Tongue-tie By Any Other Name

Does Ankyloglossia Affect Breastfeeding?

By Ann Calandro, RNC, IBCLC

, says that there are many causes for sore nipples such as improper latch, improperly removing the baby from the breast or baby sucking in the bottom lip. She feels that if these are ruled out as cause for nipple pain, the baby should be checked for tongue-tie. She lists six steps for identification of tongue-tie, medically known as ankyloglossia:

1. When tongue protrudes, tip is anchored behind alveolar ridge.
2. When infant cries, tongue remains anchored.
3. Tongue is notched or heart shaped when protruded.
4. Tongue cannot be manually extended by examiner.
5. Frenulum is short (less than 1 centimeter or 1/2 inch) and inelastic.
6. Tongue is attached close to the alveolar ridge.

Angelia Thompson, a registered nurse who successfully nursed her first two babies, had trouble nursing her third baby. Thompson asked her lactation consultant for some assistance with latch-on. Despite careful positioning and latching, she noticed that breastfeeding did not feel the same as it had with her first two babies. When her son went in for his first weight check, he was not gaining weight well.

"Breastfeeding my third child was more painful than with the first two," Thompson says. "The latch-on was particularly more painful. I had to reposition the baby often, and sometimes I had to hold my breast throughout the entire feeding to decrease the pain. Also, my milk did not come in as much in the beginning. I had to nurse and then pump after each nursing during the day to increase my milk supply. At a week of age, I took my baby to a pediatric dentist, who clipped my baby's tongue. I put him to the breast immediately following the clipping. There were no adverse effects. It bled only slightly after the clipping, but nursing stopped the bleeding completely. I immediately felt a difference with nursing – no pain. I couldn't believe it. I'm glad I had it done. I would recommend it to other nursing moms anytime for their comfort and peace of mind."

Want to see more?

• Sore Nipples
• Your Breast Friend: The International Board Certified Lactation Consultant
• Biting the Breast That Feeds
• Talk about it!