What you need to know about tongue tie
Is your baby struggling to feed well, whether breast or bottle fed? Does your baby have a poor or weak latch and is feeding challenging? It could be they’re not getting a good seal around the teat or nipple and maybe it’s a bit painful for the breastfeeding mother? It may be that your baby has a tongue tie. Don’t worry, this is easily solved and not a result of anything you’re doing as parents. So read on as we share more information about tongue tie here.
What is a tongue tie?
A tongue-tie (ankyloglossia) is a condition that is present in a baby at birth and that can restrict the tongue’s range of movements. This is thought to be a result of both genetic and environmental factors. It is caused by a short or tight membrane (lingual frenulum) under the tongue. Babies can have a posterior or anterior tongue tie or both. An anterior tongue tie is harder to see being at the rear of their mouth. It should be easier to notice a posterior tongue tie. tongue ties can interfere with feeding, if a baby is unable to mobilise its tongue, they might chew instead of suck on the end of the nipple, causing pain for the mother and affecting the baby’s ability to suck efficiently to satisfy their hunger. In bottle fed babies they may be slow to feed, take in a lot of air or dribble milk during a feed.
Research suggests that tongue tie is present in 10% of babies but in recent testing of QudoTM Soother, we found over 80% of babies had a tongue tie, either posterior or anterior, that needed treatment by a trained specialist. This is consistent with previous testing of QudoTM Soother in 2022 during the Soothing Baby Clinic where we found 83% of babies had a tongue tie.
How do I know if my baby has a tongue tie?
This is best done by a trained professional, like your Health Visitor, GP, Paediatrician or tongue tie specialist. If you’re not sure if your baby has a tongue tie, here are few ways to tell and how you can spot tongue restriction:
- Does your baby make a clicking sound when feeding?
- Is your baby unsettled during feeds and finds it difficult to stay attached?
- Sore or misshapen nipples after breastfeeding
How to see if you can spot tongue tie:
- It’s usually easier to see when your baby is crying.
- When their mouth is wide open the tongue tip should be in the middle of their mouth.
- If your baby has a tongue tie, the tongue will stay quite flat on the floor of the mouth and the edges of the tongue may curl up to form a ‘v’ or heart shape.
- If your baby can’t poke their tongue out over the bottom lip when the bottom lip is stimulated, they may have tongue restriction.
- You can try and run your finger across your baby’s bottom lip from side to side and they should follow this with their tongue.
- If they can’t move their tongue freely to follow, then contact your GP, Health Visitor or a tongue tie specialist and arrange an appointment to have a tongue tie assessment.
How is a tongue tie treated?
If your baby has a confirmed diagnosis of a tongue tie then they can have a procedure to release the restriction, called a frenulotomy. It is a quick and simple technique that involves a trained specialist snipping the frenulum with sharp, round ended scissors. Your baby may feel some discomfort at the time but can feed straight after it and complications are very rare. Before this procedure takes place, the tongue-tie practitioner will explain in detail what the procedure entails and any risk factors so you are fully informed before they go ahead.
If your baby has a frenulotomy, the practitioner will also give you guidance on how to avoid the tongue re-attaching and tips to keep your baby’s tongue mobilised.
Why is sucking and tongue mobilisation so important?
Nutritive sucking is when a baby is sucking to feed and gain the nutrition it needs to grow. Non-nutritive sucking is when a baby sucks without receiving any nutrition, for example on a soother, a little finger or an empty breast. Babies of all ages find sucking soothing. From as early as 11 weeks’ gestation the baby in your womb will have gained practice and experience of sucking.
Using a soother, or little finger turned upside down, between feeds can be extremely beneficial for your baby. Not only can it promote calm as sucking releases oxytocin but it also helps your baby’s digestion. When your baby sucks on a soother or little finger, they swallow more saliva which holds necessary digestive enzymes to break down their milk.
Researchers have noted that sucking a soother between feeds can help babies suffering with reflux. They found babies who sucked on soothers had fewer and shorter episodes of gastroesophageal or “acid” reflux by stimulating the flow of saliva and downward contractions of the oesophagus. Together, these actions help to more quickly move the highly irritating stomach fluid back where it belongs.
Giving your sucky baby a soother or little finger between feeds will also help reduce unnecessary sucking on your breast which can cause discomfort or sore nipples and over feeding as well.
Non-nutritive sucking also helps support strong suck, swallow and breathe coordination. This aids neurobehavioural organisation and maturation.
Drinking and eating are obviously essential skills for survival and the whole process is pretty complex, involving at least 26 pairs of muscles and five cranial nerves. The tongue is a key muscle linked to numerous other soft tissue networks throughout the body, such as the hyoid bone and neck muscles and some researchers report links right down to our toes too. The patterning for suck-swallow and swallow-breathing is developed during the first year of life. We are born with the reflex but it is the muscle movement and coordination of everything which inturn teaches the brain and nervous system. Everything needs to happen in an orderly way during the first few months of life to help mature the nervous system to optimise sucking, eating,, swallowing and breathing. Anything that helps this natural process to happen smoothly and without delay is important.
Is there a longer term impact of leaving a tongue tie untreated?
They are common reported issues of mothers who have to give up breastfeeding because the baby can’t latch well. In older infants they can develop into being fussy eaters finding it difficult to swallow and breath well, preferring soft textured food. They may develop a lisp or speech impediments. It is so much easier to release the tongue tie whilst a baby is young, it is much more complicated to deal with an older child or young adult.
Dentists also observe that lack of tongue mobility and mobile mouth tissues can lead to more overcrowding of teeth (therefore more orthodontics needed in later life) and narrowing of the mouth. The smaller the mouth, the more the tongue, uvula and other tissues can obstruct air flow. Tightness which in turn can create more headaches, with people developing a forward neck posture which in turn affects our overall spinal health and wellbeing.
If the tongue isn’t freely mobile and able to reach up to the top of the mouth when sleeping, children and adults become mouth breathers, leading to sleep apnea and snoring. These are children who may be more prone to ear infections, asthma and tonsillitis. Also, it might affect their talents to sing, play a wind or brass instrument, anything that needs a good co-ordinated suck, seal and swallow technique. Pretty tricky to probably suck or lick an ice cream or lolly too!
There are many potential knock-on consequences to overall health and wellbeing throughout a person’s life if the tongue isn’t mobile. This topic is so much more than coordinating suckling, swallowing and breathing. It is a crucial foundational mechanism which in turn affects our future skills and well being.
Tongue tie and QudoTM Soother
It’s common for babies with a tongue tie not to be able to hold onto or suck a hollow soother but we have found that many babies with a tongue tie can use QudoTM Soother. QudoTM Soother can also be beneficial after a frenulotomy to help keep the tongue mobile and promote non-nutritive sucking which many babies enjoy.
How to find a tongue tie specialist?
Your doctor or Health Visitor may be able to refer you to your local hospital to have see a tongue tie specialist or visit Tongue-Tie.org to find a practitioner.
Useful resources:20 July 2023