The tongue frenulum is one of the many mucous membranes in the mouth. It is a thin membrane that connects the floor of the mouth to the underside of the tongue.

In this article, we will see in which cases the tongue-tie can interfere with breastfeeding and how to remedy it.

Tongue brake and breastfeeding

In infants, it is not uncommon for the tongue frenulum to be too short. This limits the range of motion of the tongue and can interfere with breast or bottle feeding.

A baby with a restrictive tongue-limb has difficulty sticking his tongue out of his mouth. This makes it difficult for the baby to smile or to feed properly.

Requiring the child to make extra efforts to suckle, the symptoms of a short tongue frenulum in children are as follows:

• Fatigue,
• Labial blisters,
• Abnormally slow weight gain,
• Difficulty falling asleep and restless nights,
• Digestive problems: abundant burping, colic, aerophagia, reflux, etc.

However, the fact that a child has these symptoms does not automatically mean that he or she has a short tongue. If you are unsure, it is best to consult a professional.

Tongue brake and breastfeeding

It is also possible to detect a tongue brake that is too short when breastfeeding is painful for the mother.

The infant's efforts to suckle contribute to the formation of cracks or lesions and cause burning sensations.

The milk ducts, which are not sufficiently solicited, can also become obstructed.

Tongue brake and bottle

Even though sometimes switching to bottle-feeding allows the baby to get back to feeding properly, it is not always enough. A child with a short tongue-limb may have the same difficulty feeding from a bottle.

If you wish to continue breastfeeding, it is best to consult a specialist before switching to a bottle.

In case you detect the same symptoms mentioned above while bottle-feeding, consider consulting your pediatrician or a specialist.

A professional can confirm if your child's tongue-tie is indeed too short or if it is another problem.

Lip lock and breastfeeding

The tongue frenulum is not the only one that can interfere with the baby's feeding. The lip frenulum can also cause inadequate or complicated breastfeeding.

The lip brake is located in the upper part of the mouth. It connects the upper lip to the jaw. A restrictive lip lock can affect the child's ability to roll up his or her lips and therefore prevent the child from having a good position when sucking the breast or bottle.

A lip brake that is too short is more difficult to detect but can influence breastfeeding as much as a tight lingual brake.

Tongue brake: how to make breastfeeding easier?

Massages and exercises

Depending on the age and the importance of the problem, soft methods can be considered:

• Massages,
• Rehabilitation exercises,
• Repositioning of the baby during breastfeeding,
• Etc.

Some specialists recommend facial massages to soften the brake and reduce the baby's body tensions. A professional must accompany the parents in the realization of the exercises because they must be specifically adapted to the baby.

Frenectomy

If these methods are not effective, it is possible as a last resort to perform a frenectomyor freinectomy. This operation consists of incising the lingual or labial frenulum in its middle. Performed under local anesthesia, this surgical procedure does not require stitches.

Although simple and painless, it is a surgical procedure that must be recommended by a doctor and requires reflection. 

Nowadays, frenectomies are performed without other options being explored. However, this operation does not solve breastfeeding problems due to any other cause than a brake problem.

Generally, the beneficial effects of frenectomy on breastfeeding and feeding of the baby are quickly noticed provided :

• Prepare the baby by massaging him/her before the procedure,
• Follow-up after surgery to facilitate healing and remould the tongue. 

The follow-up of the frenectomy

The healing of the mucous membranes is often too fast and can be bad. After the operation, trained parents should massage the underside of the baby's tongue for a month to a month and a half every day every four hours. 

The purpose of this exercise is to prevent the floor of the mouth and the lower part of the tongue from sticking and scarring together. 

After a frenectomy, the tongue also needs to be reeducated and strengthened through various exercises. The rehabilitation performed by the parents allows to train the child to :

• Raise your tongue,
• Roll up the lips if the baby has had a labial frenectomy,
• Playing with the tongue to stimulate lingual mobility.

Breastfeeding problems: tongue-tie and other causes

Even if the baby is feeding poorly and has the symptoms of a tongue-tie, the problem may have another cause. There are many possible explanations for breastfeeding problems other than tongue-tie or lip-tie:

• Blocked channels,
• A position not adapted to the suckling,
• A nipple infected with bacteria,
• Breastfeeding sessions too far apart,
• An engorgement of the breasts,
• Underwear or clothing that is too tight,
• Cracked or sore nipples.

If you are experiencing breastfeeding problems, first consult with specialists such as a midwife or lactation consultant before considering a frenectomy.

Do you suspect a problem with your child's tongue frenulum or have you noticed any problems during breastfeeding? Do not hesitate to call Dr. Agachi's office, pedodontist in Paris.

With the help of the symptoms identified by the parents, we will be able to provide you with advice. If the situation requires it, we will schedule an examination in our office as soon as possible.

Frequently asked questions about tongue-ties and breastfeeding