News Archive

If breastfeeding a newborn is not going well, the first focus is usually on the mother

But lactation researchers have found that an ancient problem with some babies' tongues is still interfering with successful breastfeeding.

Inspired by the overwhelming benefits of breast milk, the scientists at UWA's Hartman Human Lactation Research Group (HHLRG) have long focused on identifying problems with breastfeeding and how they can be solved. Tongue tie in infants is one such problem, and while the condition has been documented since biblical times, its diagnosis and treatment is controversial.

Ongoing research by HHLR is focused on providing evidence for the benefits of correcting tongue tie in infants, based on their breast milk intake.

Tongue tie, known medically as ankyloglossia, is when a baby doesn't have full movement of the tongue. Donna Geddes, Head of the HHLR explains: "There is a fine membrane underneath your tongue that holds it to the floor of your mouth, called the frenulum. For babies with tongue tie, the frenulum is very short and acts like the anchor of a ship, restricting movement. The tongue is so closely anchored to the floor of the mouth, that it cannot function efficiently or effectively, especially when breastfeeding.

"The concern is that when a baby cannot breastfeed properly, they are missing out on the myriad of benefits afforded by breastfeeding that include increased immunity from infection, reduced risk of obesity, and reduced chance of all obesity related diseases such as diabetes and cardiovascular disease. There are also negative health implications for mothers who do not breastfeed such as increased risk of breast and ovarian cancer as well as slower weight loss after birth."

The current treatment for tongue tie involves snipping the frenulum beneath the tongue, in a procedure known as a frenotomy, in which there are rarely any complications.

But there is significant controversy surrounding the snip.

"Some conservative clinicians question whether it is really necessary to release the frenulum. There are no universal guidelines to determine when the procedure is required," Dr Geddes said.

While bottle feeding was popular, tongue tie was rarely diagnosed as the condition didn't interfere with sucking from a bottle.

"Now, with more mothers breastfeeding again, we need a more definitive answer to the question of the snip - that can be used diagnostically by clinicians," she said.

Dr Geddes and her colleagues have measured the 24-hour milk intake of tongue tied babies before and after frenotomy. The results proved how successful the procedure was in allowing a baby to breastfeed.

In their most recent study, soon to be published in Pediatrics , a specific level of milk intake is proposed as a tool for determining when a frenotomy should be performed.

Up to 10 per cent of the population suffer tongue tie, and of these, at least half will have difficulty feeding as babies.

As well as these difficulties, untreated tongue tie can cause nipple pain and potential infection for the mother, and long term implications for the child, including altered development of the oral cavity and compromised dental hygiene. "There is less chance of speech difficulties for babies who have had a frenotomy, and there are social impacts, such as the ability to lick a lollypop, and to French kiss!" Dr Geddes said.

HHLRG plans to develop universal guidelines for milk intake and hope that clinicians will use them to diagnose and treat tongue tie.