If you’re a new or expectant parent—or if you know someone who is—here’s a word to file in the back of your mind: ankyloglossia. Also known as “tongue-tie, ankyloglossia is the medical term used when the tissue that connects the tongue to the floor of the mouth (a.k.a. lingual frenulum) is short.

“Tongue-tie” may sound cute, but it’s not. Although cases vary from mild to severe, ankyloglossia can cause a host of breastfeeding problems, including:

• slow (or no) weight gain
• poor seal of mouth on the breast
• clicking sound, with maternal nipple pain
• failure of tongue to extend during feeding
• continuous sore nipples (in spite of good latch and position technique)
• increase in pain during the feeding

But here’s something else to file in the back of your mind: tongue-tie can be treated. In a recent study, all of the mother-infant dyads experienced significant improvement in breastfeeding after a simple procedure known as tongue-clipping (a.k.a. frenulotomy).

Methods
In this study, Donna Geddes, PhD and her team of researchers in Perth, Australia sought to determine changes in breastfeeding, including sucking characteristics, following frenulotomy.

Health care providers referred 24 mothers of healthy, term infants to participate in these studies. These mother-infant pairs had on-going breastfeeding problems even though they had received lactation advice and follow-up. The infants were between 4 and 131 days old at the time of the study (mean = 33 days).

The researchers used ultrasound, a breastfeeding assessment known as LATCH, reports of pain, and calculations of milk intake.

• Ultrasounds of the infants’ oral cavity were taken before and after the frenulotomy.

• LATCH is a point-based scoring system that enables the observer to rate five characteristics during a breastfeeding session: latch, audible swallowing, type of nipple,  level of comfort, and hold (positioning).

• Pain was assessed by the mother on a 0 to 10 scale.

• Milk intake was measured by weighing the babies before and after feedings.

Researchers also wanted to assess milk production through collection of test weights before and after feedings for 24-hours before the procedure and 24-hours after. However, only a small number of mothers (8 before and 6 after) were willing to provide this data. Understandably, most did not want to delay resolving their breastfeeding problems!

Frenulotomies were performed by a pediatric surgeon with the assistance of a lactation consultant. Breastfeeding was encouraged immediately afterwards.

Results
No babies experienced complications from the frenulotomies. Although most did cry immediately after the procedure, mothers were encouraged to breastfeed immediately and that seemed to end their distress.

The researchers reported improvement on all indicators following the tongue-clipping. Milk transfer, milk intake, and LATCH scores were up; reports of maternal pain were down. In addition, for those mothers who did provide 24-hour milk production data, milk production was greatly increased.

Conclusion
Perceptions of low milk production and nipple pain during breastfeeding are leading reasons why women say they quit breastfeeding. Who wouldn’t think of quitting if they worried about their babies’ weight or experienced pain every time they put their babies to breast?

While there are certainly other causes of breastfeeding problems, it is exciting to think that a simple, quick medical procedure may help solve both of these problems for many mothers and babies! If only health care providers think to look for the culprit under the baby’s tongue … and parents think to ask them to do so!

Parents, don’t be “tongue-tied.” If you experience these problems, speak up.