Is your baby tongue tied?

by Kathy Kuhn, RN (see more from this expert)



When a baby has a restrictive or tight frenulum (tongue tie), it can impair the ability of the tongue to move properly to effectively breastfeed. The frenulum is a piece of tissue that attaches the tongue to the floor of the mouth.

You can see your own frenulum in the mirror by opening your mouth and sticking your tongue out and up. The frenulum looks like a string that holds the tongue in place.

Tongue tie is just one reason a baby may be experiencing difficulty breastfeeding. It can be difficult to diagnose a baby as tongue-tied and assess if this condition has an impact on breastfeeding. For that reason, it is vital that you obtain an evaluation by a lactation consultant experienced in evaluating the frenulum if you think your baby is tongue-tied.

A restrictive frenulum may cause any, or all, of the following symptoms:

Baby:

* Heart-shaped tongue tip. The tip of the tongue may be heart shaped or have a “v” shape indentation in the center when the baby sticks out the tongue or cries. (It is possible to have a restrictive frenulum without this classic symptom or to have a tongue that functions adequately, yet has the heart shaped tip.)

* Square or round tongue tip. The tongue looks square, or round, on the tip instead of pointed when extended.

* Difficulty extending the tongue. If your baby is tongue tied Your baby has difficulty extending the tongue past the gum line. Tapping the tip of the tongue should cause the tongue to come forward, where it should cross the gums.

* Tongue does not cup well. When your little one sucks on your finger the tongue should wrap around it like a hot dog bun wraps around a hot dog.

* Difficulty moving tongue from side to side. If you rub your baby’s lower gum, the tongue should follow your finger, side to side.

* Frenulum is attached very close to the tip of the tongue. Some babies have frenulums attached near the front, but the frenulum is very elastic and allows effective breastfeeding without treatment.

Mom:



* Compression, or white stripe across the tip of the nipple when the baby comes off the breast, or a linear crack or scab going across the tip of the nipple because the tongue retracts and compresses the nipple.

* Misshapen nipple. If the nipple is misshapen after a feeding due to the retraction and inappropriate compression by the tongue.

Breastfeeding problems:

* Failure to gain weight. Baby breastfeeds very frequently and yet may fail to gain weight appropriately.

* Sound of sucking air. If your baby loses her seal or suction at the breast causing her to come off the breast frequently and creates the sound of sucking air.

* Clicking sounds. Your baby may have a restrictive frenulum if the click while breastfeeding is associated with an increase in nipple pain at the time of the click. (The click can be the sound of the tongue snapping back in the mouth or the sound of the loss of suction.)

* Tongue doesn’t extend properly. When your baby’s tongue can not been seen over the gumline when you gently peel back the lower lip during a feeding. Peeling back the lip will also frequently cause the baby with a restrictive frenulum to come off the breast because of a poor seal.

* Extremely sore nipples. If your nipples hurt through the entire feeding despite the use of good latch and position technique your baby may be tongue tied. The soreness is created by the tongue rubbing against the tip of the nipple when the tongue is in the retracted position.

* An increase in pain near the end of the feed as the baby tires and the milk flow slows. Some babies can extend the tongue properly for the early part of the feeding when the milk is flowing faster and they have more energy, but are unable to maintain the correct suck through the whole feeding.

This list is just a guideline. Be aware that some of these same symptoms can be seen in other disorders of breastfeeding and may not indicate frenulum problems.

Is your baby tongue tied?

ALSO A FRIENDLY REMINDER, MOST PLACES IE HEALTH UNITS, ONTARIO EARLY YEAR CENTERS ETC HAVE BREASTFEEDING CLINICS. THEY CAN ASSESS THE SITUATION AND ENCOURAGE YOU TO KEEP TRYING AS WELL AS WORK ON FINDING A SOLUTION TO THE PROBLEMS.