Tongue Tied Babies

Here's a great Scrabble word (too long for Words with Friends): Ankyloglossia. It is the term for being tongue tied. 

During my years as a practicing pediatrician being "tongue tied" was thought to have little consequence. Being tongue tied refers to the problem which occurs when the anterior (tip) of the tongue is attached too closely to the lingual frenulum (the piece of tissue that attaches the underside of the tongue to the floor of the mouth).   This tightness may impair movement and function of the tongue and occurs in about 4 -5 % of newborns.  

While it is not life threatening to be sure, and is really not associated with any long term speech problems, new data is showing that being tongue tied may interfere with early breast feeding. 

Several recent articles in different pediatric journals have now looked at Ankyloglossia and breast feeding success. One of the most difficult times for a new mother is when she is first attempting breast feeding. I can attest to that myself. 

While I was a pediatrician, and could perform life saving procedures on newborn infants, I was ill prepared for breast feeding. Not only did I not have any clue as to what I was doing, I was also exhausted, anxious and only knew that nursing sometimes brought tears to my eyes as the baby latched on and who even knew if they were getting any milk?  Many mother stop nursing in the first several weeks after their baby is born due to a combination of the above factors. 

Now if you add in a tongue tied newborn, who may have an ineffective or awkward latch, there may be even more pain associated with nursing. 

For some mothers the bottle seems easier and surely less painful, and they may abandon breast feeding in the first weeks.  But in these two recent studies, infants who were noted to be tongue tied and were exhibiting feeding issues, who then had their frenulum clipped (frenectomy) in the early neonatal period, had more long term success in breast feeding. Both studies demonstrated an improvement in infant latch and diminishment in maternal pain, which led to overall feeding improvement for both baby and mother. With this came more successful and longer breast feeding. 

Many young (and not so young) pediatricians have not been trained in how to perform this simple procedure. When being "tongue tied" is noted on a baby's initial exam a frenectomy may easily be done in the first few days of an infant's life. Because the frenulum has a poor blood supply and heals rapidly, the baby may be put to the breast soon after the procedure. There is typically no more blood loss than when a child loses their first tooth. I think it is less invasive than circumcision, but that is my opinion of one. 

With recent studies to document improvement in nursing it may be time for me to re-visit this procedure.Surely is it like riding a bike, you never forget how to do it!  

That's your daily dose for today.  We'll chat again tomorrow.

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