Tongue-tie is when a baby cannot move their tongue freely because they have a short, tight or thick frenulum. This is the skin attaching the tongue to the base of the mouth.
Tongue-tie affects a low percentage of babies. It is slightly more common in boys than in girls.
Tongue-tie may restrict the movement of your baby's tongue and make feeding difficult. But many will not have any feeding difficulties.
Not all babies with tongue-tie need treatment.
Tongue-tie challenges
Tongue-tie may interfere with your baby attaching (latching) to your breast. It may also reduce the amount of milk your baby gets. This can result in poor weight gain and it can also reduce your breast milk supply.
Challenges for the baby with tongue-tie may include:
- difficulty in getting a deep attachment to the breast
- difficulty staying on the breast
- weight loss or challenges to gain weight
- restless, tiring and unsettled feeds
- noisy or clicking sounds during the feed
- dribbling of milk during feeds
- too much wind during or after feeds
Challenges for the mother breastfeeding a baby with a tongue-tie may include:
- distorted nipple shape after a breastfeed
- bleeding, damaged or ulcerated nipples resulting in nipple pain
- baby does not feed enough, resulting in breast fullness (engorgement) or mastitis
Concern about your breast milk supply
Lactation support
You will need good lactation support if your baby has tongue-tie. Techniques like improved positioning and attachment can help with feeding challenges. If this is successful, further treatment may not be necessary.
Midwife Susan O'Driscoll talks about overcoming breastfeeding challenges
Your baby's tongue-tie should be assessed as part of lactation support.
If you do not have access to a lactation consultant, you can also get help from your:
- infant feeding specialist
- midwife
- public health nurse (PHN)
- GP
- neonatologist
- paediatrician
Treatment
Some babies may need a frenotomy. This is where the frenulum causing the tongue-tie is released in a minor operation. In some cases, you may be charged for this operation.
A trained healthcare professional performs the frenotomy procedure. It's usually done without an anaesthetic, but a local anaesthetic is sometimes used with older babies.
Your baby will be wrapped in a blanket and supported at the shoulders to stabilise the head.
The tongue-tie is then released. There should be little or no blood loss. You may be able to continue breastfeeding immediately.
Follow-up and support
Both you and your baby should have a check-up after the procedure. Skilled breastfeeding information and support is essential following a frenotomy.
There is a wide range of breastfeeding support available in Ireland.
Breastfeeding support groups are run by:
- lactation consultants
- public health nurses
- La Leche league leaders
- Cuidiu breastfeeding counsellors
Friends of Breastfeeding also provide social support at their Mum2Mum groups.
Breastfeeding difficulties
If you are having difficulties with breastfeeding, get support from an International Board-Certified Lactation Consultant (IBCLC).
