Friday, January 25, 2019

Tara Doman, MD discusses tongue-tie problems in newborns

Tara Doman, MD IBCLC
Tongue ties and Frenotomy

A tongue tie refers to when the frenulum, the attachment from the tongue to the floor of the mouth, is thickened, shortened or tight. As a pediatrician and a lactation consultant, I see many babies with tongue ties and parents that are concerned about them. In fact, it is estimated that between 4 and 10 percent of infants will have a tongue tie. Our office can diagnose a tongue tie by doing an exam of your infant’s mouth to see if there is limitation in tongue movement up to the roof of the mouth or past the lips. Some ties appear as a “heart-shaped” tongue.

Tongue ties can cause problems with breastfeeding.

When the tongue has limited movement, it inhibits the compression of the nipple by the tongue against the roof of the mouth which is necessary for breastfeeding. Some infants with tongue ties also have problems bottle feeding.

Symptoms of tongue tie include:
  • painful latch
  • nipple damage
  • difficulty latching or maintaining a latch
  • poor weight gain or poor milk transfer; or
  • decreased milk supply after several months of breastfeeding.


Even “mild” tongue ties can cause significant pain for a mother or breastfeeding problems. Fortunately, many infants with tongue ties breastfeed well and do not require any treatment. If you suspect your baby has a tongue tie and you are experiencing problems breastfeeding, we recommend scheduling an office visit or lactation visit here at PHA.   Sometimes, all that is needed is some repositioning and assistance with the latch at a lactation visit. However, if breastfeeding difficulties persist, we may recommend having the tie released. 

The release of a tongue tie is called a frenotomy, a brief, in-office procedure where the tie is clipped. A frenotomy is an effective treatment and usually helps resolve the symptoms of a tongue tie.   Even after a tongue tie is treated, it is important to follow up with a lactation consultant to ensure that breastfeeding has improved and that re-attachment has not occurred. Although a frenotomy can be performed at any age, early treatment is important to help relieve pain and prevent nipple damage and decreased milk supply that can interfere with breastfeeding. If your infant is under 6 weeks of age, we can perform a frenotomy here in the office.