What is Tongue Tie

Ankyloglossia, also known as tongue-tie, is a congenital anomaly characterised by an abnormally short lingual frenulum; the tip of the tongue cannot be protruded beyond the lower incisor teeth. It varies in degree, from a mild form in which the tongue is bound only by a thin mucous membrane, to a severe form in which the tongue is completely fused to the floor of the mouth.

Breastfeeding difficulties may arise as a result of the inability to suck effectively. In order to achieve a good effective latch the tongue must move up and down in the posterior portion. A tethered, or tied tongue cannot do this, and the result is ineffective and non-nutritional nursing resulting in the following:

Baby’s Signs & Symptoms

  • Unable to latch onto the breast or difficulty in maintaining latch
  • Sliding off the nipple
  • Poor infant weight gain
  • Failure to thrive
  • Clicking sounds and swallowing air while breastfeeding
  • Excessive dribbling while breastfeedin
  • Colic

  • Mother’s Signs & Symptoms

  • Nipple pain
  • Painful breasts
  • Poor milk supply
  • Mastitis
  • Engorged or unemptied breasts

  • Supporting Evidence for Tongue Tie Release

    A randomised controlled trial compared division of tongue-tie with 48 hours of intensive support from a lactation consultant. Mothers reported that 95% (19/20) of babies had improved breastfeeding 48 hours after tongue-tie division, compared to 5% (1/20) of babies who received support from a lactation consultant (p < 0.001).

    A case series of 215 babies, 80% (173/215) of mothers reported improved breastfeeding 24 hours after the procedure. In another case series of 123 babies, 100% (70/70) of mothers reported improved latch after the procedure, and the 53 mothers with nipple pain noted significant improvement immediately after the procedure. In a third case series, 100% (36/36) of babies were reported to have normal tongue motion at three months.