Breastfeeding Problems: Tongue-Tie

The baby’s tongue may be the most important part of her anatomy for breastfeeding. The baby must be able to extend her tongue past her gum ridge and cup the breast. At the same time, she moves her tongue in a wave, from the front to the back, compressing the breast and bringing the milk to her throat. Babies are born knowing how to do this but for those born tongue-tied, this may be impossible.

Tongue-tie, or ankyloglossia, occurs when the lingual frenulum, the thin membrane that fixes the tongue to the floor of the mouth, is short, tight or located near the tip of the tongue. Tongue-tied babies may not be able to extend, lift or groove their tongues as needed. This results in a variety of problems, including trouble latching on to the breast, painful feeds for the mother and slow weight gain. Tongue- tied infants often make a clicking sound while feeding, as their tongues snap back and they lose suction.

Sometimes a tongue-tie is obvious; the baby can clearly not stick her tongue over her gum ridge or when she tries, the tight frenulum pulls her tongue into a heart shape. Often it is less obvious and may actually be hidden under the mucosal floor of the mouth. If you are having breast feeding problems despite good positioning, a board certified lactation consultant should be able to tell you if your infant is tongue-tied.

Fortunately, tongue-tie is easily treatable. If it is not severe, you may be able to position your baby in a way that will help her. Otherwise she will probably need a frenotomy, a quick and simple procedure in which the doctor releases the tongue. Ask your lactation consultant which doctors perform frenotomy in your area.