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Tongue-Tied: How Ankyloglossia Affects Breastfeeding

Breastfeeding isn’t always easy. While it’s a natural part of motherhood, there can be complications that make the experience less than ideal for mother and baby. One problem to look out for is ankyloglossia, or “tongue tie.” If you suspect your infant is struggling with a tongue (or lip) tie, make sure to consult with a lactation specialist so your baby can properly feed. A consultation will help you avoid future tongue-tie complications as well. Ana M. Hill, an advanced practice IBCLC at Rocky Mountain Location, shares more information about how ankyloglossia may affect mothers and their babies.



A tongue tie is caused by a tight frenulum, which is the connective tissue that connects your tongue to the floor of your mouth. A lip tie is caused by the same thing, except it affects the tissue that connects your upper lip to that spot above your front teeth. A baby can have one or both of these ties, which create a restriction in the lips and mouth that does not allow the tongue to properly position itself for breastfeeding.



“Most of the time, we don’t identify ties based on visual identification. We’re looking for an impact on function,” says Hill.

It can be hard to identify ankyloglossia just by looking in your baby’s mouth. That’s why the first sign is often a problem with breastfeeding, such as pain, damage, or inefficient nursing. Breastfeeding requires a baby to keep their tongue on top of their lower gum while feeding. So, when they have a tie, they struggle with keeping their tongue in the right position because their tongue is restricted. Your baby may chew on, pinch, or slide off the nipple as a result, which can cause a great deal of pain.

“Tongue ties are really an airway problem, but they show up as nursing or feeding difficulties,” adds Hill. “The baby may choke on its bottles, start coughing, refuse food, or struggle with weight gain. Other signs include blisters on their lips, deep creases on their face while feeding, or a very shallow latch.”



Along with pain for the mother, the baby will struggle to get an adequate amount of milk. This is why the feedings never seem to end for a baby with a tie. This–a secondary clue for ankyloglossia.

“Parents may feel like they fed their baby 17-20 times per day, and the baby is never satisfied,” says Hill. “The first few weeks tend to go by fairly easily if there is an oversupply of milk. Then the milk regulates around six weeks, and the baby starts to struggle because they should be able to empty the breast on their own, but, really, they’re only drinking what falls out. This causes your milk production to drop.”

Since your baby is not latching or feeding well, you will have milk supply problems, your nipples may crack and bruise, and you may develop mastitis. This is why it’s important to seek treatment for your baby’s tie as soon as you notice the signs.



There are various ways a tongue tie can be fixed, but the most important part is pre-habilitation and rehabilitation. The first thing you should do is see a skilled lactation consultant to determine what treatment is best for your child.

“We found the most efficient to be oral habilitation or some special oral function exercises, then a laser removal–which is generally performed by a dentist–followed by the same body work and oral function exercises afterward,” Hill informs.

So, undoing the tie isn’t the only solution. When your child’s mouth and tongue muscles have not been used correctly their entire life, the muscles need to be woken up, strengthened, and taught how to be used correctly. This is why prehab and rehab is so important. Your baby may require a chiropractor or a physical therapist to work on their body because babies engage their whole body to feed.

It’s better to treat ankyloglossia sooner rather than later. In the event your child’s tie is not discovered until later, they may require several other therapists such as a feeding therapist, a speech therapist, and an occupational therapist because of the other issues they could develop, which may impact their long-term health.

“Patience is important!” Hill says. “It’s not always a quick fix, but it’ll be worthwhile as long as you treat it correctly.”

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