A tongue-tie is a condition that babies are born with that restricts the movement of their tongue. Their tongue is “tied” to the bottom of their mouth by the lingual frenulum (the band of tissue that connects the bottom of the tongue to the bottom of the mouth.) There’s a 3-5% chance of occurrence.
Tongue-ties prevent an effective seal while nursing and, in turn, limit suction. They may result in nipple pain for you, and latching issues and ineffective breastfeeding, which can affect your milk supply and your baby’s weight gain, if left untreated. In addition, tongue-ties can have implications post-breastfeeding that may include dental and speech issues.
Tongue-ties can be categorized differently, and many healthcare professionals use different systems to do so, such as numerical classification or the Hazelbaker assessment tool for lingual frenelum function (HATLFF). The HATLFF is used by lactation professionals to assess tongue function and to see if surgical intervention is necessary. In mild cases, professionals may choose to monitor the tie to see if it resolves itself. If more serious, your lactation professional may refer you to a doctor or an ear, nose, and throat (ENT) professional if they think that surgery (a frenectomy) may be necessary to allow the tongue more movement.
A frenectomy is a simple, short procedure (usually just a snip or laser of the frenum), though the tissue will need to be stretched for 3-4 weeks after surgery, which can be difficult for both parents and babies. You can usually expect your breastfeeding to start to improve one week post-procedure.
Though the procedure is low risk, bleeding, infection, and regrowth of the issue (if the tongue isn’t stretched) are possible. A laser surgery lowers the risk of bleeding and infection.