The problem When Titia Emrich’s second child, Justin, was born, she struggled with breastfeeding. “I was having a lot of problems getting him to latch. I was in tears,” she recalls. Emrich, now a mother of four, had nursed her first baby for a year with no problems. But Justin had an unusually short frenulum – the piece of skin under the tongue that attaches it to the mouth. The condition, called ankyloglossia, is also known as being tongue-tied, and is fairly common.
The consequences It occurs to varying degrees, says Winnipeg paediatrician Janet Grabowski. “There are mild tongue-ties that don’t affect tongue function much,” she says. “If a tongue-tie is more severe, the baby may not be able to extend his tongue for a good latch, and he won’t get enough milk. And in very rare cases, a severe tongue-tie may cause speech problems later on.”
The diagnosis As in Justin’s case, a tongue-tie is often first discovered when there are difficulties with breastfeeding. Lactation consultant Maureen Fjeld, director of The Calgary Breastfeeding Centre, says a side effect of the condition can be sore nipples for mom. “Because the baby can’t get the nipple far into his mouth, he chews on it,” Fjeld says. But if nursing moms aren’t experiencing pain, sometimes a short frenulum isn’t diagnosed until the baby fails to gain weight and the latch and feeding are looked at more closely by a health-care provider or breastfeeding consultant.
The treatment A simple procedure called a frenotomy, which involves snipping the extra piece of skin at the base of the baby’s tongue, may be recommended. Physicians typically perform it in their office and may suggest using a local anaesthetic (it’s optional; the frenulum has minimal nerve endings). In some provinces, such as Alberta, registered midwives are allowed to do frenotomies. Other less severe tongue-ties have no impact on breastfeeding, or the skin stretches as the baby grows, and eventually breaks, painlessly, on its own. Justin had his tongue-tie clipped when he was two weeks old. “One little snip and it was over,” says Emrich. After that, breastfeeding improved immediately. “He latched on in less than 10 minutes.”
This article was originally published in March 2012.