TONGUE TIE

WHAT IS TONGUE TIE?

A tongue tie is a membrane that is too tight under the tongue called a frenulum, this tight membrane can restrict tongue movement, and anchor the tongue down to the floor of the mouth, this can lead to breastfeeding difficulties.

Tongue tie can affect as many as 10% of babies born, maybe more.

 

Anterior tongue tie

 

 

Posterior Tongue tie

 

 

HOW CAN A TONGUE TIE AFFECT BREASTFEEDING?

Often a baby with tongue tie is unable to open the mouth wide to have a deep enough latch to breastfeed efficiently.  If the tongue is restricted, the mouth may not create a good seal during a feed, and so the baby often chomps down on the nipple with its jaws in order to keep the breast in place.
This can be extremely painful for the mother, and this method does not transfer milk efficiently. The nipple is also often damaged from this shallow latch.  Without a good seal the baby can swallow air during the feed, which can also cause him or her much abdominal discomfort, irritation and difficulty winding as there is increased air swallowed and reduced milk intake.
To accommodate for this, the baby may feed a lot more frequently or for very long periods of time, which can be exhausting for both mother and baby.
Sometimes the seal is not an issue but the tongue does not transfer the milk sufficiently as it is tethered. This again, may also mean long or continuous feeds.

 

SYMPTOMS



         Nipple damage
         Painful feeds
         Blanched or ‘lipstick’ shape
         Blocked ducts
         Mastitis

 

         Recurring candida
         Difficulty latching

         Small or narrow latch
         Constant feeds

 

         Fussing/ Colic
         Clicking sound during feeds
         Irritated /windiness
         Seems unsatisfied after feed
         Gumming or chomping on the nipple

 

         Leaking milk from mouth during feeds
         Gasping, coughing when milk comes
         Slow to put on weight


ASSESSMENT



If a tongue tie release is appropriate, this can be done during the same visit as the assessment.  The assessment is done by evaluating the following:

Discussing your breastfeeding so far, establish patterns, and determine your breastfeeding goals
         

Assessesing how the baby latches and feeds: narrow latch, clicking, dribbling, suck-swallow-breath.

         

Examining inside the baby’s mouth, which may identify many problems such as oral thrush, lip tie etc.

         

Examining the frenulum under the tongue and its effect on tongue mobility and tongue function.
         

Evaluating the tongues movement, lift, restriction, cupping and extension.
         

We also weigh the baby and calculate the baby’s present rate on growth percentile.




PROCEDURE



Ideally you will have already been to an IBCLC lactation consultant for breastfeeding support, and in some cases your baby will have had a cranial therapy session.

If after assessment we feel there is a tongue tie causing difficulty, we will offer to release it.  We will explain the procedure, and if you would like to go ahead with the tongue tie release, we will ask you to sign a consent form.

 

First, the baby is swaddled, then the tight membrane under the tongue, known as the frenulum, is snipped. This is called a tongue tie release, or frenotomy. This minimally invasive procedure takes seconds, and there may be just a few drops of blood, which usually stops as soon as the baby is latched on the breast, or by compression with a sterile gauze. If a lip tie is causing difficulties, this too can be released if necessary.

Often, there is an immediate improvement with breastfeeding, latch, suck, and relief in nipple pain. In other cases, improvements can be more gradual, from 3-4 days to a few weeks later.


AFTER THE PROCEDURE

We encourage gentle exercises and active wound care to encourage optimum tongue function and reduce the risk of reattachment. This is done in a very gentle and kind way, and should not upset the baby at all, if the baby is upset you should stop and sooth him or her.

The baby should be encouraged to make a deep latch at every feed (even at night when you’re really tired!), to use his/her new freedom in the tongue effectively, otherwise he or she may be inclined to continue making a shallow latch, and problems may persist.

Clear and easy instructions will be given after the procedure in order to:

         Encourage effective tongue function    

         Optimise positions for a deep latch
         Reduce or eliminate nipple pain
         Promote optimal milk transfer       

         

You will receive an individual plan regarding feeding, latch and follow up care.  



FOLLOW UP



Deirdre will follow up the day after the procedure with a telephone consultation to answer questions and give any necessary tips. She also offers a short personal consultation one week post-procedure, to assess the healing, maximise breastfeeding results, and release any significant reattachment of the frenulum if this has occurred (between 3-10% of cases). This follow-up is free of charge.


Deirdre has joined the Procuro team in Douglas, Cork, where therapists promote health and wellbeing in women and babies. Their services include such treatments as pregnancy massage, cranio-sacral therapy, kinesiology, reflexology, physical therapy, and now also tongue tie assessment, and tongue tie release with breastfeeding support.

For your convenience, appointments can be made online using this link APPOINTMENTS

 

Happy Tongue Tie Baby

Procuro Therapy Clinic
Village Green
Church Road
Douglas
Cork

Contact Deirdre on 083 8669209

 

For more information, you can visit these websites:

The Procuro Clinic 

Tongue Tie Net

Dr Jack Newman

Shelby Pediatric Dentistry 

HSE Tongue Tie