by Teresa J. Mitchell
During your baby's newborn exam, your pediatrician might have said, "Oh, she's tongue-tied."
It seems like a weird thing to say about your beautiful, perfect baby! What your doctor means is that your baby has a common abnormality that affects that the tissue at the base of the tongue.
Best estimates put the incidence of tongue-tied babies between 1.7 and 4.8 percent. It's more common in boys than in girls and tends to run in families.
A membrane called the lingual frenulum attaches the underside of the baby's tongue to the floor of the mouth. Stand in front of a mirror. If you lift your tongue up you can see this band of tissue.
Sometimes a baby will be born with frenulum that restricts the tongue's motion. A tongue-tied baby might have problems moving the tongue up and down or from side to side. It may not extend past the lower lip. A tight or short frenulum can make it difficult for your baby to nurse.
One pregnancy.org mom said, "I don't know what's wrong. I'm holding my baby right. He's taking enough breast in his mouth. He doesn't seem to get any milk and nursing hurts!"
Even though your pediatrician might not have mentioned the condition, do you suspect your baby has ankyloglossia, which is the official term for a tongue-tied baby?
Tiny newborns will try to imitate you. Try and get your baby's attention and stick out your tongue. Pause and repeat. Within a few minutes, you'll more than likely see your precious babe try to do what you just did.
Does the tongue extend past the bottom lip? Does it have a heart-shaped appearance on the tip? You can also try offering a finger, pad side up, to suck on. Does the tongue extend over the gum line to cup the bottom of your finger? If so, you may want to have your doctor take a look.
It can sometimes be a challenge to find a doctor who recognizes the condition and is willing to perform a frenotomy. As more "in-the-know" moms breastfeed, the number of pediatricians who are aware of the issues and how they affect breastfeeding babies will increase as well. In time, more will know how to properly diagnose tongue-tied babies.
The tongue has a vital position in breastfeeding. It helps pull the breast into proper position in the mouth, makes a channel to keep the breast in place and catches the milk your baby swallows.
The tongue tip elevates and traps milk in the front of the breast. It will continue to compresses from the front to about halfway back, pressing milk from the areola toward the nipple. Finally, the back of the tongue drops toward the floor of the mouth and decreases the pressure in the mouth. Milk flows from the nipple by this combination of compression and suction, all put in motion by the tongue's movements.
The symptoms below can be caused by other breastfeeding challenges. However, they are good signs to look out for if you're suspecting that your child is affected. If you're at all unsure, an empowering option is to make an appointment and speak with a qualified lactation consultant. Your baby might be tongue-tied if:
Experts do not agree whether or not mild ankyloglossia interferes with breastfeeding. In the decades when formula feeding was common, caregivers usually allowed the condition to resolve on its own.
Some breastfeeding advocates say these babies might be better off getting treatment before problems start. Three separate studies found that nursing moms report nipple pain relief and easier nursing after clipping of the frenulum.