Recently I have been contacted by several moms about feeding issues when the baby is tongue tied and has Gastroesophageal reflux. Tongue tied or Ankyloglossia occurs when the small piece of skin under the tongue (called the frenulum) is tight. The tongue may not be able to move normally and may cause problems with nursing.
Symptoms may include:
· poor suck
· poor seal on the breast
· loud sucking
· poor weight gain
· slow feeding
· painful nursing
· fussiness during feeding
You may be thinking that these symptoms sound very similar to the symptoms of infant reflux and you are correct. It may be confusing to parents, doctors and lactation specialists to sort out the cause of the symptoms and develop the best treatment plan.
The lactation specialist and the doctor will examine your baby for signs of being tongue tied. You and the medical team will also need to consider other reasons for the symptoms and poor feeding.
Often the best treatment is to wait and watch the baby. The lactation specialist and the doctor may offer advice on feeding and positions to improve intake and lessen the discomfort for both baby and mom. Most babies manage to nurse and grow without any further treatment.
In rare cases, when the frenulum is having a significant affect on feeding and growth, the frenulum may be clipped during a minor surgical procedure in the doctor's office. A topical numbing medicine is applied to the area and the frenulum is clipped. Pain is often minimal and feedings can resume right away.
While being tongue tied does not cause infant reflux, it may cause a worsening of reflux symptoms. One mom told me that her baby's feeding improved greatly after the frenulum was clipped. The reflux symptoms such as burping and vomiting improved too. I am going to add being tongue tied to my list of reflux look-a-likes.