Babies with tongue tie

Some babies are born with a tongue tie. This is where the strip of skin under the tongue connecting the tongue to the bottom of the mouth is shorter, tighter than it should be.

Tongue tie may be diagnosed shortly after birth but may not be identified until your baby is older.

For babies with tongue tie, the movement of the tongue upwards, forwards and side to side might be reduced. The restrictions can be varied, be found at any point under the tongue and can be difficult to spot.

For a baby to feed effectively, their tongue needs to be able to move freely. This is even more important when breast feeding as the tongue needs to be free to move and cup the breast tissue to the roof of their mouth so that they can effectively feed from the breast.

Signs that a tongue tie is affecting breast feeding include:

• Painful feeding throughout the feed, with damage to the nipples
• Misshapen nipples; pinched at the end, lipstick shaped. The nipple should look the same but become elongated after a feed
• Blocked ducts or mastitis as the breast is not being drained effectively
• Low milk production – as the breast is not effectively drained

Signs that a tongue tie is affecting feeding include:

• Slow or poor weight gain in your baby
• There may be a clicking sound during the feed
• Your baby may be unsettled between feeds and might suffer with excessive wind, hiccups and reflux

If feeding is not affected by the tongue tie, then you don’t need to do anything.

However, if you or your baby experience any feeding issues, it’s important to seek support as soon as possible. Speak to your midwife, health visitor or seek peer support. They can help with positioning and achieving a deeper latch, and also refer you to your infant feeding specialist/team for further support.

Treatment of tongue tie

If positioning and latch don’t improve feeding, then your baby can be referred to have their tongue tie reviewed and cut if necessary.

This is a very quick procedure and, as there are very few nerves and blood vessels in this piece of skin, it is able to be done quickly and without anaesthetic.

It’s advised to feed your baby immediately after the procedure as this provides comfort for both you and your baby. With increased movement of the tongue, feeding can often improve straight away.

Speak to your GP, health visitor or midwife to discuss tongue tie treatment options.

Useful links

• NHS– Tongue tie
• NHS Start for Life- Tongue tie and breastfeeding