Simple outpatient procedure can quickly diagnose and treat ankyloglossia

Nov 11 2011

Mothers struggling to breastfeed are benefiting from a simple outpatient procedure to fix an easily missed 'tongue-tie' condition that could be preventing their newborns from feeding properly.

Monroe Carell Jr. Children's Hospital at Vanderbilt doctors and researchers have streamlined a process to quickly diagnose and treat tongue-tie, also known as ankyloglossia, before new mothers abandon breastfeeding, according to Dale Tylor, M.D., assistant professor of Pediatric Otolaryngology.

A quick snip can remedy the problem, and the procedure rarely requires general anesthesia in babies.

"Health professionals and society are telling mothers that breast milk is the best nourishment for their child, and we need to follow through and help the moms who are having problems feeding because of tongue-tie," Tylor said.

"The goal is to increase public awareness among surgeons and pediatricians, and, more importantly, among parents who can then advocate for themselves."

Tylor said her initial research findings show that well over two-thirds of women are able to begin successfully breastfeeding their babies after a tongue-tie-clipping procedure, known as a frenotomy, is performed on the baby.

"For an infant to properly breastfeed, the baby needs to move his or her tongue to their lips to allow sucking to occur," Tylor said.

"If there's a tethering, the baby has a hard time latching on and uses his or her gums or lips. It becomes painful for the mom, and can even cause bleeding."

Other indicators of tongue-tie could be if a baby breastfeeds for up to an hour at a time, is frustrated during the feeding, or falls asleep before full.

An entire day can be spent just feeding the baby, which can cause parents to supplement with formula or give up breastfeeding altogether, Tylor said.

Previous research has estimated that ankyloglossia is present in 4 percent to 10 percent of the newborn population.

The most common type of ankyloglossia, where a tight band of tissue results in a heart-shaped tongue indentation in the front of the mouth, is relatively easy to identify. Another type, known as posterior ankyloglossia, is harder to detect and is responsible for more than half of the cases treated at Vanderbilt, Tylor said.

"When you look at the posterior type of tongue-tie with your eyes, you can't always see it," Tylor said. "But when you feel it with your finger, or push it back with a specialized instrument, you can really tell that there is something restricting the movement of the tongue."

Children's Hospital findings also show that infants who were treated early were less likely to have speech problems later in life.

Other issues could also surface later if left untreated.

"They may have problems taking a spoon," Tylor said. "Or they may not be able to lick an ice cream cone… or stick out their tongues with their brother, sister or peers. They could even have problems into adulthood with common social activities like brushing their teeth or even kissing."

Source: Monroe Carell Jr. Children's Hospital at Vanderbilt