Tongue-tie ( ankyloglossia ) is an abnormality in the frenulum of the baby's tongue so that it is too short. This causes the baby's tongue to not move freely. If not treated immediately, tongue-tie can make it difficult for the baby to suckle, as well as difficulty speaking, eating and swallowing.
The frenulum is a thin tissue under the middle of the tongue that connects the tongue to the floor of the mouth. Normally, the frenulum separates before the baby is born. However, in infants with tongue-tie , the frenulum is actually formed with a very short size, causing the tongue to remain attached to the floor of the mouth.
Tongue-tie is a congenital disorder that is estimated to occur in 3–5% of newborns. This condition is also more common in baby boys than baby girls.
Causes of Tongue-Tie
Until now, it is not known exactly what causes tongue-tie . However, in some cases, babies with tongue-tie have parents with a history of the same condition. Therefore, there is a suspicion that tongue-tie is related to genetic factors.
Babies who suffer from tongue-tie generally have the following symptoms and signs:
- Difficulty moving the tongue up or to the side
- The tongue cannot protrude past the front teeth
- The shape of the tongue looks like a heart or the letter V
- Tends to chew rather than suck when feeding
- Repeatedly inserting and removing the nipples so that the suckling process becomes longer
- It is difficult to gain weight due to not getting enough breast milk
- Always fussing because not enough to suckle
Apart from babies, breastfeeding mothers can also experience complaints related to tongue-tie . This happens because the baby is not able to suckle properly. These complaints include red breasts, swelling, pain, and sores on the nipples.
When to see a doctor
Check with the doctor if your baby shows the above symptoms and signs, especially if you also experience symptoms in the form of:
- Pain in the nipples during and after breastfeeding
- The nipples are cracked and sore
- Inflammation of the breast ( mastitis )
- Low milk production
Please note, tongue-tie is not the only cause of problems in breastfeeding. Therefore, an examination by a doctor is needed so that your baby gets the right diagnosis and treatment.
Before examining the baby's condition, the doctor will ask the baby's mother if there are any problems breastfeeding her baby. After that, the doctor will do a physical examination of the baby's mouth to see the shape and movement of his tongue.
In children with tongue-tie, the doctor will ask them to move their tongue and say certain letters, such as R or L.
Treatment of tongue-tie depends on the severity. If a baby or child who has tongue-tie can still eat well, the doctor will wait and monitor the progress of his condition. This is because the frenulum of the tongue can stretch over time so that the tongue-tie resolves on its own.
Meanwhile, for tongue-tie which makes it difficult for the baby to eat , the doctor will perform a surgical procedure whose type is adjusted to the severity of the baby. These surgical procedures include:
Frenotomy is performed on mild tongue-tie . In this procedure, the doctor will cut the frenulum with one incision using sterile scissors or a scalpel.
The frenotomy is quick and can be done with or without anaesthesia . The bleeding from the frenotomy is minimal so that the baby can breastfeed immediately after the procedure is over.
In frenectomy, the entire frenulum of the tongue is excised with a sterile scalpel. This procedure is preceded by administration of anesthetic drugs.
If the frenulum is too thick to cut, the doctor will perform a frenuloplasty. In this procedure, the doctor will cut the frenulum of the tongue with a special tool and then sew up the scar. These stitches will fall off by themselves after the wound heals.
Frenuloplasty is performed after the patient is anesthetized first. In some cases, this action is performed using a laser. During the recovery period, patients usually need speech therapy and tongue exercises to restore the ability to move the tongue.
Tongue-tie can affect the way you swallow, eat, and talk, which can cause complications, such as:
Problems with breastfeeding
Babies with tongue-ties can have difficulty feeding. Instead of sucking, the baby actually chews on the nipple, causing pain in the mother's breast.
In addition, tongue-tie also makes it difficult for babies to get enough breast milk . As a result, babies can lack nutrition so that they experience growth and development disorders.
Difficulty in speaking
Tongue-tie can cause children to have difficulty pronouncing certain consonant letters.
Difficulty doing certain activities with the mouth
Infants or children who suffer from tongue-tie may have difficulty performing simple movements that rely on the tongue, such as licking their lips.
Unhygienic conditions of the mouth
Tongue-tie can make it difficult for the tongue to clean food debris from the teeth. This condition can cause tooth decay as well as swelling and irritation of the gums.
Prevention of Tongue-Tie
As mentioned above, it's not clear what causes tongue-tie . Therefore, it is not yet known how to prevent this condition. Immediately consult a doctor if the baby always has difficulty breastfeeding, or if the mother often experiences breast pain after breastfeeding.