What is tongue tie?

How a small piece of skin could be the answer to painful breastfeeding problems

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A painful nipple could be a sign of tongue tie

A screaming, hungry baby coupled with extremely sore and painful nipples means utter frustration when you’re trying to breastfeed. And if you’ve exhausted other possibilities such as mastitis, shallow latch or poor positioning, you’re probably thinking of giving up. But more and more mums are finding that their babies have a little-known condition that’s stopping them being able to feed, called tongue tie.

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What’s a tongue tie?

It sounds like it should be related to speech problems, but actually this is about that small bit of skin between the tongue and the bottom of the mouth, known as the frenulum. When it’s too short (and some adults still have this with no problems at all), it means the tongue can’t move properly. That’s why it stops a baby being able to feed. About 100 years ago, midwives would check a baby’s mouth and snip the frenulum if it was too short. But as bottlefeeding became more widespread, they stopped it as a routine practice.

Spotting the signs

Up to 10 per cent of babies have the condition, and there are several signs to look out for. “The first clue is a mother’s painful nipple,” says paediatric surgeon Shailesh Patel, from King’s College Hospital in London. Also watch for your baby not sticking his tongue out, or if it has a heart- or square-shaped end when he does poke it out. He also might not cup his tongue well around your nipple or finger.

Check your nipples to see if they’re misshapen or have a white strip around them after feeding, as that could be a clue too.

What’s the solution?

There’s a quick procedure, called a frenotomy that should have your baby latching on in no time. The surgeon lifts the baby’s tongue and snips the frenulum just like midwives used to. There’s no anaesthetic, but it only takes seconds. You’ll be asked to keep your baby hungry before the procedure, so you can put him straight to the breast to feed as soon as it’s done.

“Most babies settle within seconds,” says Shailesh Patel. “In studies we’ve done, 100 per cent of mothers report feeling less or no pain while breastfeeding after the operation.”

“Lois was able to latch on, but couldn’t stay on so at five days we went back to hospital. The health visitor said she thought Lois was tongue-tied. Nobody had mentioned it before, but we were referred to a surgeon and they did the snip that day. Lois slept through it and instantly she could stay on my breast,” said Amy Castle-Young, 35, from Kingston, mum to Lois, 6 months.

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