Lingual frenum in babies and breastfeeding
The lingual frenum and breastfeeding are closely related. Some babies are born with a tongue tie affecting tongue mobility. This, restricts the movement for the newborn to latch on to the breast and, consequently, affects the ability to breastfeed. The mother’s breast is then replaced by the bottle and the baby is fed with artificial milks with the needed nutrients.
The doctor will be the first to notice the short tight frenum under the baby’s tongue causing breastfeeding difficulties. Therefore, they may call a pediatric dentist as a lactation consultant. At other times, the parents themselves will go directly to the pediatric dentist for evaluation and advice.
Ankyloglossia and breastfeeding
Ankyloglossia literally means tongue-tied. When the baby cries, we can see a heart shape tongue. In other words, when ankyloglossia is present, the tongue is anchored to the floor of the mouth.
The movement of the tongue ranges from practically none to a little movement. Many times, this circumstance prevents the baby from making proper tongue movements between the lower and upper lips and gums. This prevents them from being able to breastfeed or to breastfeed properly.
Therefore, if we intervene performing a frenotomy or frenectomy, the baby will be able to make the correct movements.
This will allow the newborn and the mother to nurse safely and comfortably, as tongue-tie can sometimes be the source of painful or cracked nipples.
This limitation by the tongue-tie can have direct repercussions on the baby’s growth and development. Not all babies have to experience this difficulty.
Although it is true that many mothers who have an adequate breast milk supply have difficulties in breastfeeding. The parents find later that their newborn has a medical condition that inhibits the tongue from proper mobility and they can not nurse properly, resulting in poor weight gain.
Can you successfully breastfeed a tongue tied baby?
Yes, it may happen that a tongued tied baby may not be affected breastfeeding. Also, he/she may not cause any nipple pain nor discomfort to his/her mother.
In these cases, we may observe a proper feeding, although with a limited tongue movement. However, this tongue with some movement range limitation, may be enough for breastfeeding.
Therefore, we must take this into account when deciding what approach has to be taken. We analyze then if a tongue tie release is necessary. If nipple damage does not appear and both mother and baby are comfortable, despite a tongue tie, no treatment is needed.
When can you tell if a baby is tongue tied?
First of all, apart from assessing the baby’s lingual frenulum, we should observe the baby’s position while breastfeeding, as said before.
If, after all this, it is decided to intervene, there may be several surgical options.
Some involve cutting some fibers of the frenum without complications. This technique called frenotomy is performed on an outpatient basis with scissors.
In other cases, a more specialized attention by the pediatric dentist may be required. When a frenectomy is performed, more tissue is removed and stitches are needed.
However, if frenectomy is done with a laser, we avoid the need for stitches. In surgically complex frenum types, children may need to be assisted with some form of sedation for performing the procedure. We must take all the issues mentioned into consideration before deciding the best surgical approach.
To choose the most appropriate treatment technique, parent’s preferences should be known after analyzing the baby’s tongue tie.
How long after tongue-tie does breastfeeding improve?
It improves immediately after surgery. Healing in this type of procedure is fast, especially if it is done with a laser. Mothers usually notice a difference and less painful sucking just afterwards. It is also convenient for the baby to suckle immediately after the procedure.
In conclusion, short lingual frenums in newborns can cause difficulties in breastfeeding and, as a consequence, other disorders. It is essential to check whether or not a tongue tie exists when a mother and baby are having breastfeeding problems.
Boj JR, González, P, Hernández M, Cortés O, Odontopediatría. Dudas y aclaraciones. México DF. Odontología Books, 2019.
Boj JR, Catalá M, Mendoza A, Planells P, Cortés O, Odontopediatría. Bebés, niños y adolescentes. México DF. Odontología Books, 2019.