Written by Eve Bandusena | Parents Avenue’s Editorial Assistant
Breastfeeding issues come in many forms and among them are tongue tie in babies. Having this condition poses problems both for the baby mama’s and their bundle of joy. Though tongue tied babies tend to improve with different positioning and attachment, some experience limited tongue movement then will subsequently cause breastfeeding difficulties.
Furthermore, researchers have found that out of 302 babies experiencing difficulties when breastfeeding, a staggering 57% of them were born with tongue tie.
“Tongue-tie is a condition present at birth that restricts the tongue’s movement. The lingual frenulum remains attached to the bottom of the tongue, says Dr. Matthew Chong, resident
paediatrician and neonatologist at Gleneagles Hospital Kota Kinabalu, “the cause is usually unknown, although some cases of tongue-tie have been associated with certain genetic factors and sometimes runs in families.”
Researchers have also claimed that a gene known as MTFHR which has a significant part in the development of the mouth which includes tongue tie in babies. It’s been found that people carrying the MTFHR mutation had higher chances of forming a cleft palate.
“Tongue tie affects around 5-10% of babies. It’s more common in boys than girls,” he adds further about this condition.
As mention in Kidd’s Teeth, there are four classifications of tongue tie in babies. This is further displayed in the pictures below for reference.
Class I: Tongue-tie is located from the base of the tongue, halfway to the salivary duct.
Class II: Tongue-tie located between the back of the salivary duct halfway to the base of the tongue.
Class III: Tongue-tie located for the salivary duct half-way to the tip of the tongue.
Class IV: Tongue-tie located at the tip of the tongue and extending half-way between the salivary duct and tip of the tongue.
To successfully feed off their mama’s nipple, a baby will need to be able to move their tongue freely including extending it below their lower gum with a wide-open mouth. However, if this fails to occur it will result in these symptoms.
Baby mama will experience:
•The premature ending to breastfeeding
• An oversupplying of milk since her baby can’t feed consistently
• Experiencing pain during feeding resulting in damaged nipples
• Development of mastitis and blocked ducts due to ineffectual removal of milk
• Fatigue, irritation, and disappointment from further feeding
Baby will experience:
• Inability to latch on deeply which further leads to nipple pain and damage
• Unable to remain on the breast, including producing a clicking sound
• Not getting enough milk and have to breastfeed constantly
• Development of jaundice and colic
• Become irritable when the milk flow slows down
According to Mayo Clinic, tongue-tie can affect a baby’s oral development, as well as the way he or she eats, speaks and swallows.
For example, tongue-tie can lead to:
• Breast-feeding problems. Breast-feeding requires a baby to keep his or her tongue over the lower gum while sucking. If unable to move the tongue or keep it in the right position, the baby might chew instead of suck on the nipple. This can cause significant nipple pain and interfere with a baby’s ability to get breast milk.
Ultimately, poor breast-feeding can lead to inadequate nutrition and failure to thrive.
• Speech difficulties. Tongue-tie can interfere with the ability to make certain sounds —
“t,” “d,” “z,” “s,” “th,” “r,” and “l.”
• Poor oral hygiene. For an older child or adult, tongue-tie can make it difficult to sweep food debris from the teeth. This can contribute to tooth decay and inflammation of the gums (gingivitis). Tongue-tie can also lead to the formation of a
gap or space between the two bottom front teeth.
• Challenges with other oral activities. Tongue-tie can interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.
“Treatment is not necessary if the baby can feed without any problems. If the feeding is affected, treatment involves a simple procedure called tongue-tie division,” continued Dr. Chong.
However, if the feeding is continually impacted, then tongue tie division would be a choice for parents to consider deciding.
“Tongue tie division typically involves severing the short and tight skin which connects the area beneath the tongue to the floor of the mouth. It’s relatively a brief, simple and nearly painless procedure that will clear any feeding issues immediately.”
Typically, there is either little or no bleeding at all. It’s recommended the best way to treat any bleeding is to let your baby feed as this will compress the floor of the baby’s mouth.
Tongue tie can be overlooked especially in the earlier stages especially if your baby is bottle-fed and she’s adapting well with a teat instead of a nipple. Subsequently, a tongue tie might be missed until a child starts talking. For older children, they’ll need to have general anaesthetic, so they’ll be able to sleep during the procedure.
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