Luton Tongue Tie Consultation
Tongue-tie (ankyloglossia) is where the strip of skin connecting the baby’s tongue to the floor of their mouth is shorter than usual.
Some babies who have tongue-tie don’t seem to be bothered by it. In others, it can restrict the tongue’s movement, making it harder to breastfeed.
Tongue-tie is sometimes diagnosed during a baby’s routine newborn check, but it’s not always easy to spot. It may not become apparent until your baby has problems feeding.
To breastfeed successfully, the baby needs to latch on to both the breast tissue and nipple, and their tongue needs to cover the lower gum so the nipple is protected from damage.
Babies with tongue-tie aren’t able to open their mouths wide enough to latch on to the breast properly.
If you’re breastfeeding your baby and they have tongue-tie they may:
- have difficulty attaching to the breast or staying attached for a full feed;
- feed for a long time, have a short break, then feed again;
- be unsettled and seem to be hungry all the time;
- not gain weight as quickly as they should;
- make a “clicking” sound as they feed – this can also be a sign you need support with the positioning and attachment of your baby at the breast.
Tongue-tie can also sometimes cause problems for a breastfeeding mother. Problems can include:
- sore or cracked nipples;
- low milk supply;
- mastitis (inflammation of the breast), which may keep recurring.
Other signs of tongue-tie
Other signs that may indicate your baby has tongue-tie include:
- difficulty lifting their tongue up or moving it from side to side;
- difficulty sticking their tongue out;
- their tongue looks notched or heart-shaped when they stick it out.
Treatment isn’t necessary if your baby has tongue-tie but can feed without any problems. If their feeding is affected, treatment involves a simple procedure called tongue-tie division.
Luton Tongue tie consultation
Tongue-tie division involves cutting the short, tight piece of skin connecting the underside of the tongue to the floor of the mouth (the lingual frenulum).
It’s a quick, simple and almost painless procedure that usually resolves feeding problems straight away.
The decision on whether or not a tongue-tie is impacting on feeding and whether it is appropriate to offer to divide it should be made after a detailed feeding history has been taken. This will usually include information about the pregnancy and birth and the medical history of both mum and baby. The baby is usually observed at the breast. The function of the tongue will also be assessed to establish if the baby is tongue-tied and if this is impacting on feeding, even we discous about formula feeding.
Assessment for tongue-tie requires training and skill and involves placing a finger in the baby’s mouth. It cannot be done by just taking a look.
For tongue-ties should assess elevation, lateralisation and extension. We can perform a suck assessment by placing the finger in the baby’s mouth (pad side up, nail side down) and feeling how the baby is cupping and using their tongue. Assessor sweep their finger under the baby’s tongue so they can feel the extent of the tongue tie and the tongue will also be lifted to visualise the frenulum. The appearance of the frenulum is also documented including the shape of the tongue tip, where it attaches to the floor of the mouth and the underside of the tongue and how long and stretchy it is.
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 gape resulting in biting/grinding behaviour;
- Unsettled behaviour during feeds;
- Difficulty staying attached to the breast or bottle;
- Frequent or very long feeds;
- Excessive early weight loss/ poor weight gain/faltering growth;
- Clicking noises and/ or dribbling 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 by a practitioner skilled in breastfeeding is essential.