Tongue tie, or ankyloglossia to give it its correct title, seems to be on the increase in Ireland. One reason for this may be that more babies are breast feeding now than say thirty years ago: thankfully our breastfeeding rates are slowly getting better. A bottle-feeding baby can manage to feed with a tongue tie reasonably well, but it can cause lots of problems for a breastfed baby including poor latch leading to poor feeding, mastitis, sore nipples, low milk supply and intense pain for mum.
Tongue tie is a condition where the tongue is restricted in normal movement by a piece of tissue that anchors it to the floor of the mouth. It can be anterior, which is easy to see, or posterior which is subtler. Posterior ties require a more detailed examination by an experienced health care professional such as a lactation consultant. This examination involves feeling below the tongue and knowing what to feel for.
Once diagnosed, a full feeding assessment should be made by a lactation consultant or breast-feeding counsellor. With expert help it is possible to overcome any difficulties. A good deep latch is key. However other babies may need surgical intervention to help alleviate problems. This is called a frenotomy, a procedure where the piece of tissue holding down the tongue is snipped or lasered. It is a very quick procedure and usually the baby latches on immediately afterwards and feeds well. Most mothers can feel an improvement right away and with good lactation support these mums and babies can go on to breastfeed well for as long as they want.
Body work or cranial osteopathy has also been shown to be beneficial for these babies as often they have other structural issues such as torticollis and tight jaw muscles associated with the tongue tie.
After a frenotomy it is important to remember that these babies need time to adjust. They need to get used to a new way to use their tongue. The tongue is a muscle. Like all muscles introduced to a new exercise or movement it can get tired. This explains why some mums report an immediate improvement and then a dis-improvement and why it is important to follow the aftercare recommended by the clinic where the frenotomy was carried out.
If any mum and baby are having breastfeeding problems, the earlier these are sorted the better. If tongue tie might be the cause, an early assessment by an experienced health care professional is vital. A frenotomy might be the answer or good breastfeeding advice and help with latch and positions may solve the problems. Either way get professional help and get it sorted so that breastfeeding can be the positive experience it is meant to be.
Below is a list of tongue tie resources
HSE factsheet on tongue tie: http://www.breastfeeding.ie/tonguetie
Dr Justin Roche South Tipperary general Hospital www.drjustinroche.com
Dr Rachel Quigley http://www.dundanionmedicalcentre.ie
Irish closed Facebook Support Group for Parents of Tongue tied babies.