Are you worried that your baby may have a tie?
The amount of tongue and oral ties being diagnosed in recent years has been growing rapidly, and it is hard to join a forum or mothers group that does not raise this topic! The problem is that both the diagnosis and management of these tongue ties is controversial, and there is no clear consensus on what is best. Parents are often referred for expensive and painful procedures for their babies even though the evidence for these is lacking.
What does a tongue need to do?
A normal tongue should be able to:
1. Extend beyond the lower gum line with the tip thin, rounded and flat
2. The tip of the tongue should be able to lift to at least the centre of the mouth, if not higher
3. The tongue should be round, thinnish and flat and be able to curve the sides of the tongue up, called cupping, to create a central groove around the nipple
4. The tongue should be able to move freely around the mouth, included from side to side and lifting to clear around teeth and gums to clear food
5. The tongue should be able to elevate enough to rest on the hard palate (roof of the mouth) when the mouth is closed which helps to clean milk off the tongue
If my baby has a tongue tie, what are some possible outcomes?
- nipple pain and damage
- inadequate milk transfer at the breast, which can lead to slow weight gain and a secondary low supply
- fatiguing at the breast
- unable to latch to the breast or remain latched during the feed (constantly slipping off)
- difficulty with dental hygiene in the future if the tongue does not have enough movement to clear around all of the teeth
I have read, researched and attended many conferences about this topic. If you are concerned that your baby may have a tongue, lip or buccal tie, I am more than happy to assess this for you and provide my opinion. If it is an anterior tongue tie and it is affecting your and/or your baby's ability to breastfeed, I am able to snip this during a quick and simple procedure in my office. If it is more complex, I am able to refer on to a surgeon. If you would merely like a second opinion, I am also more than happy to provide that.
I have released over 700 tongue ties in my clinic over the last five years and have revised and refined my technique over that time. It is a low risk procedure when done safely and by an experienced person. I will discuss all of the risks and benefits in detail with you during the consultation.
I practice in accordance with the following evidence base:
"Academy of Breastfeeding Medicine: Position Statement on Tongue Ties"
"Australian Dental Association: Position Statement on Tongue Ties"
The following podcast is a great overview of what we know about tongue ties, from an evidence-based scientific perspective:
