HealthInfo Waitaha Canterbury
Tongue-tie
Tongue-tie is a condition involving a small piece of tissue that connects a baby's tongue to the bottom of their mouth. This is called the lingual (meaning tongue) frenulum, often just called the frenulum.
Everyone has a frenulum, and everyone's frenulum is a different length and thickness. Sometimes a person's frenulum isn't visible.
When a baby's frenulum is short or tight, it can stop their tongue from moving properly. This is called a tongue-tie (also called ankyloglossia).
Tongue-tie problems
Most pēpi (babies) born with a tongue-tie do not have any problems breastfeeding and do not need any treatment.
But for some pēpi, the tongue-tie means they cannot move their tongue well enough to feed effectively. These pēpi may also have difficulty latching or staying latched on to their mothers' breasts. Pēpi with a severe tongue-tie can also have problems bottle-feeding.
Some pēpi have difficulties latching straight after birth even when they do not have a tongue-tie. It can take time for both mother and pēpi to recover from birth and learn how to breastfeed. Once they do, these problems often go away.
Symptoms of tongue-tie problems
If your baby's tongue-tie is making it difficult for your pēpi
baby
to latch on or stay latched on, you'll notice some of these signs.
For you
- Breastfeeding is painful for the whole of the feed.
- Your nipples are painful or look damaged after the first seven days.
- Your nipples look squashed or wedge-shaped as soon as your pēpi comes off your breast.
- Your nipples may become sore, blistered, cracked, bleeding or bruised.
- You do not make enough milk to meet your baby's changing needs.
For your pēpi
- They may have difficulty latching or staying latched for a full feed.
- They may seem unsettled or fussy during feeds. For example, they may bob on and off your breast.
- They may make clicking or slurping noises while they're feeding.
- You may notice you do not have to change their nappies much, as they produce less urine and poo.
- They might gain weight slowly, not at all, or even lose weight.
- Their feeds are too short or too long and they're still unsatisfied despite being offered at least eight feeds every 24 hours.
All these signs can also happen because of other things, so it's important to have a breastfeeding assessment to see what is causing the problem.
Getting help with tongue-tie
If you're worried about how your pēpi baby is feeding and think they may have tongue-tie, ask to have a breastfeeding assessment. Your midwife, GP, practice nurse or Plunket nurse can refer you to a free lactation consultant service. Or you may choose to pay to see a private lactation consultant.
During the assessment, a lactation consultant will talk to you about your baby's feeding history. They will watch your pēpi breastfeeding and adjust your breastfeeding technique if necessary. They will also look at how your baby's tongue is moving and how their frenulum is attached.
The lactation consultant will use a simple scoring tool to determine the amount of tongue-tie and whether it needs to be treated.
Your pēpi can be assessed as early as two days after they're born if they have severe feeding problems. But it's best to wait for a week to let normal feeding patterns develop.
On the next page: Treating tongue-tie
Written by Canterbury lactation consultants and neonatologist. Adapted by HealthInfo clinical advisers. Last reviewed December 2021.
SourcesReview key: HIBRF-24381
