What's all this about Tongue Tie?

Tongue Tie is a complicated and confusing topic. I have been hesitant to write about it. But as a Breastfeeding Advocate I feel like the time has finally arrived to attempt to shed some light on this issue. "Tongue-tie is the non-medical term for a relatively common physical condition that limits the use of the tongue, ankyloglossia." "In some children, the frenulum is especially tight or fails to recede and may cause tongue mobility problems." "Nursing mothers who experience significant pain while nursing or whose baby has trouble latching on should have their child evaluated for tongue tie. Although it is often overlooked, tongue tie can be an underlying cause of feeding problems that not only affect a child's weight gain, but lead many mothers to abandon breast feeding altogether." (American Academy of Otolaryngology-Head and Neck Surgery) Like other medical variations, there is a range of severe to more mild tongue ties. What is very important is how the tongue is functioning. The appearance is less important. Sometimes the impact or even the presence of a Tongue Tie is not realized until weeks after birth. Here are some symptoms or signs that your baby may have a restriction that is affecting your nursing relationship. 

1. Sore nipples, compressed nipples
2. Poor weight gain in the infant or weight loss
3. Long feedings (more than 30 minutes after the 1st weeks after birth)
4. Unsatisfied after feeds or very sleepy
5. More than 12 feedings in 24hr
6. Gassiness or symptoms of reflux in conjunction with some of above symptoms
7. Decreased milk supply
8. Mastitis and/or plugged ducts

​This issue can also come to light after about the first 6-8 weeks postpartum. Most parents bring in a large amount of milk initially (more than the baby actually needs). Some babies who have limited function are able to get what they need due to this extra flow. When the breast milk supply switches to solely autocrine control problems can surface. Autocrine control means that breast milk supply is reliant on the baby effectively removing the needed amount. The amount that is removed is the amount the parent will produce. Many clients will notice a dip in supply at this stage and slowed weight gain in the infant. 
Lactation Consultants and Registered Nurses do not diagnose Ankyloglossia. We are trained to recognize it and assess it's potential impact on your baby and you and your milk supply. We are uniquely positioned to take the time to observe a full feeding and take an all important breastfeeding history. We can help refer to experienced Medical Providers to evaluate, diagnose and treat Tongue Tie. It is also very important to combine release with effective myofunctional therapy to allow any release to reach it's effective full potential. A follow up with a Lactation Consultant can help ensure a smooth transition post release. 
References:
Copyright 2018. http://www.entnet.org/content/tongue-tie-ankyloglossia. American Academy of Otolaryngology-Head and Neck Surgery. 1650 Diagonal Road, Alexandria, VA, 22314. 1-703-836-4444. Retrieved on 5/19/2018.