Breastfeeding for Beginners

Experienced Lactation Consultant  (IBCLC)  & Midwife 

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Tongue Tie

What is a tongue tie?
A tongue tie (also known as ankyloglossia) is a congenital oral restriction characterised by a short lingual frenulum which restricts the tongue from lifting and lateralising sufficiently for good function and normal orofacial development.

Oral restrictions include tongue ties, lip ties and buccal ties and can have a negative impact on breastfeeding and other lifelong functions. Tongue ties occur when the membrane that tethers the under surface of the tongue to the floor of the mouth fails to retract away from the tongue by apoptosis during the first trimester. Tongue and lip ties are often seen together due to the nature of their origins during early development.

Mother - signs and symptoms:
Poor supply
Pain when breastfeeding
Sore/damaged nipples
Blocked ducts
Exhaustion due to baby feeding often

Baby - signs and symptoms:
Difficulty latching deeply
Difficulty maintaining a well-sealed latch
Air intake associated with poor seal
Clicking sound during feeding
Arches away from breast when feeding
Gradually slides off the breast during feeding
Reflux-like symptoms
Choking and/or releasing latch to gasp for air
Gumming (chewing) at the breast
Prolonged feeding
Frequent feeding – always hungry
Quickly tires at the breast
Spills milk during feeding
Blistering of lips top and bottom
Dominant central sucking blister
Milk build-up on top of the tongue (pseudoleukoplakia)
Poor weight gain
Tongue unable to reach the hard palate
Narrow and/or high palate
Bubble palate
Tongue unable to come fully forward over gum and bottom lips
Tongue may be heart shaped or flat when extended (instead of pointed)
Cupping of tongue – lateral edges are able to lift but the centre is tethered
Mouth breathing
Audible breathing
Sleep apnoea
Tongue rests on base of mouth
Tongue thrusting
Tongue protrusion after about six months
Jaw tension, clenching and grinding
Tension in lips when swallowing
Restricted jaw development
Venous pooling under the eyes
Dental malposition due to crowding
Dental caries more likely
Sleep depravation
Postural compensation

While this list is long it is by no means exhaustive. Speech problems may present because the tongue lacks the mobility to form certain sounds clearly. Mouth breathing may seem innocuous but it leads to reduced levels of CO2 which in turn causes breathing to slow or stop, as in sleep apnoea. It has also been implicated in ADHD and other behavioural issues as deep sleep is continually interrupted which prevents the brain from resting and recharging.