Tongue-Tie (Ankyloglossia)

Tongue Tied Baby Symptoms found with Ankyloglossia

Normal tongue function allows a baby to latch adequately and breastfeed efficiently. As your child grows, having proper tongue function will promote normal speech development, make it possible for a child to self-cleanse the mouth during eating, allow adequate swallowing patterns, and allow for proper growth and development. Common misconceptions regarding tongue-ties are that they will stretch and correct themselves.

How does tongue-tie affect breastfeeding?

Ankyloglossia is a relatively common finding in newborns (3-15%) and represents a significant proportion of breastfeeding problems. An infant with a tongue tie may not be able to latch correctly. By not creating a deep enough latch, the infant will compress the nipple onto the hard palate, leading to nipple pain and potential bleeding. Additionally a tongue tie is typically accompanied by a high palate, as proper tongue function allows for the formation of the palate. Infants with high palatal arch will have a decrease in suction and a reduction in milk transfer.

Signs and Symptoms of Tongue and Lip Ties

Some babies with tongue ties and lip ties are able to attach to the breast symptom free. However, many of these infants have breastfeeding problems. The following signs are common amongst infants with tongue and lip ties and their mothers. However, it is important to note that these signs can be linked to other breastfeeding problems and are not solely related to ties.

Mothers may experience:

  • Flattened Nipples after Breastfeeding
  • Nipple Pain and Damage
  • Prolonged Feedings
  • Poor Breast Drainage
  • Decreased Milk Production

Infants may exhibit:

  • Noisy Suckling or Clicking
  • Popping on and off the Breast
  • Leaking on the sides of the Mouth
  • Poor Weight Gain
  • Coughing or Gagging
  • Lip Blisters
  • Gas Pain
  • Noisy Breathing or Sleeping During Sleep
  • Reflux or Colic Symptoms

How are Tongue and Lip Ties Diagnosed

Tongues and lips are only considered to be tied if their movement is restricted, impairing mobility. Correct examination of infants requires the infant be placed on the examiner’s lap with the infant’s head facing the same direction as the person evaluating the infant.

It is important to note that not all ties cause problems and require correction.

Tongue tie is a diagnosis based upon function, so what your baby’s tongue looks like can sometimes be less important than how it can move.

Potential Effects on Breast Feeding

A normal breastfeeding motion is accomplished when the infant is able to flange their upper lip outward toward their nose, allowing the mucous membrane portion of the lip to contact the breast. When the upper lips inner mucosa or frenum is attached to the alveolar ridge (as seen below) and the lip is unable to fully move upward, it can create a shallow latch. This can allow for the passage of excess air to be introduced into the infant’s belly and thus result in reflux.