Tongue tie in babies: Everything you need to know about this condition

Have you been painfully trying to breastfeed your newborn? Is he having trouble latching? Then you might want to get him checked for a tongue tie in babies.

A tongue tie or ankyloglossia is a condition where a short thick tissue connects the bottom of a tongue’s tip to the floor of the mouth. This restricts the movement of the tongue, making it difficult for a baby to stick his tongue out, breastfeed, swallow or sometimes even vocalize.

While a tongue tie is not a serious condition and can be corrected with a small surgical procedure, you will first have to identify it.

Tongue tie in babies symptoms

Here are some of the most common characteristics of this condition in a baby:

• Difficulty lifting his tongue or moving it from one side to the other
• Inability to stick tongue out, especially past the lower teeth
• The tongue is heart-shaped at the tip
• Problem latching or breastfeeding
• You get reoccurring mastitis, blocked ducts, and sore or cracked nipples because the baby is chewing and not sucking
• The baby is attached to your breast for a very long time
• He makes a ‘clicking’ sound while trying to feed (try different feeding positions)
• Feeding means spraying into your baby’s mouth (milk ejection reflex)
• Your baby hasn’t gained much weight post birth and is hungry all the time

Impact on breastfeeding

According to Healthline’s interview with medical experts, tongue tie in babies can impact breastfeeding. Bobby Ghaheri, an otolaryngologist, says that “tongue-tie prevents an open mouth seal, and if there’s no seal, then there’s no suction”. Thus, it does not only cause pain when breastfeeding but also difficulty in latching.

Furthermore, Jessica Madden, medical director at Aeroflow Breastpumps reveals that the tongue may be unable to adequately latch onto the nipple and suck milk due to its inability to stretch and elevate. She also says that “both pain and an ineffective latch can lead to a decrease in milk supply, aerophagia (swallowing too much air), and failure to thrive or poor weight gain.”

Tongue tie in babies on bottle feeding maybe also hard, there’s no difference between your baby is latching on your breast or on a bottle.

Detecting tongue tie in babies

A doctor may check your baby’s tongue for movement and structure, as well as its appearance. All this can be done in a physical examination.

Your doctor will have to ask how feeding is going, check your child’s tongue, mouth and teeth, and examine the range of motion under your child’s tongue.

Older children may be asked to move their tongue around and make various sounds, such as an r or an l.

But why do babies suffer from this condition?

Cause of tongue tie in babies

Typically, the lingual frenulum (the short thick tissue) separates itself from the tongue before birth. This allows the tongue a free movement and larger range.

However, in some babies the lingual frenulum remains attached to the tongue, thereby, restricting free movement.

Why this happens remains largely unsolved, but it could be a result of genetics. And the condition could have its fair share of complications, especially if it is left untreated.

Complications

A tongue can largely affect a baby’s speech, breastfeeding patterns and overall dental development. But there are more issues that tag along with this condition.

• Difficulty in speech: If left untreated, a tongue tie can also interfere in your child’s speech development. For instance, he may be unable to make sounds that start with ‘z,’ ‘s,’ ‘d,’ ‘th,’ and even ‘I.’ He may also be unable to roll his tongue to clearly pronounce the word ‘r’.
• Poor oral hygiene: For a child born with a tongue tie, cleaning the lower gum can be quite difficult. This can ultimately lead to collection of germs, tooth decay and sometimes even gingivitis (inflammation of gums). A tongue tie can also lead to a gap between the two lower front teeth.
• Restriction of movement: Apart from the two aforesaid complications, a child with a tongue tie may also feel restricted in activities such as licking (food or even his lips), kissing or even playing a wind instrument.

Social and Emotional Impact of tongue tie in babies

1. Frustration and self-consciousness due to speech difficulties:Children with untreated tongue tie may struggle with certain speech sounds, leading to frustration as they try to communicate. This can be particularly challenging in social and educational settings where clear speech is important. The child might become self-conscious about their speech, especially if they are teased or corrected frequently by peers or adults.
2. Potential impact on social interactions and self-esteem:Speech difficulties and eating issues can affect a child’s ability to interact confidently with peers. They may avoid social situations or have trouble making friends. Persistent challenges and negative feedback can impact the child’s self-esteem, leading to feelings of inadequacy or withdrawal from social activities.

Addressing these issues early through appropriate interventions, such as speech therapy or surgical correction, can help mitigate these social and emotional impacts, supporting the child’s overall development and well-being.

As mentioned before, while a tongue tie is not necessarily a serious condition, it can be corrected through a small surgical procedure.

READ MORE:

How tongue and lip tie issues can hinder breastfed babies’ healthy growth

REAL STORIES: “Hirap magdede ang baby ko—may tongue-tie pala siya”

Tongue and lip ties can explain a newborn’s sudden weight loss

Treatment for a tongue tie in babies

A treatment may not be necessary for a baby who has a tongue tie but can feed with ease. Sometimes doctors carry out the surgical procedure before the newborn is discharged and sometimes, they wait for the tissue to loosen up on its own.

But, if your baby is unable to latch on or his feed is getting affected, your doctor may recommend any of the two tongue tie division procedures, based on the level of complication.

• Frenotomy: In this procedure, the thick and short (lingual frenulum) that connects the tongue to the floor of the mouth is cut. It is usually pain-free and may or may not involve local anesthesia. The doctor may examine the lingual frenulum and then use a numbing medicine in that area.
  Then, using a sterile scissors, he may cut it from the middle. This procedure is usually quick and mostly blood-free since there are fewer nerve endings and blood vessels in that area.
• Frenuloplasty: This is another procedure that is carried out if the frenulum is too thick and needs or if any additional repair to the area is required. It is usually performed under anesthesia using sterile surgical tools. After the frenulum is cut, the wound is closed with dissolvable sutures.
  Post the treatment, tongue exercises maybe recommended so the child gets used to the free movement.

Risks or disadvantages of clipping tongue tie

Both therapies are usually highly effective in preventing speech, dental, and feeding difficulties brought by tongue tie in babies. It’s quite rare for either of these to cause problems.

However, as with any medical procedure, the risks are the same for Frenotomy as well as Frenuloplasty. The foot of the mouth could get infected, there can be excessive bleeding, or the tongue or salivary glands may be damaged.

Scarring is possible after a frenuloplasty. Also, the medications used to help your child sleep could cause an allergic reaction.

Therefore, you should be prepared before fixing up the doctor’s appointment.

Here are a few things you can do on your own before opting for the surgical procedure.

Preparation for the procedure

• Prepare a set of questions for the doctor before the consultancy.
• You can ask about the severity of the condition, requirement of the surgical procedure and the risks therewith. You can also ask if the procedure can be done at home or in a hospital as well as the care post the treatment.
• And finally, you must also know if your baby would also need the care and attention of an ear, nose and throat specialist.

This way, you know exactly what are going in for and also what to do after the treatment.

The important thing to remember here is that you should first speak with your doctor to know if they think your baby has this condition. And if you get a go ahead from them, refer your baby to a specialist.

Take a look at this video to get a better understanding of what happens during a tongue tie division treatment.

Lip and tongue tie in babies

Other oral ties you could encounter in babies are lip and buccal (cheek) ties. An upper lip tie, also known as the superior labial frenulum, is the soft tissue that connects the top lip to the anterior gums, similar to a tongue tie.

A buccal tie, which is an unnatural tie stretching from the cheeks to the gums, may also be present in some newborns.

Consult your doctor right away

If you think your baby has tongue tie in babies symptoms, call a medical professional’s help and get checked right away. It’s better to be assessed immediately than suffer much risks and consequences later on.

Republished with permission from: theAsianParent Singapore

Additional information from Margaux Dolores and Jobelle Macayan

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