Breastfeeding and Tongue-tie – Wendy Birtall

In this guest blog Wendy Birtall independent IBCLC Lactation Consultant and Tongue-tie Practitioner explains what tongue-tie is, how it can affect Breastfeeding and what can be done about it. 

What is tongue-tie?

Research suggests that tongue-tie occurs in about 10% of the population, affects more boys than girls and appears to run in families. It is caused by a short or tight lingual frenulum (the membrane that attaches the underside of the tongue to the floor of the mouth) and this can restrict movement of the tongue. This in turn can lead to challenges breastfeeding which can also be painful for mum, or difficulties feeding from a bottle. The medical name for tongue-tie is ankyloglossia. 

'Not all babies with tongue-tie will experience feeding difficulties'

How can it affect Breastfeeding?

Not all babies with tongue-tie will experience feeding difficulties; sometimes support to maximise positioning and attachment can enable baby to feed effectively and without pain for mum.

Symptoms that may suggest your baby has a tongue-tie:

For baby:

  • Difficulty attaching and staying on the breast or bottle

  • Small gape / shallow latch

  • Very long and/or frequent feeds

  • Clicking sounds when feeding

  • Dribbling whilst feeding

  • Grinding, gumming or chewing on the nipple or teat

  • Falling asleep before the end of the feed

  • Restless and/or unsettled during/between feeds

  • Colic, wind, hiccups 

  • Symptoms of reflux

  • Excessive early weight loss / slow weight gain / initial good weight gain slowing as the weeks progress

For breastfeeding mum:

  • Sore, damaged, misshapen nipples

  • Painful breastfeeding

  • Reduced milk production

  • Poor milk drainage leading to repeated engorgement, blocked ducts or mastitis

  • Emotional and physical exhaustion

Because there can be other causes for the symptoms described above it is essential that a full feeding assessment is made by a skilled practitioner before considering tongue-tie division.

What can be done about tongue-tie?

For babies unable to breastfeed or bottle-feed effectively even with support, or whose mums experience ongoing pain whilst breastfeeding the tongue-tie can be divided using a simple and quick procedure called a frenulotomy. No anaesthetic is needed for young babies, and the procedure often leads to improved feeding and tongue mobility for baby, and reduced pain for the breastfeeding mum. For some mums and babies dividing the tongue-tie is only part of the solution to feeding challenges, and ongoing support may be needed.

Wendy is an experienced Nurse, Health Visitor, Lactation Consultant and Tongue-tie Practitioner and provides home visits for tongue-tie assessment and division in Norfolk and Suffolk. She can be contacted via her website