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Tongue Tie

Information for breastfeeding families

Tongue tie, also called ankyglossia, is when your infant’s tongue is unable to move in normal patterns due to a small band of tissue (frenulum) tying it to the floor of the mouth. Tongue tie is a congenital condition of unknown cause. However, it does run in certain families. Although there is controversy about the significance of this condition, mothers who breastfeed may run into difficulties that can be so severe it limits the duration of breastfeeding. If you experience breastfeeding problems, first see a lactation consultant to determine if your issues can be remedied by advice on positioning and latch-on or other feeding techniques, then see a provider who is experienced in diagnosing and treating infants with tongue tie.

Symptoms you may notice:

  • Sore nipples that occur quickly
  • Inability of the baby to latch-on to the breast or to stay attached to the breast
  • Infant weight loss or inability to gain weight
  • Reflux and/or colic
  • Heart shaped tongue
  • Blanching of the tongue when the frenulum is stretched
  • Infant cannot stick tongue out over lower gums or move tongue side to side to follow your finger in their mouth
  • Speech may be affected as child begins to speak
  • Gap between lower or upper front teeth
  • Dental carries may occur when child gets teeth because the tongue cannot clean the teeth normally
  • Difficulty licking lips, kissing, or playing a wind instrument.

Treatment options:

  • Frenotomy
    This is a simple snip of the frenulum that can be done while your baby is in the hospital or in your physician’s office. There is usually minimal bleeding and the baby can breastfeed immediately after the procedure.
  • Frenuloplasty
    This is a more extensive procedure for a more severe tongue tie and may require anesthesia and stitches.
  • Tongue exercises
    If your infant has a “clipping,” exercises are often recommended to keep the area from healing closed and to prevent scar tissue. With your clean finger, lift the tongue on both sides and gently massage the “white area” several times per day. Encourage your infant to stick the tongue out to mimic you.
  • Do nothing
    Some families may choose a “wait and see” approach to see if the tongue will grow and the frenulum will stretch over time. Get help from a lactation consultant for breastfeeding problems. It is possible that some of the conditions on the symptoms list will occur in the older child.
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Additional Resources

Using a Nipple Shield
Newborn Feeding Log
Weaning Your Breastfeeding Baby
Waking a Sleepy Baby
Congratulations on the Birth of Your Baby!
Storage and Handling of Breastmilk

"We are new to the area, and we're glad we picked MD Pediatrics. We have a special needs son and they were very attentive, sensitive & informative."
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