What is a tongue-tie?
A tongue-tie (also known as Ankyloglossia) is caused by a short or tight membrane under the tongue (the lingual frenulum). It is a congenital condition that runs in families and affects boys more than girls.
With tongue tie, the tongue tip may look blunt, forked or have a heart shaped appearance. However, when the membrane is attached further back, the tongue may look normal. The baby will still have trouble lifting the tongue and sticking it out.
Research suggests that approximately 1 in 10 babies may be born with tongue tie. But only about half of those babies display significantly reduced tongue function which makes breast or bottle feeding difficult.
These babies are likely to benefit from treatment to release the restriction that the membrane is having on the tongue and enable to baby to feed effectively. This is division of tongue tie.
Problems which may be due to a tongue-tie:
- Sore/damaged nipples
- Nipples which look misshapen or blanched after feeds
- Low milk supply
- Exhaustion from frequent/constant feeding
- Distress from failing to establish breastfeeding
- Restricted tongue movement
- Small mouth when feeding causing pain for the mother
- Unsettled behaviour during feeds; fussing and pulling away
- Baby falling asleep as soon as they latch on
- Difficulty staying attached to the breast or bottle
- Frequent or very long feeds
- Excessive early weight loss and poor weight gain
- Clicking noises and/ or dribbling and leaking milk during feeds
- Colic, wind, hiccoughs
- Reflux (vomiting after feeds)
Your baby may not display all of these signs and there can be other causes for these symptoms so thorough assessment is recommended.
The Portland Tongue Tie clinic for babies (0 to 8 months)
Mrs. Caulfield runs the Portland Tongue Tie clinic together with a Senior Lactation Consultant every Monday morning at the Portland Hospital in central London.
In the clinic, there is initially a consultation with Mrs. Caulfield and a lactation Consultant where there is time to explore the particular problems you have been experiencing with feeding you baby.
Then, your baby will be gently and expertly examined for tongue tie in a sterilized minor theatre room with the you present and the tongue tie will be demonstrated to.
If all the signs are that your baby is has tongue tie and that it is causing the breastfeeding (or bottle feeding) difficulties then the tongue tie can be divided.
You will be asked to sign a consent form and then Mrs. Caulfield will apply some pain relieving drops to your baby’s mouth. You may watch or sit on a chair in the minor theatre or even wait in the waiting room as Mrs. Caulfield gently and swiftly divides the tongue-tie.
After the procedure, which at most causes very minor pain and bleeding, your breastfeeding technique will be assessed and the lactation consultant will supervise you until you are happy to leave. Advice will also be given about strategies you may need to use to achieve exclusive breastfeeding once the tongue tie is done.
No exercises are given, as Mrs. Caulfield firmly believes that breastfeeding is the best exercise for the tongue and prevents re healing.