Recently a client sent me a nice note with a generous check. She had been feeling gratitude for the help she received to breastfeed her son. There were multiple lactation consultations in her home, a frenotomy (the procedure to release a tongue tie) and body work for baby. There were many up-front costs–some of which were not covered by insurance. Here’s what she wrote: Continue reading
The medical term for tongue tie is “ankyloglossia” which literally means “anchored tongue.”
Most health care professionals and many lactation consultants do not know how to evaluate for ankyloglossia.
Obvious does not mean severe. “Obvious” simply means the frenulum is attached near the tip of the tongue making it clearly visible.
An anterior tongue tie refers to attachment near the tip of the tongue. Posterior tongue tie refers to attachment at the base of the tongue.
If the frenulum is attached to the back of the tongue (posterior) it can cause even more restriction than if it’s attached to the front of the tongue (anterior)
There is no such thing as a mild tongue tie. Usually if someone says the tongue tie is mild, that means that the person doing the evaluation isn’t sure if it’s causing a restriction.
Tongue ties affect much more than breastfeeding.
Where the frenulum attaches at the floor of the mouth can have as much or more impact than where it attaches to the tongue.
Sometimes the frenulum can be attached to the back of the lower gum ridge as well as the floor of the mouth.
The frenulum does not stretch.
No one “grows out of” ankyloglossia.
The procedure to revise the frenulum so the tongue can move properly is called a frenotomy. It’s also commonly referred to as a revision. (It may be called different things in different parts of the world.)
The frenotomy can be done in about 2 seconds by clipping the tissue. If laser is used, it’s a little longer. It is never too late for a frenotomy!
The frenulum is NOT part of the tongue—the tongue will not be clipped during a frenotomy.
The frenulum usually has few nerves and blood vessels.
You can’t tell by looking if baby needs frenotomy.
A frenulum can not “grow back” once it’s clipped. It can, however, heal in such a way that it continues to restrict the movement of the tongue. It is important to keep the wound open during the healing process.
The frenotomy is often just the beginning of the path to full tongue function. Body work and time to learn new skills are often necessary.
There are no documented reports of any complications from a frenotomy.
In some parts of the world, ankyloglossia is commonly remedied with a long fingernail!
This story was sent to me by one of my clients, Yurika. She wants to share it with all of you and hopes that it will help to continue breastfeeding–even when facing challenges.
Mila was born 8lbs 7oz, healthy and passed all the health screening at the hospital before discharging. At our postpartum appointment 3 days after leaving the hospital, her weight loss was brought up as a concern. She seemed to be latching but she was not transferring enough milk and I was experiencing a lot of pain. Her losing more that 10% of her birth weight was addressed at her 7 day postpartum appointment with her pediatrician and we were sent to the breastfeeding center at the hospital that day for further investigation. Continue reading
Let’s assume for a moment that breastfeeding is not important. That the oral development that breastfeeding provides is inconsequential. We will ignore, for just a moment, the fact that the act of breastfeeding helps develop the baby’s jaw, his facial muscles and properly shapes the palate to make room for his future teeth. We’ll ignore all of that so that I can give you a few other reasons to agree to have your baby’s frenulum clipped. Just in case the possibility of pain free, effective breastfeeding is not a good enough reason for you.
The reason I’m being just a bit sarcastic is because there are plenty of health care professionals out there who do not “believe in” freeing a tongue tied baby’s tongue “just” so he can breastfeed. “After all,” they say, “..you can just feed your baby pumped milk or formula from a bottle.” Continue reading
My lactation consultant told me my baby is tongue tied and she needs to get her frenulum clipped so she can breastfeed. What is a frenulum? Why does my baby need this procedure?
The frenulum is a (usually) thin, fibrous band of connective tissue that connects the underside of the tongue to the floor of the mouth. The mere existence of a lingual (tongue) frenulum is not an indicator of a problem. The important thing is whether the frenulum restricts the movement of the tongue in a way that interferes with its normal functions. If it does, your baby has a condition known as tongue tie or ankyloglossia. Continue reading