Q&A: Is Tongue-Tie Surgery the Right Choice for Your Baby?

A pediatrician explains this procedure and its alternatives
new born, new born care, breast feeding, breast feed, tongue-tie surgery, infant care

You want to breastfeed your newborn baby, but she just won’t latch. Maybe her attempts to latch are even hurting you. What could be the problem?

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There are a variety of reasons that new parents and their infants have issues with breastfeeding. One of them is a condition known as ankyloglossia, commonly called a tongue-tie, which can impact a baby’s ability to latch while nursing.

Tongue-tie procedures are becoming increasingly common in newborns and have been shown to help with breastfeeding — but they’re not always the answer. Pediatrician Heidi Szugye, DO, responds to frequently asked questions about how this procedure may help and what to consider instead.

Q: What is a tongue-tie, and how can it affect babies?

A tongue-tie is a band of connective tissue — almost like a small string — that connects the base of the tongue to the floor of the mouth. It can limit the movement of the tongue.

If it’s attached at the very tip of the tongue, it can pull your baby’s tongue into a heart shape, preventing them from sticking their tongue out past the lower gum line. This can make it difficult for your baby to breastfeed and can cause pain to the breastfeeding parent, too.

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Not all babies with a tongue-tie have breastfeeding difficulties, but breastfeeding difficulties are more frequently reported in babies with tongue-ties.  

Q: What is tongue-tie surgery, and what does it do?

If a tongue-tie is suspected to be the cause of your baby’s latch issues or your nipple pain, doctors may suggest a tongue-tie surgery, which has been reported to improve both.

Performed with scissors or a laser, this quick procedure — also called a frenotomy — removes the connective tissue. This essentially frees your baby’s tongue for a broader range of movement and, hopefully, an easier time latching.

Q: Will tongue-tie surgery help my baby breastfeed?

There’s a chance the procedure will ultimately not help improve breastfeeding. In general, though, more parents than not report an improvement in pain and latch following tongue-tie surgery.

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Q: What are the risks of tongue-tie surgery?

As with any surgery, there are potential risks to the procedure, though they’re rare. They can include:

  • Bleeding.
  • Poor feeding
  • Airway obstruction.
  • Scarring.
  • Damage to the saliva ducts.

Q: Is tongue-tie surgery right for my baby?

A frenotomy may turn out to be the right move for your baby — but try working with a lactation consultant, speech therapist, obstetrician, and/or pediatrician to investigate and eliminate other causes of poor latch or nipple pain before attributing it to a baby’s tongue-tie.

Other causes of pain or breastfeeding difficulties may include:

  • Improper feeding positioning or latch.
  • Oversupply or undersupply.
  • Breast anatomy.
  • Parental infection.
  • Other craniofacial anomalies in your baby.

Not every baby is a candidate for tongue-tie surgery. There are some reasons for which a baby should not have a frenotomy, such as certain bleeding or neurologic disorders.

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