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Tongue Tie (Ankyloglossia), Tongue Clipping (Frenotomy) & Breastfeeding |
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What is Tongue Tie (Ankyloglossia)?
• Ankyloglossia is commonly known as tongue tie.
• The frenulum is a thin translucent membrane extending from the undersurface of the tongue in the middle to the floor of the mouth.
• Tongue tied infants have a short frenulum that tightly anchors (“ties”) the tongue down to the floor of the mouth.
• This makes it difficult or sometimes impossible for the infant to move the tongue as needed to breast feed correctly and efficiently.
- How common is tongue tie and why is it important in breastfeeding moms?
• Approximately 3-5% of healthy term newborns are tongue tied.
• 10-15% of breastfeeding moms experience difficulty due to the infant being tongue tied..
• The tongue has to move freely inside the baby’s mouth for efficient “correct” sucking to happen.
- When tongue tied, the infant’s tongue is unable to stretch over and above the gum pad of the lower jaw and lift up to the roof of the mouth.
- So the tongue is unable to compress (“massage”) the milk ducts when the infant nurses.
- The baby then latches incorrectly and the mom develops very sore, painful nipples.
- When tongue tied, the infant’s tongue is unable to stretch over and above the gum pad of the lower jaw and lift up to the roof of the mouth.
- Moms become discouraged because breastfeeding becomes painful and ineffective.
- Moms often prematurely quit breastfeeding because the baby is not gaining weight well ("failure to thrive").
 
- How is tongue tie diagnosed?
• Tongue tie is obvious on examination of the infant’s mouth especially when he/she is crying.
• The picture above shows the short frenulum “tying” the tip of the tongue to the floor of the mouth with a heart shaped groove at the tip of the tongue where the frenulum attaches.
• Our Lactation Consultant Paulie Gatchell R.N., IBCLC uses an assessment tool called the Hazelbaker Assessment Tool to evaluate the extent and nature of the tongue tie.
• The score on this assessment tool is used to decide if “tongue clipping” will be beneficial to improve breastfeeding.
- How is tongue tie treated?
• The frenulum can be “clipped” to release the “tie” (“tongue clipping “or “frenotomy”).
• It is a safe, simple quick outpatient office procedure that is done within a few minutes.
• Tongue clipping does not need anesthesia or sedation.
• The most common complication is slight bleeding at the site which stops as soon as the baby is put to the breast and breast milk bathes the wound.
• Mothers will often note instant relief and improved sucking after the tongue clipping.
• The baby is observed in the office for ½ hour after the procedure with the LC assisting in latching the baby at the breast to make sure there is no bleeding from the wound.
• Dr. Sudha is one of the very few Pediatricians in the Valley trained to do tongue clipping.
- When is tongue clipping (“frenotomy”) not advised?
• Tongue clipping CANNOT be done if the baby did not receive Vitamin K at birth since Vitamin K is necessary for blood clotting.
• Tongue clipping cannot usually be done in the office as an outpatient procedure if the baby weighs more than about 12 pounds and/or more than 4-6 weeks old because of the higher risk of bleeding.
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| Our Philosophy on Tongue Tie/Tongue Clipping and Breastfeeding |
- We are committed to helping mothers/babies reach their goal to breast feed successfully
- Tongue clipping should be done as soon as possible after birth to ensure successful breastfeeding..
- Every family deserves full care and close follow-up to ensure breastfeeding success.
- Therefore, Dr. Sudha only performs tongue clipping ONLY on her patients either at the office or at Chandler Regional /Mercy Gilbert Medical Centers.
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| Where can I find additional information about tongue tie and tongue clipping? |
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| Please feel free to contact us with any question or concerns that you may have on Breastfeeding. |
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| Gateway Pediatrics is committed to helping mothers breast feed |
