Breastfeeding is the biological norm for babies, though it does not always come easily. Some mothers may encounter challenges with breastfeeding, ranging from sore nipples, latching difficulties and slow weight gain in baby.
Sometimes we hear parents voice their concern that these challenges may be due to a tongue tie. Clinically termed ankyloglossia, a tongue tie is a restrictive lingual frenulum (frenulum being a fold of skin that supports or restrains motions of a body part – in this case the tongue). It should not be defined solely by appearance, but rather if it is interfering with breastfeeding. Simply being able to see a frenulum does not mean there is a problem.
The mobility of the tongue plays a vital role in breastfeeding. The baby’s tongue needs to extend past the gumline, lift upward and cup the breast tissue to transfer milk from the breast. Despite what the tongue may look like, if it cannot perform these functions, then breastfeeding may be impacted by sore nipples and feedings that are long and ineffective (due to inability to transfer milk). All of this can lead to poor infant weight gain, low milk supply and the potential to stop breastfeeding before desired.
The prevalence of tongue tie is estimated to be somewhere between 2-10% depending on the criteria used to diagnose. The first step in the process is a thorough feeding evaluation to assist families with tips on how to get a comfortable latch, and to know how to tell if the baby is feeding actively at the breast while transferring milk. A medical provider, ideally one with breastfeeding knowledge, should fully evaluate the baby’s oral function, including suck and tongue function and make recommendations if restriction in function is impacting breastfeeding.