Tongue Tie: What Mothers Need To Know
For approximately 4-11% of newborns, the tongue tie tissue is so tight that they cannot move their tongues freely. This can affect their ability to breastfeed and lead to poor latch, nipple pain and trauma, decreased milk intake and a decline in milk supply over time.
Many babies with a tongue tie, also have an abnormally tight membrane attaching their upper lip to their upper gums (the labial frenulum). This is called a lip tie. Babies with a lip tie often have difficulty flanging their lips properly to feed and can’t create a proper seal at the breast. This can cause them to take in excess air during breastfeeding, which often makes these babies gassy and fussy.
Some babies with tongue ties and lip ties are able to attach to the breast and suck well. However, many of these infants have breastfeeding problems. The following signs are common amongst infants with tongue and lip ties and their mothers. However, it is important to note that these signs can be linked to other breastfeeding problems and are not solely related to ties.
Mothers may experience
- Flattened nipples after breastfeeding
- Nipple pain and damage
- Prolonged feedings
- Poor breast drainage
- Decreased milk production
If you’re nursing, do you notice
- Breast pain, cracked or blistered nipples?
- Plugged milk ducts (which can lead to mastitis)?
- Engorgement?
- Your baby falling off the breast frequently during nursing?
- A feeling that your infant is chewing or biting on the breast?
In babies, an oral restriction can lead to complications with breastfeeding. The lack of tongue mobility can impair their ability to properly latch, suck, and swallow. This is why many oral restrictions are discovered and diagnosed due to difficulties with breastfeeding. It’s a great idea to check for oral restrictions in a baby if its breastfeeding mother has mastitis symptoms, decreasing milk supply, or clogged ducts.
How can you tell if baby is tongue tied?
Tongue tie is often diagnosed when children have issues with breastfeeding and sucking. A baby with tongue tie might slip off the breast or have difficulty latching on. They might make clicking noises and break suction during breastfeeding. If babies are experiencing feeding issues related to tongue tie, they may also have trouble gaining weight. You might suspect tongue tie if you notice your baby becomes easily frustrated during feeding and feeds for an unusually long amount of time. In some cases of newborn tongue tie, mothers might notice they’re producing less milk because they aren’t receiving much stimulation during feeding. Tongue tie issues can make breastfeeding painful and cause nipple tenderness.
You think your baby may have tongue tie. What do you do?
It’s never too late to notice an issue and seek a medical opinion and potentially therapy for newborn tongue tie. Therapy can help children with feeding difficulties and noticing an issue is the first step toward improvement that can come from treatment. If you suspect your child has a tongue tie or a feeding difficulty, you should consult your pediatrician, a certified lactation consultant, or a speech-language pathologist.
How and why do ties affect breastfeeding?
The mobility of the tongue is very important during breastfeeding, both for the mother and the baby. A baby with a tied tongue may not be able to latch deeply onto the breast, past the nipple onto the areola. This compresses the nipple onto the hard palate in the baby’s mouth, leading to nipple pain and skin breakdown for the mother. A tongue tie often accompanies a high palate, which also decreases the suction and further reduces milk transfer.
Babies with ties may not maintain a latch for long enough to take in a full feeding, while others may remain attached to the breast for long periods of time without taking in enough milk. Some infants will feed only during the mother’s milk ejection reflex, or “let-down” when the milk ejects more freely, but won’t continue to draw milk out of the breast when this slows. Bottle feeding allows milk to drip into the mouth without effort, thus requiring less tongue muscle effort than is needed for breastfeeding.
An infant’s inability to breastfeed often results in the mother giving up breastfeeding entirely, while being told that the problem is her fault. In reality, the problems may actually result from restricted tongue and upper lip attachments – making normal function, mobility and breastfeeding difficult or impossible.