Tongue tie - Transcript
Normally your tongue is attached to the base of your mouth by a piece of skin called the lingual frenulum. If your baby has a tongue tie, this particular piece of skin might be unusually short or tight, causing a restriction of the tongue.
We know that tongue tie often runs in families, and it can be more common in boys than girls. There are studies showing that anywhere between 3% to 16% of babies may have a tongue tie, and half of those could have feeding difficulties because of that, even feeding from a bottle too.
Some of those difficulties feeding at the breast can cause a baby to bob on and off, not being able to latch properly. It might be causing trauma to your nipples, and it may even be even causing a problem with poor weight gain.
IF your baby has what is called an anterior frenulum, it’s usually quite easy to see that. What you’ll also see is that your baby has difficulty raising the tongue upwards, to the roof of the mouth. Maybe extending it forward is difficult. Even lateral movements as well, side to side can be difficult. The tongue might appear heart-shaped in the process.
You might also have heard of a term, posterior tongue tie. This is a fairly recent idea that the tongue can be restricted further back and underneath the tongue, where you cannot identify that easily. Normally it is diagnosed by pushing back on the base of the tongue, on the underside of that area.
During breastfeeding your baby’s tongue needs to move in many different ways to be freely able to move – sideways and forwards, and upwards. There’s an oscillating movement as your baby is suckling. In order to actually attach at the breast, your baby’s mouth opens wide – his tongue has to extend forwards over the lower gum, and scoop up breast tissue. So there’s a real workout going on there.
So you can imagine that if your baby does have a tongue restriction, it could impact on the mechanics of the feeding, and it might have implications for yourself too. I encourage you to look at the video relating to the possible signs that may reflect the presence of a tongue tie.
If your baby is breastfeeding well and yet he does have an obvious tongue tie, there’s no real evidence to show that he will necessarily have any problems in the future in other areas. We know that that tongue tie, that tightness of that frenulum, can change over time.
We do know however that for some babies there could be an impact on dental development and even speech difficulties for some. There is evidence that continuing to breastfeed even after the procedure to release that tongue tie is a really good idea to enable your baby to develop his mouth and palate correctly.
So if your baby has been diagnosed with a tongue tie, and you really do feel that it is impacting on breastfeeding, it’s really important that you get a good breastfeeding assessment done with somebody who understands about lactation, so that you can decide together, and work out a plan as to whether a referral needs to be made, because it can be a difficult issue.
In my own work with breastfeeding mothers. I have seen babies who have a tongue tie and they’re feeding fine, and it hasn’t caused a problem for the whole length of the feeding – and then others who have a tongue tie and it really is impacting on either the mother or the baby or both.
I’ve also seen babies who’ve had a tongue tie division and the issues have carried on the same as before the tongue tie. So although we know that tongue-tie division can be a really successful procedure to help you to reach breastfeeding goals, it isn’t always the answer.
Clearly tongue tie does exist, and the gene has been identified for such, and we know that the procedure itself is a very simple procedure that can have great benefit to both mother and baby in that breastfeeding relationship.
An IBCLC and cranial sacral therapist, Hazelbaker, agrees with this and has also put forward an idea that there are other causes of tongue tie restriction too. It’s put forward that these tongue restrictions might be caused by damage or strain to ligaments or tendons, or muscles or nerves, even while your baby is in the womb or during the birth process itself.
In these circumstances before she would suggest surgery, that tongue tie division, she would encourage optimal positioning which can help to realign babies, and also other therapies like cranial osteopathy or cranial sacral therapy. Studies do seem to back up this idea of positioning, good optimal positioning, particularly laid back positions too, can help babies to become realigned, and it can take a few weeks for this to happen.
For some mother and baby pairs, with all the difficulties that a tongue restriction can bring, such as painful nipples and those difficult feeds ,waiting for the weeks and weeks to allow the optimal positioning to improve, may not be enough. Those added therapies can make a difference, but it would then be important for an IBCLC to reassess again, and decide on whether a referral for the tongue tie division is necessary.
So finally if you are having breastfeeding difficulties, please seek out that skilled support, that one to one support so that you can look at all your options, and work out what is going on -with a full breastfeeding assessment.
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V1 published June 2017. Next review date: April 2020
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