Short sublingual frenulum or ankyloglossia: how to know if my baby has it

Home » Short sublingual frenulum or ankyloglossia: how to know if my baby has it
Short sublingual frenulum or ankyloglossia: how to know if my baby has it

Short sublingual frenulum or ankyloglossia: how to know if my baby has it

All of us have a membrane located under the tongue that attaches it to the floor of the mouth and allows it to move. Generally, the growth of this frenulum is in line with that of the tongue, but it may happen that this is not the case, leaving the sublingual frenulum short. It is known as ankyloglossia , and many parents wonder what happens if my child has a tongue tie that is too short?

According to the Spanish Association of Pediatrics (AEP) this pathology affects between 1.7 and 4.8 percent of newborns, being three times more frequent in boys than in girls. As a consequence of this shortening, babies have difficulty moving their tongues and it can cause problems in breastfeeding by not being able to suck properly. However, not all children with a short frenulum have difficulty breastfeeding. You can also show diction problems when you start to speak.

There are different types of sublingual frenulum, the most common being the one that reaches the tip of the tongue. There is also the submucosal frenulum, which is not visible to the naked eye, but anchors the tongue to the floor of the mouth giving it a spoon shape.

We can check if our little one has a short lingual frenulum (or ankyloglossia) if we observe that it is difficult for him to push the lingual apex out of the teeth or if when he succeeds, the tongue curves. Check out more interesting topics on our site Faith Blog.

Symptoms of a short frenulum in babies

Not all babies with a short frenulum have difficulty taking the breast, since in some the elasticity of the frenulum or the characteristics of the mouth allow it to suck and express milk adequately. However, depending on the severity of the anchorage, breastfeeding becomes very difficult for others.

Babies with a short lingual frenulum often have problems with breastfeeding such as:

  • Can’t keep a good latch on the chest ; loosens frequently.
  • Feedings are very long and the baby gets tired: he asks a lot and spends a lot of time at the breast.
  • Inability to drink enough milk; slow weight gain
  • Sometimes, while the child is nursing, a tongue click can be heard , due to the loss of vacuum.

For the breastfeeding mother:

Among the different problems suffered by mothers who breastfeed, the AEP highlights:

  • It can cause cracks in the mother’s nipple due to friction and excessive pressure inside the child’s mouth.
  • Cracks can lead to mastitis.
  • Sensation of low milk production, since the child nurses for a long time.
  • Hypogalactia : poor milk production
  • Wean early.

Solutions can be sought such as modifying the position when breastfeeding , placing the baby’s head backwards or with the mother semi-reclining. There are women who have managed to breastfeed successfully despite ankyloglossia.

Consequences of the frenulum short to medium and long term

In the medium and long term, ankyloglossia can also cause other problems. For example, tongue mobility problems will have a negative influence on the correct development of the maxillofacial structure (such as the palate or teeth), and may cause them to breathe through the mouth continuously .

When the baby learns to speak, he will also present problems in the articulation of the different phonemes, since the existence of a lingual frenulum that is too short will give rise to dysglossia that will affect the correct pronunciation of sounds, one of the most common being rhotacism .

How is it solved?

The first thing is to assess the degree of anchorage suffered by the baby to determine if the operation is really necessary , and it cannot be resolved with other breastfeeding support strategies.

When there is a clear diagnosis and it is decided that it is the best option, to solve the problem, a surgical procedure called a frenectomy (also called frenulotomy, frenectomy, frenilectomy or frenulectomy) is performed. It consists of cutting the frenulum with a scalpel or scissors (conventional surgery) or laser.

It is a very simple procedure and the results are immediate. In infants, it is usually performed with spray anesthesia in the sublingual area, but after 10-12 months it is performed in the operating room with inhalation anesthesia.

However, there are opinions against frenectomy . A new scientific study from the University of Western Australia, presented at the XIII International Symposium on Breastfeeding, promoted by Medela , concluded that 36% of operated babies stop breastfeeding before six months of age.

According to the research, the infants studied did not show a significant improvement in tongue mobility afterfrenotomy. In addition, they may suffer from pain, bleeding, infections and refusal to drink breast milk due to discomfort.

It is important to assess each case, and that the breastfeeding mother be offered options so that her baby can feed correctly and avoid pain.

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