A lot of people are asking "why do so many babies have tongue-tie recently"? My answer is, I do not believe more babies have short frenulums than in years past. What I do believe is that more and more moms are breastfeeding and really want to be successful. When they begin to learn to nurse their babies, and symptoms arise that they can't seem to be overcome, instead of throwing in the towel, moms today are calling for help. I don't think the number of cases has increased, I think that breastfeeding and education have.
I see lots and lots of babies with feeding and tummy trouble caused by having been born with a tight frenulum, or tongue-tie. But, because I'm an IBCLC in private practice, I tend to see the pairs with "problems". No one is calling the Lactation Consultant when everything is going great. Sometimes I feel like every baby I see has one, but in reality, they don't. The only really good study I've ever found has the numbers at about 7% of the general population. If you've been struggling through breastfeeding, or know someone who is, the good news is that the vast majority of issues are fixable, or manageable. Hooray, your baby doesn't suck! Literally, because they can't!
If you choose to do so, there is a very quick procedure called a frenectomy, or frenotomy by some. I am very partial to sending babies to a pediatric dentist (DMD), who is trained in laser procedure. In my opinion, it is much less invasive and less painful than "clipping". First step: Find an IBCLC who is comfortable evaluating suck and baby's oral anatomy, and get her to help you through the process!
How do I know if my baby is tongue tied? Well, symptoms that are experienced by you or your baby are more important clues than what some "sees". There are some symptoms that are definite red flags for getting checked out.
1. Nipple Pain and/or Nipple Damage
I don't care what anyone says online of off, breastfeeding should not hurt! Pain is NEVER normal. This is one of the biggest breastfeeding misconceptions our culture has out there. Mother nature wants you to like it. She wants your brain to be awash in Oxytocin so you and your baby can fall madly inlove. If it hurt every time you peed, no one would ever tell you "it's normal" right? If your nipples are killing you and don't seem to get any better, even with a "good latch"? Get help. If your nipples come out of your baby's mouth looking pinched, have a line across them, or look like a new tube of lipstick? Get help. If you're suffering from tissue damage, or bleeding? For goodness sake mama call the IBCLC!
2. Slow Weight Gain
Slow weight gain can be caused by a myriad of things, but one of them is having an inefficient, dysfunctional suck. When lack of weight gain is caused by having a tight frenulum, it is usually not the only symptom, this is accompanied by other symptoms the vast majority of the time. Remember the absolute, most important, #1 rule: feed the baby! If you need to pump and supplement with breastmilk, or formula if you unable to pump, do it. You can preserve your supply by pumping at least 10x per 24 hours. Call an IBCLC and get help mama!
3. Clicking or Noisy Feeding
Baby should be quiet when feeding, normal noise is basically no noise. An occasional grunt, slurp or swallow is fine, but a baby who is routinely making clicking, or squishy slurping noises while feeding should definitely seen as red flag.
4. Baby Feeding "All The Time"!
This is a tricky one. It is perfect normal and appropriate for a newborn baby to want to be at breast constantly, even as much as 16x per 24 hours. Crazy, right? In fact, a newborn should be breastfeeding at least 8 - 10x in 24 hours. What is not normal is a baby who seems to feed all the time but never "seems full". This would be a baby who is fussy a lot, or shows feeding cues even after a long session at breast. Also, a baby who's diapers are dropping below 3-4 poops, or 6-8 pees in 24 hours should send you yelling for your pediatrician, the call the IBCLC.
5. Low Supply/Disappearing Supply
This one is bit tricky too as there are many reasons for a drop in supply. But, if you are 3 - 6 weeks postpartum, you've been exclusively breastfeeding (no formula), and your supply has seemed fine until now. Call an IBCLC.
Here are a few photos of babies with tight frenulums. Does your baby look like any of these?
I would like to thank Dr. Kristen Berning, DDS, MAGD of Exceptional Dentistry, Dubuque, IA.,
Dr Lawrence Kutlow, DDS, Albany, NY, and the Mayo Clinic for use of their photography.