Babies with tongue tie

Tongue tie is when the skin under a baby’s tongue is shortened or tight, making it harder for them to move their tongue forward, upwards or from side to side. Degrees of tongue-tie vary, and sometimes it can be difficult to spot, especially if the tightness is further back and not at the tip of the tongue.

      

To breastfeed well, a baby needs to be able to move their tongue freely and extend it over their lower gum with their mouth wide open so as to get a good mouthful of breast. Some babies with tongue-tie breastfeed well from the start, others breastfeed well when steps have been taken to improve positioning and attachment, but some babies can’t latch on properly because of their tongue-tie.

If your baby has tongue tie and it’s affecting their ability to breastfeed, you may experience:

  • Painful feeding, with damage to your nipples. After a feed your nipple might look misshapen
  • Blocked ducts and mastitis because not enough milk is being removed from the breast
  • Low milk production because less milk removed means less milk is made

For a baby with tongue tie, not only will there be difficulties latching onto the breast and staying in that position, but they may be feeding for a long time (perhaps falling asleep during feeds). They’ll be unsettled and seem hungry, and won’t be gaining weight as quickly as expected. They might make clicking noises as they try to feed, suffer with excessive crying, wind or hiccoughs and might suffer from reflux (vomiting after feeds).

Tongue-tie can also affect your baby’s ability to feed from a bottle. They may take a long time to feed, drink only small amounts, dribble a lot of milk during their feeds and suffer from the same symptoms above, like slow weight gain, crying, wind, hiccoughs  and reflux. In addition, they might not be able to keep a dummy in their mouth (if you’re using one).

Managing tongue-tie

If your baby has a tongue-tie, but feeding doesn’t seem to be affected, then you don’t need to do anything. However, if you and your baby are experiencing any of the problems and symptoms described here, then you need to get help, both to improve feeding and to maintain your milk supply if you’re breastfeeding. Talk to your midwife, health visitor or GP straightaway.

If you’ve had support to improve your baby’s feeding position, and the tongue tie is still a problem, then you can ask to be referred for a simple procedure to snip the piece of skin and release the tightness. There are few nerves and blood vessels in this piece of skin, and the procedure is done quickly so young babies won’t need anaesthetic. There’s usually minimal bleeding and the wound heals quickly. After the procedure is carried out, it helps to feed your baby immediately. Again, ask your GP, midwife or health visitor for further advice about referral.

Useful links

National breastfeeding helpline

 

Page last reviewed: 21-10-2017

Next review due: 21-10-2020