October 15, 2018

Tongue Tie and Breastfeeding


What is Tongue Tie?

Tongue tie, also known as ankyloglossia, affects up to 5% of the population. It is a relatively common condition that is present at birth and can cause a number of difficulties including problems with breastfeeding. Assessment and diagnosis can be made by a range of professionals such as pediatrician, midwife, lactation consultant and pediatric dentists.

Before Tongue Tie Revision

Before Tongue Tie Revision

Immediately After Laser Tongue Tie Revision

Immediately After Laser Tongue Tie Revision


What Does It Look Like?

All tongue ties look different. Some are long, skinny and white like a guitar string, and some are wide, muscular and pink. A tongue with a severe tie look heart shaped when extended and the tongue tip is unable to stick out. For infants, it can present itself as lack of weight gain and breastfeeding difficulties.


Does It Cause Breastfeeding Difficulty?

Studies found that 13% of infants with breastfeeding problems had ankyloglossia. Ineffective latch, inadequate milk transfer, and maternal nipple pain can be caused by tongue tie.  This is because the infant compresses the nipple against the gum pad instead of the tongue. Some of the signs of tongue tie caused problems are:

Lack of latch

Shallow and unsustained latch

Prolonged and frequent feeding

Clicking, smacking sound

Poor weight gain

Gassy, colic and reflux


Does It Cause Speech Disorder?

There is a lack of scientific evidence that tongue tie causes speech disorder. It does not delay the onset of speech, but can interfere with articulation of words that include “t,” “d,” “l,” “th,” and “s”.


Does It Need To Be Fixed?

It is a controversial topic and if you ask a pediatrician, otolaryngologists, pediatric dentist, oral surgeon, speech therapist and lactation consultant, they will all have different opinions regarding its definition, clinical significance, need for surgical intervention, and timing of treatment. However, we all agree that if it is severe and causes feeding or articulation problems, it needs to be fixed.


Would Tongue Tie Revision Improve Breast Feeding?

Many of the successful cases are anecdotal, and good scientific study is lacking. We can’t guarantee the outcome, but if you feel that you have tried everything else and do not want to give up on breastfeeding, tongue tie revision a treatment option you should look into.


What is the Procedure Like?

Your baby is wrapped in a swaddle to minimize untoward movement. We use laser to minimize bleeding during the procedure and promote quick healing process. Your baby will be upset during the procedure. After the procedure, we recommend that you breastfeed your baby to soothe him/her. You can give baby acetominophen if you think that your baby is in discomfort.


How Do I Care for the Surgical Site?

We recommend that you massage the area after the procedure to prevent any scar tissue to form and cause the tongue tie again. We will show you how to do this exercise.



Dr. Ella Choi is a certified specialist in pediatric dentistry serving South Surrey, White Rock, Langley and Cloverdale in Beautiful British Columbia.




Reference: http://www.aapd.org/assets/1/25/kupietzky-27-1.pdf

Photo Credit: Jaybird https://www.flickr.com/photos/jstar/2203340563


“I am extremely happy with our experience, all the staff we have met are extremely friendly and helpful. Dr Ella Choi and her staff have been wonderful and patient with my son that has an anxiety disorder and have done all they can to try to calm him. All dental work and costs that have been needed have been explained in detail and they take the time to make sure you understand what is involved. I have been to other Pediatric Dentistry Clinics and have often felt rushed. Thank you all at Playtime Pediatric Dentistry I appreciate all you have done for us. - Daniella D.”