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  8. Tongue-tie

Tongue-tie and breastfeeding

Tongue-tie is when the strip of tissue attaching the tongue to the floor of the mouth (called the frenulum) is shorter than normal.

It can make it harder for your baby to breastfeed by preventing them from latching on properly, which can then lead to sore or cracked nipples.

Symptoms of tongue-tie

Tongue-tie can range from mild to severe. In severe cases, the tongue may be completely fused to the floor of the mouth.

You may be able to see if your newborn or baby has tongue-tie by looking into their mouth when they're yawning or crying, although it's not always easy to spot.

Signs of tongue-tie in your baby might include:

  • your baby's tongue not lifting or moving from side-to-side
  • their tongue looking heart-shaped when they stick it out
  • difficulty sticking their tongue out

How does tongue-tie affect breastfeeding?

If your baby has tongue-tie, you may experience:

  • low milk supply reducing your milk supply as your baby is not latching on and feeding well
  • having sore or cracked nipples, which can make breastfeeding painful
  • mastitis – engorged breasts (which can lead to mastitis) caused by poor latching on and ineffective feeding

If your baby has tongue-tie, they may:

  • have difficulty attaching to the breast or staying attached for a full feed
  • feed for a long time, have a short break, then feed again
  • be unsettled and seem to be hungry all the time
  • not gain weight as quickly as they should
  • make a "clicking" sound as they feed – this can also be a sign you need support with the positioning and attachment of your baby at the breast

Some babies with tongue-tie have no problems at all. They may still be able to latch on and feed well, so not every case of tongue-tie needs treatment.

If your baby does have tongue-tie, it will hopefully be picked up in the first routine check by your midwife.

However, tongue-tie is not always easy to spot and may be discovered at a later stage, usually after feeding issues become apparent.

Did you know?

Not every baby with tongue-tie needs to be treated – they may just grow out of it.

Treatment for tongue-tie

If treatment is necessary, your baby will have a straightforward procedure called a frenulotomy.

This is carried out by specially trained doctors, nurses or midwives and is very quick (it takes a few seconds).

The surgery simply involves snipping the short, tight piece of skin connecting the underside of the tongue to the floor of the mouth. Generally, no anaesthetic is used.

As soon as it's done, you can feed your baby, which helps to heal any bleeding.

Breastfeeding Friend from Start for Life

The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and expert advice to share with you – and because it's a digital tool, you can access it 24/7.

Help and support

For confidential breastfeeding information and support, call the National Breastfeeding Helpline on 0300 100 0212. Lines are open 9:30am to 9:30pm every day.

Read more about tongue-tie on the NCT website.

The Association of Tongue-tie Practitioners (ATP) has a directory of NHS tongue-tie practitioners.

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