If you have ever been around breastfeeding mothers or in breastfeeding circles, you must have heard the word “tongue tie” once or twice. Most mothers whose children have tongue tie often stop breastfeeding prematurely due to inability of the baby to breastfeed or intolerable pain. The parents often never come to know that the reason behind the pain and inability to breastfeed is a tongue tie. Most pediatricians will not check for a tongue tie. You must discuss with a tongue tie expert to make sure whether your baby has a tongue tie or not.

Below we will discuss with Pediatrician and tongue tie expert Dr. Medhat Abu-Shaaban all questions related to tongue ties from what it is, how it relates to breastfeeding and how to treat it. We also have a breastfeeding specialist and nutritionist Mirna Sabbagh as part of the team who will help you with breastfeeding after the release.

What is a tongue tie?

A normal tongue should be able to move up, down, outward and inward. A tongue tie is when the tongue is tied to the bottom of the mouth in an unusual way that restricts the tongue from moving freely. The same way a leash restricts the dog from moving freely.

Tongue ties are often missed. There are different types of tongue ties, some are easy to spot and others are quite difficult. As you can see from the photo below, an anterior tongue tie is evident, however most tongue ties are not evident and needs a skilled practitioner to see it.

What is the affect of the tongue restriction caused by a tongue tie?

An untreated tongue tie can cause speech delay, problems with speech, inability to accept solid foods, changes to teeth, changes to mouth shape, and most importantly difficulty with breastfeeding.

How does tongue tie affect breastfeeding?

To understand how tongue tie affects breastfeeding, we should explain how normal breastfeeding works. A normal painless breastfeeding experience involves the baby latching onto the breast. Then the baby should be able to create a suction by cupping the bottom of the breast with the tongue and lower lip, and the top of the breast with the lip. It involves the tongue portruding out of the mouth the same way you would suck on a large popsicle with your tongue and not with your lower lip.

Now when the tongue is tied down, it is unable to extend under the breast correctly. This could mean one or two things:

1. The baby will not be able to latch at all. The mother will think the baby does not want to breastfeeding

2. The baby will latch, however incorrectly. This can cause either breastfeeding pain with bleeding painful nipples, or it will lead to the baby latching but not removing the milk efficiently which is even more dangerous.

What happens if the baby is unable to remove the milk efficiently due to a tongue tie?

The baby will not gain weight appropriately. The inadequate weight gain will be a red flag for more pediatricians who will then ask the mother to supplement blaming the mother’s milk supply. When in fact, it is not a problem with a milk supply but a problem with the anatomy of the child’s mouth

The other problem is that since the baby will not be able to remove milk efficiently, the mother’s milk supply will be in jeopardy creating a vicious cycle which leads to the baby failing to thrive, and the mother stopping breastfeeding.

What are the signs my baby has a tongue tie?

1. Inability to latch

2. Clicking sound when latching

3. Painful breastfeeding

4. Cracked bleeding nipples

5. Crying and colicky baby

6. Baby not gaining weight adequately

7. Baby not accepting foods.

What do I do if I suspect my baby has a tongue tie?

If at any point you suspect your baby has a tongue tie, get it checked by a tongue tie expert and not any pediatrician as it can often be missed, especially a posterior tongue tie.

What do I do if my child indeed has a tongue tie?

If your baby has a tongue tie, you can choose to have it released. Either using scissors or as we use in the clinic, radiofrequency. Radiofrequency technique takes a few seconds and causes minimal pain and bleeding. The tongue tie release will cause an immediate change in breastfeeding.

How soon after a tongue tie release can I breastfeed my baby?

You can breastfeed your baby immediately after a tongue tie release. We have a breastfeeding specialist as part of the team who will help you immediately post release as part of the tongue tie diagnosis and release.

Note: Lip Ties can also cause breastfeeding pain and similar symptoms. Some babies often have both tongue ties and lip ties. Lip ties can also be released using the same method.

Do not hesitate to check your baby for a tongue or lip tie, it will save you both a lot of pain. Diagnosing a tongue tie takes a few seconds with a skilled tongue tie expert. Contact Dr. Medhat Abu-Shaaban, pediatrician and tongue tie expert in Dubai, or Mirna Sabbagh breastfeeding specialist for any questions you have on the topic by calling the clinic 050-8985198.