglossia, is a condition that restricts the tongue’s movement. The frenulum, the piece of skin that attaches the tongue to the floor of the mouth, is shorter than normal. This can make it difficult for the baby to latch on properly. Some tongue tied babies don’t gain enough weight, and breastfeeding can be painful for the mom. Long term, tongue tie sometimes causes speech problems.
A new study, just published in Pediatrics, found that a freunulotomy, a minor surgical procedure to cut the frenulum, can improve breastfeeding. Here’s the study abstract:

OBJECTIVE. There is evidence that infants with ankyloglossia can experience breastfeeding difficulties including poor attachment to the breast, suboptimal weight gain, and maternal nipple pain, which may lead to early weaning of the infant. No studies have investigated the cause of these breastfeeding difficulties. The objective of this study was to determine the effectiveness of frenulotomy in infants experiencing persistent breastfeeding difficulties despite professional assistance by measuring changes in milk transfer and tongue movement during breastfeeding before and after frenulotomy.
PATIENTS AND METHODS. Twenty-four mother-infant dyads (infant age: 33 ± 28 days) that were experiencing persistent breastfeeding difficulties despite receiving professional advice were recruited. Submental ultrasound scans (Acuson XP10) of the oral cavity were performed both before and ≥7 days after frenulotomy. Milk transfer, pain, and LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scores were recorded before and after frenulotomy. Infant milk intake was measured by using the test-weigh method.
RESULTS. For all of the infants, milk intake, milk-transfer rate, LATCH score, and maternal pain scores improved significantly postfrenulotomy. Two groups of infants were identified on ultrasound. One group compressed the tip of the nipple, and the other compressed the base of the nipple with the tongue. These features either resolved or lessened in all except 1 infant after frenulotomy.
CONCLUSIONS. Infants with ankyloglossia experiencing persistent breastfeeding difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of breastfeeding difficulties, ankyloglossia should be considered as a potential cause.

For more informtaion, Kellymom.com has a series of articles on this topic. And here’s an excellent article that can help you figure out if your baby is tongue tied. Surgery is not the only option. (Read this too). But bottom line, talk to your pediatrician and a lactation consultant to figure out if your baby is tongue tied, and what is the best treatment option.



2 Responses to “Tongue Tied Babies”

Great post! My first baby was a bit tongue tied and no one realized it. Wound up pumping for 4 weeks and feeding her bottles until it stretched and she got better at sucking and she could finally latch on her own.
My next baby just had a bit of tight tongue and since I knew what to look for this time, I was very diligent about getting him latched correctly and he nursed great from the start.

My girl had this! Within the first week of nursing, I nearing the limit of tollerance despite working with breastfeeding consultants at the hospital and reading everything I could on the topic. I knew what I should be doing but couldn’t get her to stay latched correctly.
Fortunatly, one of the consultants was familiar with the problem and knew of an ear, nose and throat doctor in town who was proactive in treatment. While I waited for the appointment, we used a nipple shield (still do) due to the extremely painful blisters on my nipples – the shield is the only reason I am still nursing her.
The tounge clipping procedure itself is nothing at all to worry about. No pain meds and only a quick snip – probably about as painful as getting your ears pierced. She had stopped crying within 5 minutes (about as long as it took after her first round of vaccinations) and immediatly began sticking her tounge out and moving it every which way.
Long term result? We’re still using the shield. She can and does nurse without it at times, and I try to get her to not use it when possible, but… we’re working on it. That said, I think that long term it has helped just in her non-nursing use of her tounge. We noticed immediatly an increased play level with it…
And, an interesting side note, the lactation consultant told me that this condition often runs in families… After she said that, I remembered that as a baby I had had my tounge clipped and then later found out that so had my dad.

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