At birth, babies are screened for several congenital abnormalities during a routine physical assessment that is carried out within 72 hours of birth and then later at six to eight weeks of age, as some conditions may take a while to develop.
Conditions they are assessed for include congenital hip dysplasia, heart murmurs, cataracts and cleft palates. Tongue tie or ankyloglossia is not routinely checked for, yet can cause significant difficulties for new mothers who are attempting to breastfeed. A recent BBC article demanded that NHS midwives and health visitors receive specialist training to help spot the condition.
Signs of tongue tie
It’s estimated that 10% of babies are affected by tongue tie, a condition where the tongue is tethered to the bottom of the mouth by a strip of tissue known as the lingual frenulum.
Often the first sign of tongue tie is difficulties establishing and maintaining breastfeeding. One study estimated that 60% to 80% of women experience problems breastfeeding, and 42% of all women who attempt breastfeeding quit within six weeks. A speedy diagnosis and treatment of tongue tie could support more women at this time.
Issues with tongue tie and breastfeeding:
- For the mother, breast feeding can often be painful
- Can cause mastitis and blocked ducts
- For the baby it can cause limited tongue movement including inability to poke out their tongue
- Unable to open mouth wide when breastfeeding
- Fussy behaviour when feeding
- Coughing during feeds
- Frequent or extended feeds
- Poor weight gain
The women interviewed in the BBC article were both second-time mums and their previous experience of breastfeeding meant they suspected tongue tie. However, they both had to fight hard to get a diagnosis and treatment, which is typically tongue tie surgery.
About half of babies with ankyloglossia will require a surgical procedure to release the tongue. Paediatric plastic surgeon Mr Juling Ong performs both frenotomy, where the tongue is released with surgical scissors, and frenuloplasty, in which plastic surgical techniques are used to release the lingual frenulum prior to reconstruction. Dissolvable sutures are used.