A tongue-tie occurs when the band of tissue under the tongue (the frenulum, which remains from the development of the embryo) doesn’t allow normal tongue movements: either because it extends until the tip of the tongue (or just behind the tip), or because it is more behind but too tight. Around 4 to 10 per cent of babies have a tongue-tie, but it is a much higher percentage among those visiting a lactation clinic, as the tongue plays a crucial role for breastfeeding.
Tongue-tie can be associated with an inability or difficulty attaching to the breast, which often results in the baby latching onto the nipple only, thus causing nipple pain/damage, reduced removal of milk, very frequent unsatisfying feeds, inadequate weight gain (unless the mother compensates initially with a robust milk supply), maternal pain, exhaustion and frustration – all of which can result in premature weaning, leaving the mother with a feeling of failure. Sometimes bottle feeding is also affected.
This suffering can (and should be) prevented by early detection; from day one, during the newborn examination, or via thorough assessment by a lactation consultant. If tongue tie is confirmed, there are a couple of things that can be done to help. Some types of tongue restriction, attributed to a posterior or ‘hidden’ tie, can benefit from a gentle technique (called cranio-sacral therapy), which can release tension pulling the tongue backwards. If this is not successful, and the signs and symptoms are persisting, then a release of the tongue tie is indicated. In the early weeks/months, this is a simple and quick procedure, and the baby is usually brought back for breastfeeding within a few minutes. Improvement is usually felt immediately or within a few days.