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Tongue Tie

Tongue-tied

‘I couldn’t breast feed my baby’: One in five babies are born tongue-tied but many, like this woman’s son, go undiagnosed for years

By RACHEL ELLIS FOR THE DAILY MAIL

 

  • The string-like skin under the tongue, is too short, restricting movement
  • It can prevent ability to breastfeed and even can lead to speech problems
  • Both sons of Justine Sullivan, 42, from London, suffer from rare condition

As soon as Justine Sullivan’s son Conor was born, he had trouble breastfeeding.

Midwives at the hospital gave him formula milk, much to his mother’s exasperation. ‘Conor’s first feed was from a bottle,’ says Justine, 42, a TV producer from London.

‘I was desperate to breastfeed, but they advised I should top up with formula because it was unlikely he was getting enough from me. It was frustrating, but I took their advice.’

‘I’d seen my GP at least four times and Conor was given treatment for colic and reflux, which causes stomach cramps and vomiting in babies — neither of which he had,’ says Justine.

‘After six weeks, I went to a breastfeeding counsellor and the first thing she did was put her finger in Conor’s mouth. She told me he was tongue-tied and this was the reason he was having trouble. I couldn’t believe no one had checked before.’

 

Tongue tie

‘Desperate families need better help’ with tongue tie

By Jane Dreaper, Health correspondent, BBC News

Services for babies with breastfeeding problems because of tongue tie need to be improved, a parenting charity says.

The condition, which restricts the movement of the tongue, can be treated with a simple procedure.

No safety concerns

Tongue tie varies in severity. If a procedure is needed, the fold of the skin is cut in what is known as division.

The healthcare watchdog NICE endorsed the procedure in 2005, saying there were no major safety concerns. It is often done by surgeons but other healthcare professionals can perform it.

Figures from the Health and Social Care Information Centre show that more than 5,000 babies in England had tongue-tie division in hospital last year. Others may have had the procedure in community settings.

cut the frenulum

Tongue-tie occurs in up to 10% of newborns and can affect breastfeeding and even speech.

Article by Dr Luisa Dillner in The Guardian

So should you cut the frenulum?

What is it?

For a relatively minor congenital problem, there is some controversy about tongue-ties.

Tongue-ties affect 3%-10% of newborns and are diagnosed when the baby is checked over by the midwife or doctor. The tongue is usually only loosely connected to the floor of our mouths, but in tongue-tie the tissue connecting the two (called the frenulum) is shorter and tighter. It can vary from a thin membrane that can break naturally, to a thick and fibrous tissue that restricts normal movement. Most tongue-tie is mild and stretches as the baby grows.

Professor Mitch Blair, a consultant and officer for health promotion at the Royal College of Paediatrics and Child Health, says tongue-ties used to be routinely snipped, but some doctors now think the risk of infection and tongue damage means babies should be watched, not automatically cut.

But watched for what? They may have problems breastfeeding, be unable to suck properly, fail to put on weight and give their mothers sore nipples. They may struggle with bottles because their mouths can’t form a seal round the teat. Tongue-tie might also interfere with speech development (lisps or mispronouncement of Ls as Ws). There are studies showing that adults with tongue-tie have problems licking ice-creams or kissing. So is it better to snip the frenulum just in case?

The solution

In 2006, health watchdog Nice concluded there was controversy about the significance of tongue-tie and that only children whose tongue-tie is causing problems should have frenulotomy. So, first of all find out if the tongue-tie is affecting feeding. A doctor or expert in breastfeeding should watch feeding to see if the tongue-tie is causing problems. There isn’t always a correlation between what the tongue-tie looks like and what it does. A survey of lactation consultants and paediatricians found the former much more likely to blame tongue-tie for poor feeding, so advice may differ. Some doctors wait to see if the baby is losing weight, while others think this is going too far. The frenulotomy, however, should be done using local anaesthetic by an experienced operator. One study, comparing frenulotomy with 48 hours of support from a lactation consultant, found 19 out of 20 babies had better breastfeeding 48 hours after frenulotomy, compared with one in 20 whose mother had the support. Even allowing for some bias – a mother who allowed frenulotomy may be more motivated to say it worked – the number is still high. Complications are rare but include ulcers under the tongue, bleeding, infection or damage to the tongue and salivary ducts.

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