Until very recently, when my baby was born, I used to think that the expression that someone was tongue-tied was a figurative one. Little did I know that the term actually describes an actual condition. Apparently, some people are born with a short lingual frenulum. “A what!?” I can almost hear you say. A lingua frenulum. This is the membrane that attaches the underside of the tongue to the floor of the mouth. We all have it, but for some their lingua frenulum is shorter than others. Abnormally short, one would say, and thus the movement of their tongue is restricted. Tongue tie also goes by the more daunting name of ankyloglossia.
By whatever name it goes, this can be bad news for infants and their nursing mothers. It’s bad news if it interferes with breastfeeding. Breastfeeding is perhaps the first pleasurable activity an infant enjoys. Aside from being a source of essential nutrition, feeding on her mother’s breast bestows on the infant a sense of warmth and security and encourages bonding between baby and mother. Unfortunately, some infants who are afflicted with ankyloglossia have difficulty sucking milk from their mother’s breast, turning what is supposed to be a rewarding experience to a frustrating one for both baby and mother
Normally, an infant’s tongue strokes her mother’s breast and draws out the flow of the breast milk. Her tongue’s movement strokes her mother’s breast, causing her mother’s nipple to lengthen so that it is pointing down her throat and pointing the milk towards her esophagus. Her tongue massages the milk sinuses of her mother’s breast, causing the release of breast milk. In order for all this to occur, the infant needs to open her mouth wide enough to take a big mouthful of breast and her tongue needs to extend beyond the gum ridge to her mother’s nipple to massage the nipple and areola, stimulating the milk to flow.
Some infants who are tongue tied are unable to do this. First of all, they are unable to open their mouths widely enough to be able to latch on to their mother’s breast. Thus, they continually slip off the breast during feeding. To compensate, they may latch on to the mother’s nipple instead, gumming or chewing it. This causes intense pain to the mother and eventually may result in cracking or distorting her nipple and may even cause the nipple to bleed. The mother should then beware of infection or mastitis.
Because he has to work so hard to get fed, the infant gets tired and often falls asleep in his mother’s arms, only to wake up still hungry and wanting to feed some more. An infant with normal sucking capabilities can empty a breast in 10 to 15 minutes. However, mothers with tongue tied infants who have problems in sucking have reported two-hour feedings involving excruciating pain for them and intense frustration for their infant who is not getting sufficient nutrition and often getting colic instead.
Furthermore, proper sucking and the peristaltic movement of the infant’s tongue is what stimulates breast milk production. If the sucking is not done properly, milk supply may not be replenished and may eventually dry up.
The good news is that many infants who are tongue tied do not experience these problems.
In the event that mother and infant are experiencing the difficulties mentioned above, one alternative would be for the mother to pump her breast milk and nourish baby with this milk from a bottle. Because the action of sucking from a baby bottle is different from sucking on a breast, this has been found to be a positive alternative for both infant and mother.