Breastfeeding Tops

Breastfeeding baby with Tongue tie / ankyloglossia

First things first do not worry, tongue tie or ankyloglossia as it’s formally known is a common occurance in babies ( i know 2 of my friends babies had this condition). It can affect how your baby breast feeds so it is an important thing to check if you baby is having problems latching on or feeding. Remember if you or your baby are having problems please always refer to your midwife or health visitor, and if you don;t find them approachable seriously ask to change because if you get the right midwife / health visitor they can be worth their weight in gold!

 

I found this great article which explains a bit more about what is tongue tie and what can be done to help.

What is tongue-tie? 

Even if you don’t know what it is, you’ll probably have heard the expression ‘tongue-tie’ used to describe someone who has a speech problem. The term actually refers to a condition where the tongue remains more anchored to the bottom of the mouth than it should be, restricting movement. Babies and children with this condition have a short lingual frenulum (the piece of skin that joins the tongue to the floor of the mouth) and it may or may not cause problems withbreastfeeding and speech (see below). The medical name for the condition is ankyloglossia

How is it diagnosed? 

 

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A tongue-tie is sometimes identified in the routine medical examination your baby has in his first 24 hours of life. Your midwife may put her finger in your baby’s mouth to check the palate and tongue. But a tongue-tie is not always apparent and may not be picked up until your baby has feeding difficulties (see below) or speech problems at the age of two or three. 
 

How common is it? 

Research at the University of Cincinnati, USA, published in 2002, found that around 16 per cent of babies who were experiencing problems with breastfeeding had a tongue tie. Another study conducted at Southampton General Hospital found about 10 per cent of babies born in the area were affected. ‘This was much higher than all the medical text books say,’ says Carolyn Westcott, lactation consultant at the hospital. ‘We think this is because those books were written at a time when bottle-feeding was the norm and tongue-tie doesn’t normally affect a baby’s ability to bottle-feed. Now breastfeeding is becoming more common, more cases of tongue-tie are being picked up again.’ 

What are the symptoms? 

The good news is that lots of babies with tongue-tie experience no problems at all, either with feeding or speech. However, some babies will have problems with breastfeeding because they won’t be able to use their tongue to massage their mother’s nipple and areola. If they can’t stick their tongue out beyond their lower gum they won’t get enough milk. Any of the following can be symptoms of tongue-tie: 

• failure to latch on 

• slipping off the breast while feeding 

• Sore nipplesmastitis and/or blocked ducts 

• continuous feeding 

• colic 

• slow weight gain 

Remember, a baby with tongue-tie may not have all of the above symptoms and some babies will have these symptoms, but not have a tongue-tie. 

How is it treated? 

This is highly controversial — prevailing medical opinion says do nothing and it will usually right itself by the end of the first year of life. If the baby still has a problem after this period, a paediatric surgeon may consider surgery to divide the frenulum from the base of the mouth (a procedure called a frenulotomy). 

Others will only perform surgery much later if the child has had speech problems and has not responded to speech therapy. 

But, in some areas, doctors are prepared to divide the frenulum much earlier if the baby either has problems withbreastfeeding or has a sibling with speech problems due to a tongue-tie. 

Mr Mervyn Griffiths, consultant paediatric surgeon at Southampton General Hospital, has conducted research that shows performing a division of a tongue-tie before the age of three months allowed 64 per cent of babies to breastfeed successfully for at least three months afterwards. 

What does the surgery involve? 

Again, it varies. Some areas of the UK do the division with a general anaesthetic requiring a hospital stay, while in others it is done without anaesthetic on a day-case basis. The procedure itself involves simply snipping the skin to divide the frenulum from the bottom of the mouth and takes a matter of seconds. A study carried out by Mervyn Griffiths on 217 babies under three months found that 18 per cent of babies who had the frenulum divided without an anaesthetic slept through the procedure. Although 64 per cent cried more after the operation than before, it was only for a matter of seconds in most cases. There was no bleeding or complications in any of the babies. 

Will I have problems breastfeeding? 

There is growing evidence to suggest that tongue-tie can cause problems with breastfeeding in some babies. 

‘To breastfeed effectively a baby needs to make a rippling action with his tongue, pushing the nipple and areola against the roof of his mouth to release milk’, says Carolyn Westcott. ‘If he can’t do this then he won’t get enough milk and he may chomp at the nipple causing soreness. He may feed constantly, falling asleep exhausted on the breast only to wake and begin feeding again. He may also be more prone to wind and colic and take a long time to feed. Mothers understandably become exhausted and sore and want to give up breastfeeding.’ 

Will I have problems bottle-feeding? 

Bottle-fed babies use a different sucking action to get milk from a teat and are not so badly affected. 

‘Symptoms of tongue-tie in bottle-fed babies are not so noticeable — they may just take longer to empty their bottle, become colicky and dribble a lot. It doesn’t usually affect their ability to gain weight,’ says Carolyn Westcott. 

Where can I get further information? 

The Lactation Consultants of Great Britain produce a leaflet ‘Breastfeeding and Tongue-Tie’. Visit www.lcgb.org for more information. 

If you suspect your baby has a tongue-tie which is causing problems, mention it to your GP or midwife. They may refer you to a paediatrician at your local hospital. 

Reviewed March 2006.

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