Is My Baby Tongue Tied?
“My lactation consultant told me my baby is tongue tied and she needs to get her frenulum clipped so she can breastfeed. Is this really necessary? Why does my baby need this procedure?”
The frenulum is a (usually) thin, fibrous band that connects the underside of the tongue to the floor of the mouth. The mere existence of a lingual (tongue) frenulum is not an indicator of a problem. The important thing is whether the frenulum restricts the movement of the tongue in a way that interferes with optimal function. In other words, if a baby has a tight frenulum, but can still use her tongue properly, no intervention is needed.
One of the vital roles of the tongue for a baby is for feeding. Your baby depends on her tongue for creating a vacuum (latch), sustaining a vacuum, moving the milk to the back of her mouth and swallowing. These things are important whether a baby is breastfeeding or bottle feeding. But when a baby is breastfeeding, the function of the tongue is even more critical because incorrect tongue movement/placement equals sore nipples, for mommy!
How do you know if your baby is tongue tied? It takes a skilled professional to assess your baby’s tongue mobility, but you can get a pretty good idea by doing some careful observation. Take a few minutes to observe your baby and respond to these questions:
- Does your baby have a hard time latching on?
- Do your nipples looked creased or flattened after breastfeeding?
- When your baby cries, does the center of his tongue look “’stuck” to the floor of his mouth with just the edges curling up?
- When your baby sucks on your finger, do you feel the lower gums either constantly or intermittently?
- Does your baby seemed stressed with a fast flow of milk?
- Do feedings take a long time? Or is baby feeding very frequently and never seems satisfied?
- Is baby off and on the breast frequently during a feeding?
- Does your baby have symptoms of reflux?
If the answer to any of these questions is yes, Your baby may be tongue tied! Check with an experienced lactation consultant to be sure. She will examine the baby—paying particular attention to assessment of tongue function. She will also observe the baby feeding. After a thorough evaluation, the lactation consultant may recommend that the baby have the frenulum clipped. She should refer you to a doctor experienced in this procedure.
The procedure is called a frenotomy or frenulectomy. The doctor will assess tongue function, may observe a feeding or ask you detailed questions about feeding. You should be given instructions to stretch your baby’s tongue periodically after the procedure to ensure that it heals properly. Sometimes a topical anesthetic is used, but not always. The pain the baby experiences is mild and brief (similar to biting your tongue) and bleeding is minimal. After this very quick procedure (it literally takes about 1 second!) most mothers and babies notice an immediate difference in breastfeeding.