The Lip and Tongue Tie Problem

When parents meet us for the first time to discuss their child's tongue or lip-tie, the first question they ask is "Why has no one ever mentioned this to me before?" This is usually followed by a second and third question, "Is the procedure really necessary?" and "What will happen if we do not do it?" To answer all these questions, a complete oral examination is always required so that we can discuss all the clinical and, when appropriate, x-ray findings. Diagnosis and rational for treatment of Tongue-Tie.

A common myth that is often repeated is that "the frenum will stretch and that we do not need to treat this condition." The reality is that a tongue-tie, by interfering with normal tongue mobility, can exert a harmful effect on many aspects of life. Ankyloglossia is a relatively common finding in the newborn population (approximately 3%) and represents a significant proportion of breastfeeding problems. Sadly, it is one of the most misdiagnosed and overlooked congenital abnormality observed in children today.

The Academy of Breastfeeding Medicine suggests the following be used when evaluating whether a newborn requires a revision of the frenum: Un-sustained latch, Creased, blanched or bleeding nipples after feeding, Prolonged feeds, Mom in severe pain with latch, Unsatisfied infant after prolonged feeds, incomplete breast drainage, Infant falls asleep on the breast, Gumming or chewing on the nipple, Infected nipples, Plugged ducts, Poor weight gain or Failure to thrive, and Inability to hold pacifier.