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Ask The Dentist: Breastfeeding difficulties may point to a tongue tie

Dentist Lucy Stock of Gentle Dental Care in Belfast says ‘tongue tie' can make for an unhappy breastfeeding experience but is easily remedied

Trouble breastfeeding can sometimes be an indication that a baby has a tongue tie or Ankyloglossia

FOR some mums breastfeeding is a breeze; others struggle, which makes for a stressful time. If your baby has trouble latching on, vomits straight after feeds, makes clicking noises, is unsettled or needs frequent or very long feeds then they may have a tongue tie.

Some mothers have reported feeding their baby two-hourly, day and night, while others describe a feed that might last two hours. It’s no wonder that these type of feeding patterns, which can lead to breast pain, the baby not sleeping well or putting on adequate weight, end up with the mum feeling distressed.

Research in the United States found that around 16 per cent of babies experiencing difficulty with breastfeeding had a tongue tie.

A tongue-tie happens when the string of soft tissue, the frenulum, under your baby's tongue, is too short. The medical term for tongue-tie is Ankyloglossia. Tongue ties stop the baby moving their tongue freely and in older babies it means that they can’t stick the tip of their tongue out past the lower front teeth. If a severe tongue tie is left then it can interfere with speech, chewing or licking an ice-cream.

Since all tongues don't look the same they can be difficult to spot. In mild tongue-tie, the tongue is bound only by a thin strip of tissue, called a mucous membrane. In the most severe cases, the tongue is completely fused to the floor of the mouth. The tongue can look heart-shaped when it sticks out and occasionally it can give pain when the tongue is raised.

Sometimes surgical treatment is needed. In appropriate circumstances the tongue tie can be simply cut. It’s quick and simple, and young babies usually don’t need any pain relief. The procedure releases the tie, and allows the tongue to move more freely. The result of one study on breastfeeding after snipping the tie found that 57 per cent improved immediately and 80 per cent were better by 24 hours.

More severe tongue ties require different treatments and the decision on whether surgery is an appropriate treatment has been the subject of many debates.

However, not all tongue ties need treated; it's only if the baby is having problems that you need to intervene. If you are concerned about a tongue tie then you may want to start by asking your health visitor, GP, midwife or local breastfeeding counsellor for advice.

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