Materiały źródłowe

• #1 Tongue-tie (ankyloglossia) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tongue-tie/symptoms-causes/syc-20378452

  Tongue-tie (ankyloglossia) is a condition in which an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. If necessary, tongue-tie can be treated with a surgical cut to release the frenulum (frenotomy). If additional repair is needed or the lingual frenulum is too thick for a frenotomy, a more extensive procedure known as a frenuloplasty might be an option. […] Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue’s range of motion. […] With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. Depending on how much the tissue restricts tongue movement, it may interfere with breastfeeding. Someone who has tongue-tie might have difficulty sticking out the tongue. Tongue-tie can also affect eating or speaking.

• #2 Ankyloglossia (Tongue-tie) – ENT Health

  https://www.enthealth.org/conditions/ankyloglossia-tongue-tie/

  Ankyloglossia, which is also referred to as tongue-tie, is a condition where the tongue cannot move normally because it is attached to the floor of the mouth by the frenulum, which is too tight. […] In infants and children, ankyloglossia can sometimes cause breastfeeding and speech problems. […] The typical treatment of symptomatic ankyloglossia is a frenotomy, a surgery that involves cutting the band of tissue between the tongue and floor of mouth to release the tongue and help it move more freely. […] Not all patients with ankyloglossia require or would benefit from surgery, so it is critical that each patient is evaluated based on their individual symptoms to avoid unnecessary surgery. […] If nonsurgical interventions do not resolve the problem or ankyloglossia is moderate to severe, a lingual frenotomy may be recommended. […] While many infants benefit from frenotomy, not all infants with ankyloglossia experience symptoms or require any intervention. […] A few rare risks of frenotomy may include bleeding, infection, scarring, salivary duct injury, and airway obstruction.

• #3 Ankyloglossia – Conditions We Treat – Breastfeeding & Lactation Medicine – Golisano Children’s Hospital – Rochester, NY – University of Rochester Medical Center

  https://www.urmc.rochester.edu/breastfeeding/conditions-we-treat/tongue-tie

  Everyone has a lingual frenulum, a fibrous attachment that holds the tongue to the base of the mouth and covers the muscle. About 1 in 10 babies will have some kind of tongue „tie,” or ankyloglossia, which means that their frenulum is tighter or farther out on the tongue than other babies. Only about 1/2 of these tongue ties will cause trouble with breastfeeding. […] Signs that a tongue tie is impacting breastfeeding include: Parental pain with nursing: We do not recommend that parents try to „get used” to this, or live through it. Pain with nursing indicates damage to the nipples, which can set up a parent for plugged ducts, mastitis, and even hospital admission, which isnt good for lactating parents or breastfed babies. […] Problems with „milk transfer”: This means whether the baby can get the milk out of the breast.

• #4 Tongue-tie symptoms and treatment – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/the-truth-about-tongue-tie

  Tongue-tie, or ankyloglossia, is when an unusually short, thick or tight band of tissue tethers the bottom of the tongue’s tip to the floor of the mouth. The band of tissue is called the frenulum. When it is too short or tight, it can restrict the tongue’s range of motion. Up to 10% of all newborns are born with ankyloglossia. […] The most common symptom of tongue-tie in newborns is difficulty with breastfeeding or bottle-feeding. This is because a baby must be able to get the tongue to the roof of the mouth to squeeze the nipple and express milk while feeding. If a tongue has a limited range of motion, the child can’t create a good seal and is less effective with expressing milk from the bottle or nipple and pushing it to the back of the mouth to initiate the swallowing mechanism. […] Not all people with tongue-tie require treatment. Some health care professionals recommend treating it right away, while others take a wait-and-see approach. Otorhinolaryngology, or ear, nose and throat, professionals work in concert with lactation consultants and speech therapists to recommend the right treatment option for each patient.

• #5 Tongue Tie (Ankyloglossia) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/tongue-tie.html

  Tongue tie is when a tight band of tissue connects the underside of the tongue to the floor of the mouth, keeping it from moving freely. […] Tongue tie can range from mild (only a tiny fold of tissue holds the tip of the tongue) to severe (the entire bottom of the tongue connects to the floor of the mouth). […] Babies recover very quickly, and often can start feeding shortly after a frenotomy. […] Talk to the doctor if you’re worried that your child’s condition is getting worse.

• #6 Tongue-tie (ankyloglossia) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tongue-tie/diagnosis-treatment/drc-20378456

  Tongue-tie is typically diagnosed during a physical exam. For infants, the doctor might use a screening tool to score various aspects of the tongue’s appearance and ability to move. […] Treatment for tongue-tie is controversial. Some doctors and lactation consultants recommend correcting it right away even before a newborn is discharged from the hospital. Others prefer to take a wait-and-see approach. […] Surgical treatment of tongue-tie may be needed for infants, children or adults if tongue-tie causes problems. Surgical procedures include frenotomy and frenuloplasty. […] A simple surgical procedure called a frenotomy can be done with or without anesthesia in the hospital nursery or doctor’s office. […] The doctor examines the lingual frenulum and then uses sterile scissors or cautery to snip the frenulum free. The procedure is quick and discomfort is minimal since there are few nerve endings or blood vessels in the lingual frenulum.

• #7 Ankyloglossia – Conditions We Treat – Breastfeeding & Lactation Medicine – Golisano Children’s Hospital – Rochester, NY – University of Rochester Medical Center

  https://www.urmc.rochester.edu/breastfeeding/conditions-we-treat/tongue-tie

  If these sound like you, get the tongue and latch checked soon by the babys provider, a breastfeeding specialist or a lactation consultant. A full tongue assessment should include checking out the: Babys palate for a high arch, Babys upper lip for flexibility (low lying lip „tie” doesnt tend to cause trouble on its own), Whether babys tongue can lateralize (move side to side), lift up, extend out of the mouth, cup the finger and wave (peristalsis), A comfortable latch, A before and after breastfeeding weight to see if the baby got a full feed. […] Things to consider when you are thinking about clipping a tongue tie: Are there other things going on? Neurodevelopmental issues, prematurity, torticollis and reflux are often found with infants with tongue tie. These may be the cause of the feeding trouble, or may be separate issues, but should be addressed by the babys provider.

• #8 Tongue-tie (ankyloglossia) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tongue-tie/symptoms-causes/syc-20378452

  Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction. […] See a doctor if: Your baby has signs of tongue-tie that cause problems, such as having trouble breastfeeding. A speech-language pathologist thinks your child’s speech is affected by tongue-tie. Your older child complains of tongue problems that interfere with eating, speaking or reaching the back teeth. You’re bothered by your own symptoms of tongue-tie. […] Tongue-tie may affect a baby’s oral development, as well as the way the child eats, speaks and swallows. […] For example, tongue-tie can sometimes lead to: Breastfeeding problems. Breastfeeding requires a baby to keep the tongue over the lower gum while sucking. If unable to move the tongue or keep it in the right position, the baby might chew instead of suck on the nipple. This can cause significant nipple pain and interfere with a baby’s ability to get breast milk. Ultimately, poor breastfeeding can lead to inadequate nutrition and failure to thrive.

• #9

  https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/tongue-tie-in-babies-how-ankyloglossia-affects-breastfeeding.aspx?_gl=1*8qijpe*_ga*MTMzODgxODcyNS4xNjYwMjU3ODMx*_ga_FD9D3XZVQQ*MTcyMzIzMzMzMS4yMi4wLjE3MjMyMzMzMzIuMC4wLjA

  Tongue tie (ankyloglossia) has been gaining attention as a possible cause of breastfeeding issues. […] Less than half of all infants with physical signs of tongue tie have trouble nursing. In fact, one U.S. study of 115 babies referred for tongue-tie surgery found that 63% did not need the procedure to solve nursing issues. […] Although more studies are needed to confirm the role tongue tie plays in nursing, research does show that a tongue-tie release can relieve nipple discomfort at least in the short term. […] Nursing newborns with possible signs of tongue tie should be closely monitored in the first few days of life. […] When breastfeeding does not improve after the release procedure, it is important to investigate other causes. […] Post-surgical stretches and exercises have not been proven to help infants recover from tongue-tie surgery. In fact, they may even cause babies to temporarily draw back from nursing. Without evidence that they help, the AAP does not recommend these exercises after tongue-tie surgery.

• #10 Tongue-Tie (Ankyloglossia) in Children

  https://myhealth.umassmemorial.org/Library/Encyclopedia/160,101

  Tongue-tie (ankyloglossia) is a problem with the tongue that is present from birth. It keeps the tongue from moving as freely as it normally would. […] Symptoms are different in each child. Some children may not have any symptoms. […] It causes breastfeeding problems in some infants. […] Your child might have trouble making certain sounds. […] Not all children with tongue-tie need surgery. Your child may need surgery if their tongue-tie is more severe and causes major symptoms. […] If your child is having trouble breastfeeding, the provider may advise working with a breastfeeding specialist. If that doesn’t work, your child may need to have a surgical procedure. […] A simple surgery called a frenotomy is an effective treatment for many children. […] Your child might need to see a speech therapist after a frenotomy. This can help them learn how to retrain the tongue muscles.

• #11 Infants with Ankyloglossia (Tongue-Tie) Clinical Pathway — Outpatient Specialty Care and Primary Care | Children’s Hospital of Philadelphia

  https://www.chop.edu/clinical-pathway/infants-ankyloglossia-tongue-tie-clinical-pathway

  Infants 6 mos with Suspected Tongue-Tie or Restriction Impacting Feeding, Weight Gain […] Physical exam features of Tongue Restriction […] Band of tissue that tethers tongue to floor of mouth […] Limited tongue mobility (extension, elevation, and lateralization) […] Tongue may be notched or heart-shaped […] Consider Lactation Consult […] Milk production concerns […] Difficulty with latch […] Breast or nipple pain/trauma […] Post procedure follow-up with PCP […] Monitor weight […] Continue lactation and/or SLP referral for resolution of any continued feeding challenges […] Restrictive Lingual Frenulum with impact on feeding identified […] No Restrictive Lingual Frenulum but continued feeding difficulties […] Monitor feeding and nutrition […] SLP may refer to interdisciplinary feeding team if concerns appear more complex.

• #12 Tongue-Tied: How Ankyloglossia Affects Breastfeeding – Colorado Parent

  https://coloradoparent.com/tongue-tied-how-ankyloglossia-affects-breastfeeding/

  Breastfeeding isnt always easy. […] If you suspect your infant is struggling with a tongue (or lip) tie, make sure to consult with a lactation specialist so your baby can properly feed. […] A baby can have one or both of these ties, which create a restriction in the lips and mouth that does not allow the tongue to properly position itself for breastfeeding. […] It can be hard to identify ankyloglossia just by looking in your babys mouth. […] Breastfeeding requires a baby to keep their tongue on top of their lower gum while feeding. […] Tongue ties are really an airway problem, but they show up as nursing or feeding difficulties. […] Along with pain for the mother, the baby will struggle to get an adequate amount of milk. […] Since your baby is not latching or feeding well, you will have milk supply problems, your nipples may crack and bruise, and you may develop mastitis.

• #13 Tongue-tie in babies | NCT

  https://www.nct.org.uk/information/baby-toddler/feeding-your-baby-or-toddler/tongue-tie-babies

  Tongue-tie (ankyloglossia) in babies can affect both breastfeeding and bottle-feeding. Here we explain about tongue-tie symptoms and treatment. […] Tongue-tie can affect both breastfeeding and bottle-feeding. For some babies, the effects will be quite mild. For others, tongue-tie can make feeding extremely challenging or even impossible. […] If your baby has a tongue-tie and you are breastfeeding, you might experience one or more of the following in your baby: difficulty in latching, difficulty in maintaining a latch, with your baby frequently coming off the breast or slipping back to the nipple, a shallow latch, clamping down on the breast, clicking noises while feeding, unsettled behaviour during feeds, frequent or long feeds, poor weight gain or excessive early weight loss, colic/wind/hiccups/reflux.

• #14 Tongue-tie in babies | NCT

  https://www.nct.org.uk/information/baby-toddler/feeding-your-baby-or-toddler/tongue-tie-babies

  If you are breastfeeding your baby and they have tongue-tie, you might find your nipples are sore and appear squashed after a feed, often appearing ridged, lipstick-shaped, flattened or blanched. If your baby isn’t draining your breasts adequately, this can lead to engorgement, blocked ducts and mastitis. It can also have a negative effect on your milk supply. […] If you are bottle-feeding your baby, you might notice one or more of the following your baby: is very slow to take a bottle, chomps on the teat, needs to be fed very often in order to get enough milk, dribbles a lot during feeds, tends to push the bottle teat out, gags on feeds even when you slow the feed down, can only manage a teat that has a very slow flow. […] A tongue-tie is diagnosed by the baby’s tongue function too what they can do with their tongue. It can only be diagnosed by a qualified tongue-tie practitioner.

• #15 Tongue-tie

  https://www.nhs.uk/conditions/tongue-tie/

  Tongue-tie is where the piece of skin connecting the tongue to the bottom of the mouth is shorter or tighter than usual. It’s most common in babies. It may not cause any problems, but if it does treatment is available. […] In babies, tongue-tie can make it difficult for them to breastfeed or bottle-feed. […] If your baby has tongue-tie and you’re breastfeeding, you may have sore nipples or painful and swollen breasts. […] Treatment is not usually needed if tongue-tie is not causing any problems. […] If it’s causing problems, such as difficulty feeding in babies, treatment may include: breastfeeding or bottle-feeding advice from a trained health professional; a small surgery to cut the piece of skin connecting the tongue to the bottom of the mouth. […] After surgery, most babies get better quickly and are able to feed better.

• #16 Tongue-tie (ankyloglossia) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tongue-tie/diagnosis-treatment/drc-20378456

  Complications of a frenotomy are rare but could include bleeding or infection, or damage to the tongue or salivary glands. […] A more extensive procedure known as a frenuloplasty might be recommended if additional repair is needed or the lingual frenulum is too thick for a frenotomy. […] After a frenuloplasty, tongue exercises might be recommended to enhance tongue movement and reduce the potential for scarring.

• #17 Frenotomy Procedure To Treat Tongue-Tie

  https://my.clevelandclinic.org/health/procedures/frenotomy

  Infants dont need anesthesia in any form for this procedure. Some healthcare providers recommend using oral sucrose (a sugar solution) before the procedure to help your baby feel more comfortable. Most babies are comforted afterward with feeding. […] Healthcare providers recommend feeding your baby right after the procedure ends. Doing so helps comfort your baby and stop any bleeding. […] Possible benefits of a frenotomy (frenectomy) include helping your baby breastfeed more effectively and reducing pain or discomfort you feel from breastfeeding. […] A frenotomy is generally very safe. Rarely, it can cause a baby to have bleeding, infection, scarring, feeding aversion, or injury to the saliva ducts or nerves in their mouth. […] Your provider will tell you when you should bring your baby back for a follow-up. At this follow-up, your provider will check for any complications, ask how breastfeeding is going and discuss any difficulties, and offer help with breastfeeding, as needed. […] Just the thought of something being cut in your babys mouth might make you nervous or scared. Thats normal. But a frenotomy is typically a simple, safe and quick procedure. Healthcare providers exhaust all other methods of helping your baby breastfeed before doing a frenotomy.

• #18

  https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/tongue-tie-in-babies-how-ankyloglossia-affects-breastfeeding.aspx?_gl=1*8qijpe*_ga*MTMzODgxODcyNS4xNjYwMjU3ODMx*_ga_FD9D3XZVQQ*MTcyMzIzMzMzMS4yMi4wLjE3MjMyMzMzMzIuMC4wLjA

• #19 Tongue-Tie (Ankyloglossia) in Children

  https://myhealth.umassmemorial.org/Library/Encyclopedia/160,101

  Some children need a slightly more complex procedure called a frenectomy. […] Talk with your child’s provider about the risks and benefits of a procedure. […] Contact your child’s health care provider or breastfeeding specialist if your child is having trouble breastfeeding. If you believe your child is having problems making sounds, see your child’s provider or a speech pathologist.

• #20 Tongue and Lip Ties – La Leche League International

  https://llli.org/breastfeeding-info/tongue-lip-ties/

  A baby with tongue tie may find it easier to latch on if your breast is soft, so breastfeed frequently to avoid engorgement. […] If your baby is sleepy or has jaundice, or if you have engorgement or inverted nipples, a tongue tie can make things worse. […] Frenotomy—dividing the tongue tie—can dramatically improve breastfeeding comfort and efficiency for both mother and baby. […] Dividing a tongue tie is a quick and simple procedure. […] The health professional lifts the tongue and divides the frenulum by cutting it with a pair of round-ended sterile scissors or by cauterising it. […] You will be asked to breastfeed your baby as soon as the procedure is over, to offer comfort, clean the wound and get his tongue moving as soon as possible. […] If you suspect that the initial procedure has not resolved your baby’s breastfeeding problems, arrange another consultation.

• #21 Tongue Tie – La Leche League GB

  https://laleche.org.uk/tongue-tie/

  After the health professionals initial assessment, your baby will be swaddled and held so they stay still during the procedure, which only takes a minute or two. […] You will be asked to breastfeed your baby as soon as the procedure is over, to offer comfort, clean the wound and get their tongue moving as soon as possible. […] If you suspect that the initial procedure has not resolved your babys breastfeeding problems arrange another consultation. […] If healing is slow, continued pain may be a sign that treatment (or further treatment) of your babys tongue tie is needed.

• #22 Tongue and Lip Ties – La Leche League International

  https://llli.org/breastfeeding-info/tongue-lip-ties/

  Using different feeding positions can help if breastfeeding is painful. […] Ask your LLL Leader about breast compression, which can help your baby get extra milk more quickly. […] When the underlying problem is corrected, moist wound healing can help your nipples heal without scab formation. […] If healing is slow Once your baby starts latching on well you should feel more comfortable and notice signs of healing within a few days. […] This is a time when the support of other mothers in your local LLL group can be invaluable.

• #23 Ankyloglossia – Conditions We Treat – Breastfeeding & Lactation Medicine – Golisano Children’s Hospital – Rochester, NY – University of Rochester Medical Center

  https://www.urmc.rochester.edu/breastfeeding/conditions-we-treat/tongue-tie

  The frenotomy procedure is a low-risk, but not no-risk procedure in which the tongue-tie is cut. It may be recommended to treat certain kinds of tongue-tie that are impacting feeding. […] Risks of frenotomy include bleeding, infection, cutting of surrounding structures such as muscle or salivary ducts. These are all rare outcomes. […] Keeping the frenotomy area open and scar-free: Some practitioners advise exercises to prevent the cut edges of the frenulum from re-attaching and forming a scar that makes an even worse „tongue tie.” […] We encourage you to try and slowly normalize breastfeeding over the next 1-2 weeks, transitioning as you see fit from the things you might have been using, like a nipple shield or bottles with expressed breast milk or formula. But dont feel rushed.

• #24 Tongue-Tie and Breastfeeding – Children’s Health

  https://www.childrens.com/health-wellness/tongue-tie-and-breastfeeding

  „Milk supply is hormone-driven, and the hormones are regulated by supply and demand. If milk is removed, then milk is made. If milk is not removed, the body will start to shut down the milk supply process,” explains Brooks. […] If your baby’s feeding does not improve, your pediatrician or specialist may suggest an in-office procedure that releases the tongue-tie. This is called a frenotomy. […] „Even if a baby is growing, if they can’t latch deeply enough due to a tongue-tie and it’s hurting mom, we can intervene and release the tongue-tie,” explains Dr. Lenes-Voit. […] To ensure your baby gets proper nutrition while tongue-tie issues are being resolved, your pediatrician may recommend nipple shields or supplemental bottle feedings. […] After a tongue-tie release, some babies will have an instant improvement in their ability to latch and nurse.

• #25 Tongue-tie (ankyloglossia) division – in babies | CUH

  https://www.cuh.nhs.uk/patient-information/tongue-tie-ankyloglossia-division-in-babies/

  The aim of tongue-tie division is to allow the tongue to move more freely and potentially improve the baby’s attachment to the breast during feeding. […] Following the division of a tongue-tie, many mothers report an immediate improvement in breastfeeding. However, this is not the case for everyone as many other factors also influence breastfeeding. Support from your midwife, health visitor or local support group is very important to assess attachment and sucking, as it can take up to two weeks before any improvements are felt. […] Your baby should be settled and any bleeding stopped before you leave the clinic. There may be a small white area under the tongue for the first couple of days. If your baby seems to be in pain or there is any bleeding from the site, please either contact your GP surgery or your local AE department. […] Your midwife or health visitor can give you help and support with breastfeeding.

• #26 Tongue and Lip Ties | La Leche League Canada – Breastfeeding Support and Information

  https://www.lllc.ca/tongue-and-lip-ties

  Before seeking treatment for a tongue tie it is important to consider other possible causes of breastfeeding difficulties. The tongue tie may not be the main problem. […] If you think tongue tie is the problem, you’ll want to see a healthcare provider who specializes in diagnosing and treating tongue ties. […] Diagnosing and Treating a Tongue Tie In order to determine whether or not your baby has a tongue tie that needs treatment, your healthcare provider should use an assessment guide. Not all healthcare providers believe that nursing is affected by tongue ties. They may not be knowledgeable about how to diagnose or treat them. If your healthcare provider is not helpful, consider getting a second opinion. This may be a family doctor, nurse practitioner, pediatrician, pediatric dentist, oral surgeon, ear-nose-and-throat (ENT) doctor, or a breastfeeding clinic with a team of professionals. Some practitioners charge a fee. Ask about the cost before agreeing to the consultation.

• #27 Has Your Baby Been Diagnosed With Tongue-Tie? | Children’s Hospital Los Angeles

  https://www.chla.org/blog/advice-experts/has-your-baby-been-diagnosed-tongue-tie

  Depending on your babys ability to feed, your care team may recommend a tongue-tie surgery. […] Pediatricians, oral surgeons, ear, nose and throat (ENT) doctors, and pediatric dentists may be skilled at performing tongue-tie procedures. […] The care team may recommend follow-up visits to make sure the tongue is healing well. They may also recommend seeing a lactation consultant or a feeding therapist after the procedure, to assure your baby is feeding effectively. […] Not all babies with tongue-tie will need a tongue-release procedure, say Danto. […] You may decide that a tongue-tie procedure is the best option if you have significant breast or nipple pain or if feeding is especially difficult. […] Many babies and parents have benefitted from tongue-tie surgery. These procedures are generally safe and may help with: Alleviating nipple pain and discomfort in the breastfeeding parent, Helping babies gain weight, Improving a babys feeding efficiency, Facilitating bonding between the baby and the parent, Reducing fussiness and irritability that can result from feeding issues. […] It’s important to remember that everyones situation is unique, and tongue-tie release may not necessarily be right for yours.

• #28 Tongue-tie (ankyloglossia) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tongue-tie/symptoms-causes/syc-20378452

  Speech difficulties. Tongue-tie can interfere with the ability to make certain sounds such as „t,” „d,” „z,” „s,” „th,” „n” and „l.” […] Poor oral hygiene. For an older child or adult, tongue-tie can make it difficult to sweep food debris from the teeth. This can contribute to tooth decay and inflammation of the gums (gingivitis). […] Challenges with other oral activities. Tongue-tie can interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.

• #29 Tongue Tie (Ankyloglossia ) | Rady Children’s Hospital

  https://www.rchsd.org/health-article/tongue-tie-ankyloglossia/

  Tongue tie is when a band of tissue connects the underside of the tongue to the floor of the mouth, which keeps it from moving freely. […] Tongue tie can make it hard for kids to: speak clearly or say certain sounds (d, l, t, th, etc.). […] If a baby with tongue tie has trouble breastfeeding, the care team will try to solve the problem without surgery. […] A speech-language pathologist can work with a child who has trouble speaking clearly. […] Symptoms can come and go as kids grow. A tongue tie that caused no trouble through early childhood may become a problem for older kids or teens who want to play a wind instrument or are frustrated or embarrassed because they cant stick out their tongue.

• #30 Tongue-Tie (Ankyloglossia) in Children | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/tongue-tie-ankyloglossia-children

  Tongue-tie (ankyloglossia) is a problem with the tongue that is present from birth. It causes speech and eating problems in some children. […] Some children have a lingual frenulum that is too short and tight at birth and may attach to the tip of the tongue instead of attaching farther back. When that happens, the tongue cant move around normally. Your child might have trouble sticking their tongue out, moving it from side to side, or bending it to touch the upper teeth. The tongue often has a notch at its tip. These problems can cause trouble with speaking and eating. […] Tongue-tie can make it hard for your child to do other activities. These include licking an ice cream cone, playing a wind instrument, or kissing. And it may cause embarrassment or social problems in some children. […] Most babies with tongue-tie don’t have trouble with breastfeeding. But some babies with this condition may have trouble latching to the nipple. Or the breastfeeding might cause nipple pain. If not corrected, your baby may not gain weight normally. It causes some women to give up breastfeeding earlier than they would like.

• #31

  https://www.bhs.org.au/bhsapps/govdoc/gdhtml/cpp0403.html

  Management is determined on a case by case basis taking into consideration anatomical appearance, any functional restriction of tongue movements and breastfeeding assessment. […] If tongue-tie is suspected as the cause of breastfeeding problems, early frenotomy within the first few weeks of life appears to be associated with better breastfeeding outcomes. […] Clinicians should avoid using the term 'tongue-tie’ until a definitive diagnosis has been made on the basis of skilled breastfeeding and oral assessment. […] There is limited evidence about the effectiveness of non-surgical management for tongue-tie. A 'wait and see’ approach is often appropriate as many early breastfeeding problems may be overcome with skilled support, without the need for frenotomy. […] If conservative management is the preferred option in the newborn period, follow up at Breastfeeding Clinic should be offered within 2 weeks to re-assess and frenotomy offered if indicated.

• #32 Tongue-tie and breastfeeding problems | British Journal of General Practice

  https://bjgp.org/content/73/732/297

  The GP should explore any concerns the mother has about breastfeeding and tongue-tie, and ask about her mental health. […] After checking there is nothing seriously wrong with the baby, the mother, or their interaction, the GP should usually signpost the mother to a lactation expert. […] For mothers who are interested in exploring frenulectomy, GPs can explain that, although it may reduce nipple pain, there is not much reliable evidence for benefits for the baby. However, many mothers find it helpful. Possible risks of tongue-tie operations to the baby include discomfort, bleeding, anaemia, infection, and recurrence in around 13%. It is important to know that many breastfeeding/tongue-tie problems resolve spontaneously within a few weeks without intervention. […] GPs can support mothers concerned about breastfeeding problems and tongue-tie by explaining the limited evidence for the benefit of tongue-tie operations, and signposting to lactation experts. Engaging struggling breastfeeding mothers early will empower them to make an informed decision about the best care for them and their baby.

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