Could it be a Tongue Tie? What to look for & how to treat.

tongue tie symptoms and treatment

Why am I having trouble breastfeeding? It could be a tongue tie.

What is a tongue tie?

A tongue-tie is an unusually tight band of tissue anchoring the tongue to the floor of the mouth.  This causes the tongue to be restricted as it attempts to move as needed when breastfeeding.  While it definitely can affect breastfeeding, a tongue tie can affect other activities of life later on as well. 

Tongue ties are actually quite common.  While anterior ties (the kind attached towards the tip of the tongue) have been known about for a really long time often providers (for example pediatricians, IBCLC’s) are less knowledgeable about posterior ties (the kind where attachment is closer to the base or back of the tongue).

This lack of knowledge sadly leads to mothers seeking help, intuitively knowing something is wrong and even point-blank asking – IS THERE A TONGUE TIE? – but being told there is definitely not a tongue tie (even when there is).

Even more disturbing is a mother asking about a tie and having it confirmed by a provider but told it is mild and no intervention is needed despite some or many of the symptoms listed below.  Imagine having bleeding, cracked nipples and anticipating each and every feeding with fear and being told there is a tie but it is mild!  No intervention needed!  Time to find another provider!

Here are some of the most common signs and symptoms of tongue ties:

Nipple pain and damage

Tongue ties can also commonly lead to cracked, bleeding, scabbed, abraded nipples when starting off breastfeeding your baby. This is NOT a normal experience when breastfeeding and should be a sign to seek help.

Creased, cracked or blanched nipples

You may notice your nipple appearing to be compressed or appear blanched after breastfeeding (white on the tip of the nipple) or even lipstick shaped.

Chomping, gumming, or chewing on the nipple

When baby has restricted movement of the tongue they try to breastfeed but their tongue is used abnormally and if they can’t get it over the bottom gums it may feel like their gums are clamping down on your nipple – BECAUSE IT IS!  OUCH!

Latching Problems and Tongue Ties

Your baby may be completely unable to latch or you may notice your baby latches but when he/she attempts to suckle the baby can no longer stay latched.  There are attempts over and over to latch and you and your baby then become frustrated.  Some babies can latch and stay at breast but appear to slip or move towards the tip of the nipple as feeding progresses. This often causes pain or a pinchy feeling. 

Inadequate emptying of the breast/plugged ducts/mastitis

You may feel like your breast is not emptied adequately and stays full after feeding.  If this is happening you are prone to develop plugged ducts and even mastitis.  As well, if this is happening and the milk is not emptied from your breast your milk supply suffers eventually. This leads to the need for supplementation in order for baby to gain weight. 

Baby falls asleep at breast

Babies with ties who are having trouble with emptying the breast begin to suckle but often the milk does not flow adequately from a bad latch and tongue restriction.  It is the flow of milk that keeps a baby engaged with suckling so without easy flow of milk the baby falls asleep quickly at breast but appears very hungry if you take baby off the breast thinking they are done!

Exhaustion/depression

Imagine being a parent who is breastfeeding with cracked, bleeding nipples along with having a baby who seems hungry all the time because they are not achieving easy milk flow and they are wanting to nurse excessively frequently!  You want to feed your baby but your body is screaming – DON’T  DO IT- IT HURTS! Either exhaustion or feelings of inadequacy, concern, guilt seep in!  

Excessively frequent breastfeeding sessions

If baby is having difficulty latching/getting the flow of milk going then they are unsatisfied, crying a lot, & fussy, and you feel the need to feed very often.  

Poor weight gain either at the outset or even in later months

If achieving a good latch and easy milk flow is difficult for the baby then weight gain issues will be seen at some point.  It often happens in the first days/weeks of breastfeeding but it also can happen much later – two months, three months or four months of life.  If you are having to supplement with formula because with normal breastfeeding 8-12 times/day baby is not gaining weight adequately consider a tongue tie as a potential reason. 

Reflux behavior

These babies often make clicking, smacking noises while nursing resulting in excessive air being taken in while breastfeeding.  They seem to do better/sleep better when kept in an upright position.  

While this is not an exhaustive list of every potential problem that tongue ties can cause in newborns – these are some of the very most common symptoms seen.  

What do I do if I suspect or have concern that my baby has a tongue tie?

An IBCLC (International Board Certified Lactation Consultant) is where you should start for tongue tie diagnosis.  Besides performing an oral exam we need to evaluate a feeding.  This is an IBCLC’s specialty.  If we suspect or find ties we can help you to find the BEST providers in your area to connect with for next steps and start you out with some helpful bodywork/exercises to begin to relax the jaw in preparation for what comes next.  

Since COVID there are plenty of options on ways to connect with IBCLC’s either via home visits, office visits,  or telehealth if you are in an area where it is difficult to find a provider.

Every family deserves a comfortable, amazing breastfeeding experience.  You can have this too!  Reach out if you are concerned about infant tongue tie and we will find you help for diagnosis and treatment.

Here is a great video of how tongue ties can affect breastfeeding.

Be sure to also check out our article 10 Steps to Breastfeeding Success.

About Patrice Jones

I have 20 years of helping moms as an IBCLC and also 30+ years of experience as a physician assistant working with babies and families. I am also the mother of three breastfed children and understand the pressures of working and being a mom. I get the total exhaustion you feel but the commitment to do everything you can to give them the best.

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