Tongue-Tied Babies

Lingual Frenectomy

Ankyloglossia is also known as a tongue-tie. This condition restricts the range of motion of the tongue. Everyone has a lingual frenulum. It is the thin membrane seen under the center of the tongue. The frenulum is too short or too tight if you are tongue-tied. An infant with a tongue-tie may have trouble with breastfeeding, eating and swallowing. Later in life tongue-tie has been linked to pronunciation problems in speech, snoring, sleep apnea and craniofacial pain.

Symptoms of a Tongue-Tied Baby Include

  • Shallow or weak latch

  • Clicking sound during feeding

  • Frequent reflux or spit-up

  • Gassy tummy or Colicky

  • Fatigues quickly during feeding

  • Excessively frequent feedings

  • Excessively long feedings

  • Sucking blister or callus

  • Little or no weight gain

  • Becoming fussy or fighting you at the breast

  • Thrush

  • Popping on and off the breast

Symptoms of a Breastfeeding Mother Include

  • Pain or discomfort while feeding

  • Damage to the breast

  • Low milk supply

  • Oversupply

  • Breast still full after feeding

  • Mastitis or thrush

  • Recurrent nipple blisters/blebs

Tongue-tie is diagnosed in 4 grades. Grades 1 and 2 are thought to be posterior whereas grade 3 and 4 are anterior. The grade however does not technically determine the severity.
Grade 1
The lingual frenulum is not seen. This is the most commonly missed tongue-tie. The sides and tip of the tongue are able to elevate however the middle of the tongue is tied to the floor of the mouth.
Grade 2
The lingual frenulum is still slightly visible however it is attached towards the back of the tongue.
The lingual frenulum connects to the tongue just below the tip of the tongue. The heart shape is not present however the tie is still very clear.
Grade 3
The lingual frenulum connects at the tip of the tongue and when the tongue is raised shows the classic heart shape. This is usually the only tongue tie that is caught by medical professionals that are not familiar with tongue-ties.
Grade 4

Treating Tongue-tie

Medical professionals often suggest that treatment for a tongue-tie is not necessary if the infant can receive food and is gaining weight. This is NOT our philosophy.

Treating tongue-tie is a team effort. Our team includes a lactation specialist; a bodywork specialist; a myofascial therapist; a myofunctional therapist; a psychologist; and our dentist with a specialty in orthodontics, diplomate status in dental sleep medicine, and advanced infant and adult training in tongue-tie treatment.

Research demonstrates that there is a link between the tongue and sleep disorders. Dr. Smith has spent hundreds of hours studying the tongue and has found that even if your child is feeding well; it is also important that your child is sleeping well. Contrary to popular belief, your child should be completely silent while sleeping. Dr. Smith has met with many mothers who have stated, “I can hear one of my children sleep, but I worry that my other child is not breathing.” We worry about the noisy child. If an infant or child is breathing through his or her mouth, this is not normal.  The silent child is actually the healthier child. The mouth is for eating and the nose is for breathing.

We have also spoken with many mothers who have stated, “It’s painful for me, but my child is doing great. Should I feel bad going through with treatment for my child?” It is very important to note that if your child is younger than 12 weeks old; the mom’s body is still doing most of the work. After 12 weeks, your baby’s tongue will need to work for the milk.  Improper latching from the tongue-tie will prevent the baby from efficiently nursing positive effects gained from breast-feeding will be lost.

The procedure

The day you and your child come in for the procedure, you will be with other parents and their babies in a group setting. Our group setting insures that you have support from other parents in your shoes. We encourage members to help each other through the emotionally difficult day and to share ideas or encourage each other to follow post-operative care.

A bodywork specialist will relax any tension your child may have.  It is very important that your child is relaxed so the lingual frenulum can be easily accessed.  The bodywork also assists Dr. Smith in confirming the extent of tongue-tie after tension is reduced in the facial muscles.

When your baby is ready to have the tongue released, our assistant will swaddle your child and a sleep mask will be placed on your child to protect the their eyes. The assistant will securely hold your child while Dr. Smith places an instrument under your child’s tongue to elevate it. Using a laser, he will release the short membrane connecting the underside of the tongue to the floor of the mouth. Until a child is two years old, there are no developed nerves in the lingual frenulum. Therefore, the procedure is painless and only takes seconds.

After the tongue is released, your child will be brought immediately to you to attempt latching for feeding; this will be guided by our lactation specialist. Keep in mind, every child is different so some may start feeding immediately where others will still need some time to adjust to their new tongue movements.

The next task is to prepare you and your child for insuring that the unattached tongue, lip, or cheek does not reattach. We demonstrate and videotape our training, so you are comfortable and confident in caring for your child. When you take your child home, you will be responsible for aftercare for approximately 30 days. The aftercare is simple and only requires you to be consistent. We also offer a support Facebook group to which you will be added and have follow-up appointments with Dr. Smith to answer your questions and insure healing is going well.