Ever since Manisha started breastfeeding her son, she noticed some problems. For a while, she chalked it up to initial latching issues but when it started getting too painful she talked to a friend. She learnt about a condition called tongue tie and wanted to discuss it with her son's paediatrician Dr. Desai. Let's see how their conversation went.
Manisha: Dr. Desai, I have been having trouble breastfeeding my baby. It is painful and difficult. My friend told me she had a similar issue and her baby was tongue-tied. What is that?
Dr. Desai: Manisha, it’s possible that your baby has tongue-tie, also known as ankyloglossia. It is a condition where the frenulum, a tissue under the tongue, is shorter or tighter than normal. It affects the movement of the tongue, making it difficult for babies to latch and breastfeed.
Manisha: Oh. So what are the symptoms I need to look out for?
Dr. Desai: The most common signs of tongue tie in babies include:
- Difficulty latching: Babies may struggle to maintain a proper latch.
- Poor weight gain: If the baby is not feeding properly, they might not gain weight as expected.
- Irritable: Frequently falling off the breast due to a poor latch will make them irritable.
- Painful experience: Breastfeeding for the mother is also painful. If the baby’s latch is shallow, it can cause nipple pain.
- Smacking or clicking sounds while feeding: This is an indicator that the baby is unable to create a proper latch with their mouth.
Manisha: Yes. I have noticed some of these signs. Like I do experience nipple pain during breastfeeding and hear a smacking sound.
Dr. Desai: That pain and sound can be linked to tongue-tie. When your baby cannot move their tongue properly, they cannot latch on. That is the cause of your discomfort.
Manisha: Are there any other physical signs I can look for when checking my baby?
Dr. Desai: Definitely. A few signs you can watch for include:
- Restricted tongue movement: Try lifting your baby’s tongue. If it doesn’t move freely or touches the roof of their mouth, they might have tongue-tie.
- Heart-shaped tongue tip: The tip of the tongue might appear heart-shaped or have a small dent.
- Difficulty sticking out the tongue: Babies with tongue ties have trouble sticking their tongue out."
Having said that, diagnosis is usually done through a physical exam. I will check the baby’s mouth and tongue movement.
Manisha: So, is there any way to treat my baby’s tongue-tie problem? I am ready to try anything.
Dr. Desai: Do not worry, Manisha. There are a few options, depending on the severity of the tongue tie. We usually start with less invasive treatment options, but if needed, we can consider surgical treatments.
Here's what we usually do:
- Monitor: For mild cases, we might just monitor the situation to see if it improves as your baby grows.
- Breastfeeding support: I recommend working with a lactation consultant to improve your breastfeeding technique.
- Tongue-tie release surgery (frenotomy): For more severe cases, this quick procedure can be performed to cut the frenulum and release the tongue’s movement. It will cause minimal discomfort to the baby.
Manisha: In case surgery is needed, is there any special care required afterwards
Dr. Desai: Yes. After the surgery, we recommend gentle stretching exercises for a few weeks to prevent the frenulum from healing too tightly again. You will also want to monitor your baby’s feeding habits and any signs of discomfort. I will give you specific instructions on how to do the stretches.
Manisha: What happens if my baby’s tongue-tie isn’t treated? Could it affect her in the long run?
Dr. Desai: Unfortunately yes. Untreated tongue-tie can lead to long-term issues such as:
- Speech problems: Difficulty pronouncing certain sounds as they grow.
- Dental problems: Limited tongue movement can affect the development of the mouth and teeth.
- Continued feeding difficulties: If not addressed, it could cause persistent problems with feeding or weight gain."
Manisha: I’m hopeful you will help me find the best possible treatment for my baby.
Dr. Desai: Absolutely. I always advise my patients to address tongue-tie early on. If we do need to perform a frenotomy, the earlier, the better. It can help your baby enjoy the benefits of breastfeeding.
Manisha: Thank you, Dr. Desai. I feel so much more confident after speaking to you. I really want my baby to be okay.
Dr. Desai: You’re welcome, Manisha! We will work together to make sure your baby’s feeding gets better. Feel free to reach out if you have any more questions.
