Baby tongue tie culprit in case for breastfeeding

April 1, 2014 by Kerry Faulkner
Ankyloglossia or tongue tie is a well-recognised cause of breastfeeding problems. Credit: Jacob & Kiki Hantla

Tongue tied newborns and their mothers will benefit from an intensive investigation of a case of a 16-day-old boy by UWA human lactation researchers.

Ankyloglossia or tongue tie is a condition where the frenulum or membrane under the tongue holding it to the floor of the mouth is very short, restricting full movement.

Experts estimate four to 10 per cent of babies could be affected, although with a lack of large scale studies the figure could be higher.

Current treatment is to snip the membrane in a procedure known as a frenotomy.

According to recently published research from UWA's Hartmann Human Lactation Research Group (HHLRG) the condition is a well-recognised cause of breastfeeding problems and if untreated can cause nipple pain, trauma, ineffective feeding and poor infant weight gain.

Report co-author Donna Geddes says as a result, some mothers give-up trying to breastfeed and children are at risk of missing-out on a host of benefits, including increased immunity from infection.

"We have shown impacts on all areas of the mother's life including feeding, mood, sleep and it is well known nipple pain itself is a major cause of premature weaning," Dr Geddes says.

"Also if the infant is unable to remove the volume it requires from the breast the mother will need to express and feed the milk to the infant.

"This is demanding and time consuming and for some mothers unsustainable."

The paper details the case study of a healthy baby boy whose mother visited a lactation consultant when the child was 16-days-old because he was not feeding well and seemed 'fussy'.

After investigation, it was found poor transfer of milk volumes by the infant and diminished maternal milk supply were to blame.

A second test was done after a period where the mother expressed milk and took medication to stimulate production. It revealed a 'remarkable' increase in milk production yet little improvement in the baby's ability to transfer the milk.

After assessment by the HHLRG, a paediatric surgeon identified a tight band extending from the frenulum to the tip of the tongue.

The study reveals a dramatic improvement in the baby's breastfeeding milk intake four days after a frenotomy.

Dr Geddes says one of HHLRG's studies suggests women breastfeed longer after frenotomy.

"But this has not been confirmed yet because no study has been properly designed to investigate this," she says.

Explore further: Manual breast milk expression better than breast pump for poor feeders

More information: "Evidence of improved milk intake after frenotomy: a case report." Garbin CP, et al. Pediatrics. 2013 Nov;132(5):e1413-7. DOI: 10.1542/peds.2012-2651. Epub 2013 Oct 7.

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