What is tongue tie?

Ankyloglossia

This occurs in children or infants when the band of tissues that connect the tongue to the rest of mouth is shorter and limits the tongues’ range of motion. Approximately 4-10% of newborns are born with tongue tie, otherwise known as ankyloglossia.

Is your baby struggling with nursing because of tongue tie?

Frenotomy

Many parents and doctors have associated infants that are tongue-tied with breastfeeding problems, such as latching issues. There has been research but the results were inconclusive when trying to find a clear link between the two. Although there is no clear link, there has been a spike of 110% since 2012 in tongue-tie release surgeries, known as frenotomy, being performed. This has raised controversy in the medical community that many of these procedures are being performed based on a fear of speech, sleep and dental issues – not breast feeding related concerns.

What the research shows:

• 63% of the tongue-tie surgeries performed were not needed for breast feeding problems
• The tightened band of tissues under the tongue does have the ability to stretch with continued breast feeding and without the need of surgery to be performed. The lengthening of muscle will correct the nursing issues on its own.
• The milk flow while nursing shows that the middle of the baby’s tongue is the most vital part of nursing and the tip of the tongue not as important. This further proves that this surgery is not as effective in correcting nursing issues that you may be experiencing with a baby that has tongue-tie.

Can tongue-tie surgery help with nipple pain?

More research is being done but recent studies have shown that having the tongue-tie release surgery has helped nursing mothers since that nipple discomfort can be extremely painful and can lead to parents abandoning the idea of breast feeding.

Tongue-tie surgery in infants does not fix speech, dental or breathing concerns in the future

• Tongue-tie does not cause speech development delays. Those with tongue-tie may have problems making certain sounds letter sounds that can be evaluated and taken care of through speech therapy.
• None of the findings through research have found that having tongue-tie surgery will help with future dental and sleep apnea problems. It has also been thought that having the surgery will improve reflux, bedwetting and other issues but none of the are based on evidential findings.

What to consider when thinking about tongue-tie surgery

There are many things that can affect breastfeeding and it is important to have a coordinated team of doctors and specialists to properly diagnose and treat the root cause.

What and why coordinated care?

Coordinated care gives your family and your team of care providers the opportunity to study the problems and different ways to address those concerns.

Newborns that are facing nursing problems must be monitored in their first few days of life. They will check the baby’s suck reflex and test the coordination of their tongue. One other important step is to carefully weigh the newborn before and after each feeding to ensure that they are getting the proper amount at feeding times.

While testing continues follow up care is important to carefully monitor the infant’s weight gain and wellness. If breastfeeding issues do not resolve, then having the tongue-tie release surgery should be considered.

What to expect with tongue-tie surgery

Who performs tongue-tie surgery?

• Pediatric Dentists
• Otolaryngologists
• Pediatricians trained in the procedure

It is encouraged to find a qualified provider that is able to bill your insurance. There is concern that arises when requesting out-of-pocket payments that can lead to health inequities, so work with your insurance provider when choosing your care team.

Most frenotomy surgeries are in-patient, brief and anesthesia is not needed. The care providers will use sterile surgical scissors or laser to do the clipping of the tongue-tied muscle.

Your infant will most likely have some pain and will cry, but the procedure takes less than a few minutes to be performed. The doctor and the care team will observe the infant for a brief period before allowing you and your infant go home for much needed rest. The infant should be given over-the-counter pain relievers as needed after the procedure and parents must watch for bleeding and pain if it is ongoing for more than a few days post-surgery.

 

For more information please visit: healtychildren.org