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Mothers struggling to breastfeed are benefiting from a simple outpatient procedure to fix an easily missed "tongue-tie" condition that could be preventing their newborns from feeding properly. Doctors and researchers at Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center have streamlined a process to quickly diagnose and treat tongue-tie, or ankyloglossia, before new mothers abandon breastfeeding.
A quick snip can remedy the problem, and the procedure rarely requires general anesthesia in babies, explained Dale Tylor, MD, assistant professor of pediatric otolaryngology.
"Health professionals and society are telling mothers that breast milk is the best nourishment for their child, and we need to follow through and help the moms who are having problems feeding because of tongue-tie," said Dr. Tylor. "The goal is to increase public awareness among surgeons and pediatricians, and, more importantly, among parents who can then advocate for themselves."
Well over two-thirds of women are able to begin successfully breastfeeding their babies after a frenotomy, a procedure to clip tongue-tie, is performed on the baby, her initial research findings have shown.
"To properly breastfeed an infant needs to move their tongue to their lips to allow sucking to occur," Dr. Tylor said. "If there's a tethering, the baby has a hard time latching on and uses their gums or lips. It becomes painful for the mom and can even cause bleeding."
Other indicators of tongue-tie could be if a baby breastfeeds for up to an hour at a time, is frustrated during the feeding, or falls asleep before full. Spending an entire day just feeding the baby can cause parents to supplement with formula or give up breastfeeding altogether.
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Dale Tylor, MD, performs a frenectomy on Andrew Dodd to correct his tongue-tie condition.
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Previous research has estimated that ankyloglossia, where a tight band of tissue results in a heart-shaped tongue indentation in the front of the mouth, is present in 4 percent to 10 percent of the newborn population. The most common type is relatively easy to identify.
Another type, known as posterior ankyloglossia, is harder to detect and is responsible for more than half of the cases treated at Vanderbilt, Dr. Tylor said. "You can't always see this type, but you can tell that there is something restricting the movement of the tongue when you feel it with your finger or push it back with a specialized instrument."
Infants who are treated early are less likely to have speech problems later in life. Other issues also could surface later if left untreated.
"They may have problems taking a spoon, or they may not be able to lick an ice cream cone or stick out their tongues with their brother, sister or peers," Dr. Tylor said. "They could even have problems into adulthood with common social activities like brushing their teeth or even kissing."
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