A too tight attachment of the tongue to the floor of the mouth can interfere with breastfeeding or the ability to suck on any nipple. A cleft palate or a small jaw can also create problems, but at least a tongue tie can be relieved by a quick, easy procedure clipping the attachment, called the frenulum.
These babies often are unable to touch the roof of their mouth with their tongues or they don't extend beyond the gum line. The tongue can even have an abnormal shape. But occasionally the defect is difficult for a mother to detect, but she may be experiencing nipple pain or breastfeeding may be prolonged or ineffective, with the baby not latching on well. Hopefully, the lactation consultant or an examining physician will recognize or suspect the problem.
Dr. Erik Bauer, an Atlanta pediatric ENT references several studies*showing the procedure's overwhelming success (92-96% improvement) with most of the mother's able to continue to breastfeed at 3-4 months of age. Feeding time decreased and difficulty feeding diminished dramatically. Of note, the infant's of mothers who had nipple pain improved the most in the one study that assessed that feature.**
* Berry J, Griffiths M and Westcott C. A Double Blind, Randomized, Controlled Trial of Tongue Tie Division and Its Immediate Effect on Breastfeeding. Breastfeeding Medicine. 2012, 7: 189‐193.
Hogan M, Westcott C, Griffiths M. Randomized, controlled trial of division of tonguetie in infants with feeding problems. J Paediatr Child Health. 2005; 41: 246‐ 50.
** Khoo AKK et al. Nipple Pain at Presentation Predicts Success of Tongue‐ Tie Division for Breastfeeding Problems. Eur J Pediatr Surg 2009; 19: 370 – 3.