Our blog “How will I know if my baby has a tongue tie?” should have helped you to work out whether your baby may have a restriction in their tongue’s movement. This blog will look at tongue-tie ‘correction’ in more depth and will discuss feeding strategies that are likely to help those babies who are tongue-tied or have other feeding difficulties.
What can I do if my baby has a tongue tie?
Cutting, or ‘snipping’, your baby’s frenulum is often recommended as a treatment for tongue tie. This must be done by a qualified person who might be an ENT (Ear, Nose and Throat) doctor, a specialist nurse or midwife, or a dentist with specific training. It is a very minor surgery which most babies tolerate very well, although it can make them sore for a day or so.
Is a tongue tie snip always the answer?
Unfortunately not. Sometimes babies are still not able to make the wave-like movement that is needed to easily feed from the breast or bottle. This may be because their tongue movement has been so limited that they need to learn how to move it more freely. For some babies, even those with what looks like an obvious tongue tie, snipping does not help and we don’t currently know why.
One of the challenges with tongue tie symptoms is that they are very similar to other feeding problems, such as a baby who has not yet learnt how to breastfeed well or who may not be latching deeply because of the position they are being held in. These issues can lead to sore or cracked nipples, low weight gain and reflux symptoms – just the same as can happen if a baby is tongue tied!
Are there risks to being wrongly diagnosed with tongue tie?
People who are qualified to cut tongue ties are also usually skilled at recognising whether a tongue tie may be causing feeding problems, so it is unlikely that your baby’s tongue will be snipped if there isn’t a tie there.
Before getting an appointment for the operation, some parents may not be offered other support to help with feeding. This distressing situation can be made worse if they find that a tongue tie snip is not the solution after all. Days or weeks may have been lost when other solutions could have been tried!
The good news is that there are feeding strategies that can be used which help many babies, whether the problem is caused by a tongue tie or something else. They can also be used after a tongue tie is treated, to support babies in learning to feed well.
What feeding strategies can help with tongue tie symptoms?
Often, the symptoms of a tongue tie can be improved by working hard to get a deep latch for every feed.
When breastfeeding, the ‘flipple’ technique – sometimes called the exaggerated latch – is great for getting baby to take more breast tissue into their mouth. This can help many different breastfeeding problems and make it easier for babies to latch as they re-learn breastfeeding following a tongue tie snip.
To do the flipple, press the base of your areola so that your nipple points very high towards their nose. This tilts the tip of your nipple up and almost away from your baby’s mouth. As baby starts to latch, allow the nipple to gently flip into the back of their mouth. You want to get as much of the bottom part of your areola into your baby’s mouth.
One breastfeeding position that can help a lot of babies is called laid-back breastfeeding. For this, lie back, comfortably propped up and put your baby between your breasts, letting them find their own way to the nipple. Because the baby is facing downwards – perhaps with their head tipped sideways – their tongue drops forward and this can help them to feed better. This position helps with other problems that can look like tongue tie, such as oversupply or a strong let-down of milk. Oversupply can make babies splutter, choke and swallow air, causing colic and reflux. In this position, the milk has to flow against gravity, so babies don’t get so overwhelmed and can more easily cope with the flow.
Bottle fed babies may do better using the paced bottle feeding method. For this, hold your baby in a seated position, with one hand behind their head and supporting their back. Offer the bottle horizontally – just tipped enough to keep milk in the teat but not enough so that gravity tips the milk into their mouth. Encourage baby to open their mouth wide by tickling their mouth with the teat and, once they latch, have them take regular breaks. All of this will help them manage the flow of milk more easily.
While it is important for doctors and midwives to recognise tongue ties when they are there, and treat them if possible, sometimes waiting times are long. During this time, you may not get the support you need, which can be very distressing. Knowing what feeding techniques and positions to try in the meantime can prove crucial in helping babies with tongue-ties or other feeding problems.