When babies are unable to breastfeed, it is usually their inability to latch on that is seen as the problem. This could be caused by holding your baby in an uncomfortable position, or because of a shallow latch due to him or her being too close to the tip of your nipple when trying to feed. It could also be something much more serious than that.
The problem known as Tongue Tie
In the case of a patient of lactation consultant Pinky McKay, the latching problems were caused by a condition known as tongue tie. Also known as ankyloglossia, tongue tie is a condition present at birth that restricts the movement of a baby’s tongue.
This hereditary disorder is caused by having an unusually thick, short, or tight frenulum, which is the membrane that connects the underside of the tongue to the floor of the mouth. This condition doesn’t just affect breastfeeding, it also affects speaking and swallowing. A person with tongue tie could even have a hard time just sticking out his or her tongue.
How tongue tie affects breastfeeding
Success when you breastfeed depends a lot on a baby’s ability to control his or her tongue. First, it helps in pulling the nipple into the proper position in the mouth of the child. It is also what keeps the breast secure inside the mouth, creating a groove along its length to keep it in place.
The milk is also held at the back of the tongue as a baby sucks, in preparation to swallow. This requires specific tongue movements from your baby while you breastfeed in order to complete the entire process.
Babies who have tongue tie face various problems when they breastfeed due to their limited tongue control. One of these is overcompensating with increased suction, which can be painful to the mother, and cause much damage to the nipple. It could also lead to mastitis later on if the wounded nipple becomes infected.
Loss of suction can also occur, causing the baby to detach from the breast. When this happens, the mother’s milk supply is not fully used up during the feeding. This may lead to engorgement, and even supply issues later on.
Find out how you can detect tongue tie, and what can be done to treat this disorder on the next page.
Indicators of tongue tie
Here are some issues and breastfeeding problems that may show that your baby suffers from tongue tie:
- Your baby cannot stick out his or her tongue beyond the lips
- Your baby’s tongue is heart-shaped at the tip
- You suffer from sore nipples and/or mastitis
- Your baby’s weight drops because he or she is unable to consume enough milk
- You notice a shallow latch when you breastfeed your baby, or loss of suction and choking
- Your baby makes a clicking sound when feeding
- Milk dribbles down your baby’s mouth while feeding
- Your baby bites or chews on your breast instead of sucking
- Your milk supply is low due to a lack of proper stimulation
Treating tongue tie
There are cases of tongue tie that do not cause feeding problems, and therefore do not require any treatment for your baby. However, in severe cases where the tongue movement does become a cause for concern, there is something that can be done to correct the issue. This is known as tongue tie division or frenotomy.
The surgical procedure involves cutting the frenulum using sterile scissors in order to free the tight frenulum. This can be done at a hospital nursery or in a doctor’s office, with or without the use of anesthesia. The procedure is simple, and your baby should be able to breastfeed immediately after.
The risk of complications is still present, however. These include possible infection, excess bleeding, and, in some cases, having the frenulum reattach itself to the base of the tongue.
More serious cases require a more complex procedure called a frenuloplasty. This is done when additional repair needs to be done, or if the frenulum is too thick for a frenotomy. Tongue exercises are recommended after this procedure in order to help enhance movement and lessen the chances of scarring in the tongue.
ABOUT THE AUTHOR: Patricia de Castro-Cuyugan
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