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UNDERSTANDING TONGUE-TIE

Updated: Jan 17


Understanding Tongue-Tie: A Guide




Everyone says that having a new baby is exhausting and hard and the baby will feed

non-stop and cry a lot, but what about if your baby has a tongue tie? Here are some things that might sound familiar:-


You have cracked or bleeding nipples, your baby rarely seems satisfied after feeds and you have had no sleep. You may begin to dread feeding time because it is exhausting and painful, but feeding time is all the time.


Tension can affect the amount of oxytocin that is released and this can affect the let-down reflex, meaning the baby has to work harder to get the milk, making them more distressed and angry, making the whole thing more difficult. All the while your partner is standing by, wanting to help but being able to do very little. Your baby may become angry and frustrated at the breast as they fight to be fed. Your baby may not be gaining weight and you may need to supplement. This means that you are either pumping in the few spare moments in between feeding, or topping up with formula, which may make you feel guilty as this had not been your plan, or may make you concerned that your milk supply may reduce. Pumping and supplementing means having to do a lot of sterilisation, which takes even more precious time. Your whole life can be taken over by this issue.

 

You may be wondering what a tongue tie is and why it suddenly seems to be so prevalent when in the past it was something that was not commonly talked about. Tongue tie has always been around. The first mention of tongue tie in literature was in the 1600s and it is reported that midwives used to have a long fingernail to break the waters and cut the tongue tie.

Tongue-tie, also known as ankyloglossia, is a condition that affects the movement of the tongue. It is caused by a shortened or tight lingual frenulum, the thin band of tissue that connects the underside of the tongue to the floor of the mouth. This restriction limits the tongue's range of motion, potentially leading to various challenges.

It is being discussed now because mothers are encouraged to exclusively breastfeed their babies for the first six months of life, following guidance of the health benefits of breast feeding from the World Health Organisation.

 

For infants, tongue-tie can significantly impact breastfeeding. The restricted tongue movement can make it difficult for the baby to latch on properly and transfer milk effectively. This can lead to frustration for both the mother and the baby, potentially affecting the baby's weight gain and overall well-being. As little as 20 years ago, mothers were encouraged to give babies solid food at 16 weeks and were more likely to accept that breastfeeding may be painful. Difficulty with breastfeeding was often put down to a mother not having much milk or the baby being a 'difficult or tricky feeder', rather than the possibility that it may have been a tongue tie.

Tongue-tie is relatively common, affecting approximately 4-11% of newborns. It is more prevalent in boys than girls. While some individuals with tongue-tie may not experience any significant issues, others may face various challenges, particularly in infants and young children.

As children grow, tongue-tie can also affect their speech development. The restricted tongue movement can make it challenging to produce certain sounds clearly, potentially leading to speech articulation problems. Additionally, tongue-tie can impact oral development, affecting the way the child chews, swallows, and maintains proper oral hygiene.

The diagnosis of tongue-tie is made by a qualified tongue-tie practitioner, through visual examination of the tongue and its range of motion, along with a details feeding history assessment.  A midwife, paediatrician, health visitor or lactation consultant will be able to let you know if they suspect your baby has a tongue tie. In older children, further evaluation by a speech-language therapist may be recommended to assess the child's speech development.

Treatment for tongue-tie typically involves a simple procedure called a frenulotomy, which involves snipping the shortened or tight lingual frenulum. This procedure is usually quick, painless, and can be performed in a clinic or your home.

Following a frenulotomy, it is important to encourage and support the child's tongue movements to promote healing and maximize the benefits of the procedure. This may involve tongue exercises, stretches, and massage techniques. For infants, breastfeeding can resume immediately after the procedure.

While frenotomy is generally considered a safe and effective procedure, there are potential risks, including bleeding, infection, and scarring. However, these complications are rare and typically minor.

Please feel free to contact me for more details: clovermidwife@gmail.com.





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