Being tongue-tied conjures up, for most of us, an image of a nervous, stammering person tripping over words. But did you know it’s a common condition that’s thought to affect 1 in 10 newborns? And what’s worse it often goes undetected or ignored by some medical professionals. In fact, it’s still not a mandatory part of the routine baby check. This fact gets me on my high horse as I see this condition over and over again in my practice. Tongue-tie leaves many babies and parents to suffer in silence the multitude of difficulties which can arise from this condition. But if detected early after birth it can be easily treated and many complications avoided. So why isn’t it taken seriously and being made a priority?
What is Tongue Tie?
Tongue-tie, also known as “ankyloglossia or anchored tongue”, is a structural abnormality of the lingual frenum (the funny looking strip of skin that stretches from under the tongue to the floor of the mouth). When the frenum is normal it is elastic and doesn’t interfere with the movements of the tongue. In tongue-tied babies it can be short, thick, tight, positioned too far back or too far forward. This reduces tongue mobility which can affect sucking, eating, swallowing and speech not to mention anything else that requires optimum tongue mobility, like licking ice cream!
How Do I Know if My Baby is Tongue-tied?
As this condition is often overlooked, a lot of babies, Mumas (when breastfeeding directly and otherwise indirectly) and Dads, unnecessarily suffer from the effects of tongue-tie. And these are not just physical but emotional as well. The most obvious but not only early sign is that the baby cannot breastfeed properly, which of course can have implications on all aspects of the baby’s growth and development
So what are the signs and symptoms?
- Low sucking ability limiting milk supply
- Refusal to breastfeed
- Failure to thrive
- Low weight or poor weight gain
- Vomiting or gagging during feeding
- Prolonged, excessive drooling
- Sleep deprivation
- Unusual appearance of tongue and it’s movements
- Perfect visible latch but any of the above symptoms
- Tightness in the jaw and neck
- Nipple damage, bleeding, blanching or distortion of the nipples
- Mastitis, nipple thrush or blocked ducts
- Severe pain with latch or losing latch
- Sleep deprivation caused by the baby being unsettled
- Depression or a sense of failure
The above symptoms are not exclusively related to tongue-tie, but as a precaution must be checked by a professional who has experience in diagnosing tongue-tie.
Unfortunately, tongue-tie is a very common yet often overlooked condition. Up until 1940 tongue-tie was routinely checked and treated to help feeding. This began to change for two reasons, doctors were encouraged to avoid any unnecessary surgery, no matter how non-invasive, and the practice of breastfeeding was declining. The belief quickly spread that it was not a “real” medical problem and was soon left out of routine baby checks.
This is such a shame because if diagnosed and treated early tongue-tie can be easily corrected. It’s something that’s a mandatory part of my routine baby checks and luckily for me, and my clients, I work with a family doctor that not only recognises tongue-tie, but also understands the issue and treats it with a simple in-office procedure. Tongue-tie can be diagnosed by a trained professional by easily lifting the baby’s tongue and observing the length, width, thickness and elasticity of the strip of skin under it as well as the mobility of the tongue. An anterior tongue-tie is easier to diagnose and a bit more recognised than a posterior tongue-tie though both types can cause havoc.
‘I always wanted to breastfeed but I was told that my milk supply was low and had to switch to formula. When my little girl was 3 months old we found out that she had a severe poster tongue-tie. We had it reversed but it was too late to restart breastfeeding’ E, Muma to baby Georgia
How does a baby get a tongue-tie?
Tongue-tie is most often hereditary. It is more likely to be found in males than females and more often that not if a Father is tongue-tie, the children have a higher likelihood of being tongue-tie as well. Since there is such a strong genetic link there may be physical similarities in family members who were not treated such as postures of the lips, habits of speech and shapes of the nose and face.
Tongue-tie can also occur together with other congenital conditions such as cleft palate or lip, severe hearing loss and cerebral palsy. That is not to say that your baby has one of these conditions if they are diagnosed with tongue-tie, but it is rather a symptom of these conditions.
How is it Treated?
With early diagnosis, treatment is quite simple and can be done in the doctor’s office in a matter of minutes. The most common technique is called snipping, or frenulotomy in medical terms. This involves simply cutting the strip of skin under the tongue and allowing it to become elongated and thinner as it literally “frees” the tongue from being anchored. It’s so simple in fact that most babies can begin to feed immediately after the procedure. Within a week after the procedure has been done this will improve the baby’s ability to suck, improve the efficiency of latching and prevents the severe pain experienced earlier on by the mother from breastfeeding a tongue-tie baby. Of those babies who have been given the procedure, 57 % of Mumas noticed an immediate improvement in breastfeeding, and 80% after only 24 hours.
‘My baby’s tongue-tie was picked up when he was 5 days old. We had it reversed immediately and within 4 days after the procedure breastfeeding felt better than it ever had with my two older children.’ J, Muma to baby Jack
Tongue-tie is a real condition that needs to be taken seriously and included in infant medical checks. If we want women to be able to breastfeed and have their babies thrive it is imperative that medical professionals see this as a real and very treatable condition. There is no reason for any baby or parent to ever suffer from it’s effects. Too often the condition is ignored or dismissed. In the vast majority of cases, it won’t go away on it’s own and it is something parents of newborns need to be aware of and diligent about it’s diagnosis. It is slowly being more and more recognised and treated, but not quickly enough. Delay in treatment can have serious effects and is absolutely unnecessary in our day and age. So speak up if you suspect your baby may suffer from tongue-tie and if you’re ignored seek a second opinion. One baby suffering today is one baby too many.
A Postnatal Home Visit from Urban Hatch includes an examination to determine if your baby may be tongue-tied.
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