A tongue-tie (also known as a restrictive frenulum or ankyloglossia) is when the thin membrane that attaches the tongue to the floor of the mouth is too tight or short and restricts the tongue's movement. When this membrane (the lingual frenulum) is attached to the front or close to the tongue tip (anterior), this can cause a forked or heart-shaped appearance. If the membrane is attached further back (posterior) the tongue may look ‘normal’ in appearance. However, both can affect tongue function and feeding!!!
Approximately, 1 in 10 babies will have a restriction under their tongue, but only half of these babies will need a procedure to improve tongue function.
A tongue-tie division is performed by a health professional (Tongue-Tie Practitioner) who has had specialised training in assessing and dividing tongue-ties.
To improve the tongue’s function, the Tongue-Tie Practitioner can ‘cut’ this membrane to allow the tongue to move freely. This procedure is known as a frenulotomy, or tongue-tie division/release and specialised blunt-ended scissors are used.
Before this procedure, your baby will have a detailed feeding and oral assessment to identify if a tongue-tie is causing feeding issues or if problems can be resolved by changes such as different feeding positions and techniques.
At Kent Tongue-Tie Professionals, we are not only experienced in assessing and dividing tongue-ties but are we skilled in providing infant feeding support.
In the UK, the National Institute for Clinical Excellence (NICE) state that a tongue-tie division should only be performed to assist mother and baby to feed more effectively. A tongue-tie division should not be performed because of parents’ concern for future issues, such as speech, weaning and cosmetic reasons. There is no research to support that a tongue-tie division will prevent future speech issues.
The lingual frenulum is a normal part of the mouth, and some can be obvious but do not affect the tongue function.
The tongue function is more important than the appearance!
You cannot diagnose a tongue-tie just by looking at it!
Your baby will need to have a full oral assessment by a professional who has had specialised training in assessing and dividing tongue-ties, as well as being skilled in infant feeding.
However, there are certain signs and symptoms that can suggest a tongue-tie is causing feeding issues. The following list is not exhaustive.
· Restricted tongue movement – tongue staying low in the mouth when baby cries; tongue not poking out past baby’s gum or lip; dimples in the tongue
· Small gape resulting in biting/grinding behaviour
· Unsettled behaviour during feeds
· Difficulty staying attached to the breast/bottle
· Frequent or very long feeds
· Excessive early weight loss/poor weight gain/faltering growth
· Prolonged jaundice
· Clicking noises and/or dribbling during feeds
· Colic, wind, hiccoughs
· Reflux (vomiting after feeds), chokes, gags
· Sore/damaged nipples
· Nipples which look misshapen or blanched after feeds
· Mastitis/engorgement
· Low milk supply
· Maternal exhaustion from frequent/constant feeding
· Use of nipples shields to enable a latch to be maintained
Your baby may not display all these signs and there can be other causes for these symptoms. If you are worried about your baby and feeding, it is a good idea to seek skilled help as soon as possible.
We don’t think that babies find it a long-lasting pain as babies will feed following the procedure. Feeding, in and of itself, is a form of pain relief and babies obtain comfort from being close to you. In the next few days following a tongue-tie division, your baby may be a bit fussy as their tongue may feel tired and heavy as they are using it in a different way.
We encourage you to continue practising the techniques we will have discussed in the appointment, as well as having lots of tummy time and interaction with your baby.
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