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Tongue Tied Newborn & Breastfeeding | FAQs answered by a Lactation Consultant

Tongue Ties in Newborns: Your questions answered!

Hey! I’m Jaimie, Air Force Wife, Homeschooling Mama of 4, nurse, doula, and lactation consultant. My mission is to help MamaBears like you breastfeed with a sense of peace and confidence! Today I wanted to answer common questions I get about tongue ties in newborns!

Information on tongue tie and breastfeeding is near and dear to my heart because I almost gave up on breastfeeding because of poor support and little information when my baby had a tongue tie. Eight years later I've successfully managed tongue ties in all four of my children and I've become an IBCLC helping other families navigate tongue ties in their babies. This topic is something I'm extremely passionate about and constantly working on learning more about to better serve MamaBears like you.

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What is a tongue tie?

A tongue tie is the colloquial term for ankyloglossia which translates to “anchored tongue”. Essentially this is when the tissue that creates the frenulum between the tongue and floor of the mouth is short, inelastic, or tight and restricts mobility of the tongue.

What causes tongue tie?

Researchers are still undecided on what specifically causes tongue tie. One thing we do know is it can be genetic. Many believe that it can be related to certain methylation defects when processing b-vitamins. Sometimes limited range of motion in the tongue is actually not a tongue tie at all, but rather related to excess tension in the facial, cranial, and neck muscles due to malpositioning in utero, traumatic birth, etc.

Can I breastfeed a newborn with a tongue tie?

You can breastfeed a newborn with a tongue tie. Each baby is extremely unique. Some babies have obvious tongue ties with no obvious feeding issues, other babies have not-so-obvious tongue ties with a litany of breastfeeding issues, and of course there are all the combinations in between. Many times, people assume that if breastfeeding is going “well” based on weight gain and moms’ comfort there is no tie. That is not necessarily true. Even if breastfeeding is challenging, with support from a lactation consultant, and other professionals, there is a great likelihood of being able to continue at breastfeeding

How do I know if my baby has a tongue tie?

Determining a tongue tie can sometimes be tricky. Some providers don’t believe in tongue ties, others are poorly trained in evaluating them, and others, yet, are overzealous in diagnosing ties. I’m going to share another video soon on how to tell if your baby has a tongue tie, but the major “litmus test” for tongue tie is a functional examination of how your baby uses their tongue. Some things to look out for are difficulty sticking the tongue out, difficulty raising the tongue, difficulty sucking consistently, pain when breastfeeding, quickly tiring during feeds, and of course the obvious divot in the tongue tip or thick webbing connecting tongue to floor of mouth.

How do you fix a tongue tie?

Fixing a tongue tie is not an overnight procedure. Fixing a tongue tie often requires a multidisciplinary approach of tension release, training oral motor skills, and surgical release of the tethered oral tissues. Surgical release is either done via laser or scissors. Properly fixing a tongue tie often requires care form a combination of providers including a skilled pediatric dentist or ENT, IBCLC, and bodyworker (Chiro, CST, CFT, OT/PT/SLP), a strong commitment from parents, and possibly weeks of preparation and post-op support.

Should I fix a tongue tie if my baby breast or bottle feeds well?

First of all, we have to better understand what it means to breastfeed well. I’ll go into this in depth in another post, but many times we assume that painless breastfeeding and a growing baby mean breastfeeding is going well. But many times these babies are compensating and still don’t have great nursing skills. Other times parents think that since their baby is growing well with bottle feeding, that fixing a tongue tie just isn’t necessary. While I support every parent’s right to choose how to feed their baby and decide if release is right for them, I think we can get tunnel vision. Untreated ties that don’t cause major problems in infancy can often grow into problems when starting solids, cause feeding issues as a toddler, impact speech issues, cause snoring and airway issues that can lead to behavioral and learning problems in childhood, and can even impact the proper development of the craniofacial bones and muscles, resulting in dental problems, Obstructive sleep apnea, and other issues. This isn’t meant to scare anyone, and we have no way of reliably predicting which babies will go on to have issues and which ones won’t. But taking a multifaceted approach to properly managing a tongue tie in infancy can decrease many of these concerns later on. That said, an improper release that doesn’t fully address tongue function can result in increased breastfeeding problems, feeding issues, airway issues, dental issues, and sleep problems as well.

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I hope this helped answer some of your questions about tongue ties in newborns. If you are having a baby soon or struggling with breastfeeding, I wanted to let you know of three ways you can get free breastfeeding support now! 1. You can take my free online breastfeeding basics class. This will make sure you have a strong foundation of breastfeeding knowledge to make any small or simple changes that may help you with breastfeeding

2. Check out my YouTube channel - I have tons of tips on birth and breastfeeding

3. Check to see if your health insurance is working with The Lactation Network for Free Breastfeeding Support Visits. If they are, you can schedule a telehealth lactation consultation with me with no out of pocket cost! If your insurance is not working with TLN, I have a variety of options for you. Tricare East families qualify for free telehealth support, Tricare West and Medicaid patients qualify for 15% off their lactation consult. Everyone else is able to use FSA/HSA funds to cover their consults, and if you check your coverage through TLN and are denied, I’ll offer you a 5% cash discount as a courtesy (but you have to check through TLN first!!! I get notified of all denials and approvals)

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