Frenectomy / Tongue Tie

Many babies can find it difficult to breastfeed and draw in a lot of air into their belly if they are tongue tied. In a baby, tongue tie affects their ability to move their tongue properly and they have to use their mouth and face muscles to express the milk and maintain a good seal.

The frenulum may look like a string that holds the tongue in place and in the past, it was thought that by relieving the anterior tie that feeding would improve but that isn’t the case. Poor expression of milk occurs because the baby is unable lift the middle of their tongue underneath the nipple to express the milk.

This inability to lift the middle part of the tongue is known as a posterior tongue tie. A posterior tongue tie or submucosal tongue tie restricts the tongue from lifting upwards and can make it look like the child has a short tongue. This form of tie is much more likely to be the cause of poor feeding. Like an anterior tie, it can be released very quickly and without any complications.

Babies may also have an upper lip tie, an attachment under their upper lip, which restricts the upper lip from flanging and creating a good seal on the breast. This attachment can come down to the ridge where the baby teeth will erupt and hold the upper lip down. Often this results in a blister forming in
the middle of the upper lip. Freeing the upper lip tie allows the lip to turn upwards and rest comfortably on the breast, creating a relaxed but effective seal.

Early treatment usually results in a significant improvement in feeding for both the child and mother.
Less air is drawn in and the baby is less colicky. Lactation specialists, early childhood nurses and speech therapists will often see this and can advise if a laser frenectomy or tongue tie revision is necessary.