Under the tongue we all have a whitish vertical strip of tissue called the frenulum, which attaches to the floor of our mouth at one end and to the tongue at the other. When the frenulum is tight or short, it can prevent the baby from getting his tongue well forward to cup under the breast and extract the milk. If the tongue does not protrude well, the mother can get sore nipples from the baby’s tongue striking the nipple.
An infant can obtain milk from a bottle without the wide-open mouth and consistent suction needed for a good breast latch. If the tongue-tied infant cannot maintain the tongue over the lower gum ridge during breastfeeding, the “bite reflex” or chewing is triggered. This chewing motion is sufficient to transfer milk from the bottle, but is a problem at breast. Bottle-feeding allows milk to drip into the mouth without effort. Breastfeeding requires well-defined peristalsis (the sports wave) from the front to the back of the tongue as well as grooving and cupping around the nipple. Some tongue-tied infants cannot even manage a bottle.
During the last several decades of mainly bottle-feeding, tongue-tie was considered not a problem because of the lack of impact on bottle-feeding behaviors. Even though many tongue tie babies have problems with bottle-feeding. Therefore, many of today’s practicing physicians were taught that treatment of tongue-tie is an outdated concept. Among breastfeeding specialists today, tongue-tie has emerged as a recognized cause of breastfeeding difficulties and a very easily corrected one.
Tongue- tie results in problems for:
- nipple pain/cracks
- painful breasts
- low milk supply
- plugged ducts/mastitis
- frustration, disappointment, and discouragement with breastfeeding
- untimely weaning
- everything with breastfeeding may be going very well in the early weeks then all of a sudden around 6-8 weeks even months the milk supply plummets/baby’s weight stops increasing.
- poor latch with a disorganized suck
- clicking sound while breastfeeding
- ineffective milk transfer, “snacker”
- slow weight gain or weight loss
- irritability or colic
- fussiness and frequent arching away from the breast
- gassy, hick ups, spitty, sometimes diagnosed with reflux
- fatigue within 1-2 minutes of beginning to breastfeed
- difficulty maintaining suction and a deep latch.
- gradual sliding off the breast
- chewing on the nipple
- falling asleep at the breast having taken less than a full feed
- The toddler may gag on solids refusing to eat or only eat soft food
Unresolved tongue ties can cause health problems over a lifetime
Some ways an unresolved tongue-tie could possibly negatively affect the health of a child and adult:
- Speech impediments: trouble pronouncing t,k,l,n,r, sh and th.
- Mumbling, not opening mouth wide to speak, stumbling over words later in the day.
- Needing to speak very slowly in order to enunciate correctly
- Chronic Headaches and Migraines.
- Dental carries: cavities on the outside of the teeth and upper inside.
- Tongue thrusting, needing Orthodontia
- Uncontrolled salivation
- Improper skeletal development of the palate, chin and jaw
- TMJ may leading to jaw surgery
- Predominant chin
- Sinusitis leading to ear infections and sinuous infections.
- Deviate swallow and breath
- Digestive problems
- Heart burn
- Chronic constipation
- Airway integrity and apnea, mouth breathing
- Sleep apnea leading to later in life the use of C-pap
- Restless sleep, snoring, waking frequently, waking not rested
- Chronic fatigue, grumpy, impatient
- Not able to chew with ones mouth closed without holding the breath while eating. Holding ones hand in front of ones mouth while chewing due to not being able to chew with the mouth closed.
- Sloppy eater especially with any liquid food such as soup
- Eating disorders
- Bulling in school
- Low self esteem
Each facet of the orofacial complex influences the others. The craniofacial, oral and pharyngeal structures are so complex and physiologically linked; one compromised factor can disturb all the others. Tongue-tie comprises the first “domino.” As Palmer(2001) states so pointedly, “There is NO MEDICAL BENEFIT to having a tight lingual or labial frenum. There are many major medical and dental consequences that result from tight frena.”