Ankyloglossia / Tongue Tie 

What is a Tongue Tie? What is the Frenulum?

The medical term for tongue tie is “ankyloglossia," also called “short frenulum" or “tight frenulum."

A frenulum of the lower lip is the small piece of skin or membrane, which anchors the tongue to the bottom jaw. In babies with tongue tie, this frenulum is holding the tongue too close to the bottom jaw, interfering with the normal movement of the tongue.

frenulum gallery, tongue tie picture, tongue tie photoTongue Tie

A tongue tie is present from birth and may be hereditary. It is only considered a health problem if it causes breastfeeding problems. 

A baby with tongue tie might not be capable of sticking the tongue out past the lower lip. The tongue usually appears heart-shaped, and bulges out slightly on the sides, as shown in the picture. 

Signs of Frenulum Tongue Tie while Breastfeeding

newborn baby crying
  • A poor latch, or having to re-latch often.
  • Baby is not getting in enough milk. (Read the signs here)
  • Baby is not gaining weight fast enough. 
  • Baby seems fussy while breastfeeding
  • Baby dribbles milk down the sides of the mouth while breastfeeding. 
  • Baby never seems to get enough and breastfeeds continuously. 
  • Mom experiences excruciating nipple pain while latching on.
  • Mom has very painful and/or cracked bleeding nipples. 
  • Baby makes strange clicking sounds while breastfeeding. 
  • Mom’s breasts are engorged or infected due to insufficient milk flow. 

A tongue tie baby may experience other problems too, such as displacement of the epiglottis and larynx, this can lead to increased problems while breastfeeding. These problems can cause a baby to swallow more air during feedings. With these extra problems a mother may also notice:

baby with fingers in his mouth

  • Baby takes long pauses between sucking. 
  • Baby is choking while breastfeeding.
  • Baby pushes away from the breast often. 
  • Baby falls asleep at the breast.

Tongue Tie / Ankyloglossia Help

Tips for Breastfeeding a Baby with Tongue Tie

  • Get the frenulum cut. This is a minor procedure done by any family doctor or dentist. In this procedure, the small membrane that holds the tongue down is clipped, to give the tongue freedom to move. A baby may need some time to re-learn latching on. 
  • Breastfeeding positions. Holding Baby more upright while breastfeeding can help pull the tongue down. 
  • Help the latch. Stroking Baby’s tongue downwards, before a latch, can help Baby position his/her tongue. 
  • Using a nipple shield. This can help, especially if Mom is struggling with nipple pain, due to bad tongue positioning. The shield can sometimes also help a baby latch on more effectively. A mother should plan to wean from the shields as soon as her baby outgrows the feeding difficulty. 
  • Pump milk. A mother may need to pump milk between feedings, to make sure that her milk supply does not drop. She can feed her baby the pumped milk as an extra supplement. Alternative feeding methods can be used, if the baby is younger than 6 weeks to avoid nipple confusion. 
  • Keep an eye on the baby’s weight gain and urine output. 

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Tracy Behr, CBC, CLD (CBI)

Reference: Course information through Childbirth International on the physiology of breastfeeding / Health problems / Tongue-tie.

Tracy Ann Behr, is a breastfeeding mom of two, breastfeeding helper and studying through Childbirth International for her breastfeeding counselor and Birth Doula certification. 

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