Identifying tongue tied infants
Ankyloglossia, or commonly referred to as a "tongue tie", is a condition seen in newborns when the lingual frenulum (the connecting membrane that supports the tongue) is short. The act of cutting the frenulum is called a lingual frenectomy. Two types of frenectomies exist. There are labial frenectomies (membrane is attached toward the lips) and lingual frenectomies (membrane is attached at the tongue). A labial frenectomy is performed when the frenum pulls on the gum tissue.. A tissue pull can cause the recession of gum tissue or the exposure of a root surface. A tongue tied infant can have a moderate to severe issue with their tongue. A severely tongue tied infant is when the frenulum of the child is attached from the tip of the tongue to the lower mandible gum tissue. This problem allows only the sides of the tongue to lift and move and not the center. When the tongue is lifted, it gives the tongue the appearance of a heart shape.
Problems related to tongue tied infants
This issue presents problems for the child. Tongue tied babies often have difficulty breastfeeding as well as bottle feeding. A tongue tied child typically has problems latching onto the breast as well as issues with maintaining suction. The child may make clicking noises while nursing and have problems maintaining proper suction which allows the nipple to easily fall out of the mouth due to the lack of negative pressure.
For proper nursing to occur, the infant needs to be able to latch onto the mother's areola with their upper gum ridge and tongue extended out over the bottom gums. When the infant begins to suckle, the tongue and jaw move forward in a wavelike motion. Upon nursing the tongue begins to ripple back and forth towards the throat while the lower jaw squeezes milk from the sinuses or ductiles. This process causes tongue depression which leads to subsequent swallowing and negative pressure. When a child is tongue tied the tongue cannot extend over the lower jaw. Since the tongue cannot extend properly, the mother's nipple cannot extent into the soft palate.
Problems for nursing mothers with tongue tied babies
This insufficient latching often causes a "chomp" which is when the mandible bites down onto the mother's nipple. This causes a lot of maternal pain. In addition, splitting of the nipples, ischemia, and greater incidence of mastitis can occur. Many nursing difficulties are correlated to a tongue tie issue.
Correcting tongue tied issues on infants
Fortunately, this condition of ankyloglossia on infants is easy to correct. A simple snip of the connecting membrane under the tongue with a micro scissor is all that is needed to correct the problem. There is little or no feeling in this area for the infant during the first 6 months of age. With proper technique, the process is quick and allows the child to immediately begin proper nursing or feeding. Since ankyloglossia or tongue tie is a hereditary issue, it is common for siblings to have the same problem. With immediate care, nursing can resume and a favorable outcome can be achieved for both mother and child.
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