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Infants with Tongue Tie Struggle to Breastfeed


The best possible nutrition for infants is breast milk, yet a significant percentage of newborns have a condition that makes it a struggle for them to breastfeed properly. Tongue tie interferes with an infant’s ability to move his or her tongue properly in order to nurse, which can lead many new mothers to give up breastfeeding.

Tongue tie, also known as ankyloglossia (or anchored tongue), is a common but often overlooked condition that is seen at birth. It occurs when the connective tissue under the tongue is too tight. According to tonguetie.net, the consequences of untreated tongue tie can impact the structure and appearance of the face and teeth, as well as oral function, including breastfeeding. Left untreated, tongue tie can make speaking difficult as a child gets older.

University of Florida researchers report in the latest issue of Pediatrics that a simple procedure called a frenotomy can correct the problem, but many doctors do not perform it, says lead author Sandra Sullivan, MD, a neonatologist and assistant professor of pediatrics at the University of Florida. “It is far simpler than a circumcision, which we do fairly routinely,” she said.

Yet many doctors were taught that a frentomy is not medically necessary, according to Sullivan. What makes it medically necessary is that most infants who have tongue tie cannot manipulate their tiny tongue effectively to breastfeed, a practice that new mothers are advised to do for at least the first six months of their child’s life.

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To breastfeed effectively, an infant must be able to move the tongue up and down. Tongue tie hinders or prevents this movement. Infants with tongue tie can still bottle feed because it does not require all the same tongue movements involved in breastfeeding.

The exact number of infants born with tongue tie is uncertaqin. Some research indicates that about 2 to 5 percent of infants are born with tongue tie and that about half of them have difficulties with breastfeeding, according to Isabella Knox, MD, EdM, an associate professor at the University of Washington. Since about 4 million babies are born in the United States each year, between 40,000 and 100,000 infants are born with tongue tie.

Other research suggests different numbers. A study from the University of Cincinnati published in 2002 found that about 13 percent of infants who were experiencing problems with breastfeeding had tongue tie. A study from Southampton General Hospital in the United Kingdom found that 10 percent of babies born in the area had the condition.

Regardless of the number of infants born with tongue tie, it obviously occurs in a significant number of children. Given that breast milk is considered the optimal source of nutrition for infants, and that it offers babies protection against diseases and common childhood illnesses, any obstacle to breastfeeding should be broken down. That includes tongue tie.

“We want to encourage mothers to breastfeed and do it successfully for as long as they would like, “says Jerry Isaac, MD, a pediatrician and past president of the Florida chapter of the American Academy of Pediatrics. To accomplish that, more infants will need to be screened for tongue tie, a process that Sullivan and members of an international organization focused on issues related to tongue ties are doing now.

Ballard JL et al. Pediatrics 2002 Nov; 115(5): 63.
University of Florida news release, June 30, 2010