Elad et al (2014):
Changes in mouth volume (tongue undulation up and down) dictate vacuum generation, which leads to milk extraction. Peristaltic movement is not responsible for breastfeeding. The elevation of the back of the tongue is necessary for breastfeeding, not the ability to stick the tongue out.
Tongue tied babies are 3 times more likely to be 100% bottle fed at 1 week of age compared to non-tied babies. Tongue tie cause difficulty latching and may lead to abandonment of breastfeeding if not treated early.
Delaying treatment of tongue tie leads to increases in nipple pain and abandonment of breastfeeding. Early treatment of tongue tie helps reduce nipple pain and breastfeeding difficulties.
Delay beyond 4 weeks from referral to assessment of neonatal tongue-tie is more likely to be associated with abandonment of breastfeeding
For mothers who were not depressed during pregnancy, the lowest risk of PPD was found among women who had planned to breastfeed, and who had actually breastfed their babies. The highest risk of postpartum depression (2x) was found among women who had planned to breastfeed and had not gone on to breastfeed. The ability to breastfeed for women who plan do to so significantly reduces the risk of PPD.
Difficulties with latch, pain, and milk supply negatively affect 1 in 8 women (12%). In women who experience disrupted lactation, median weaning age is 1.2 months, whereas in women who don’t experience disrupted lactation, the median weaning age is 7.0 months. The presence of postpartum depression nearly doubles the risk of disrupted lactation. Addressing feeding difficulties early on leads to more long-term success with breastfeeding.
There is an immediate improvement in nipple-pain and breastfeeding scores after tongue tie release, despite a placebo effect on nipple pain. Treatment of tongue tie immediately improves nipple pain.
Surgical release of tongue-tie/lip-tie results in significant improvement in breastfeeding outcomes. Improvements occur early (1 week postoperatively) and continue to improve through 1 month postoperatively. Milk transfer rates increased from 3.0mL/min preoperatively to 4.9 mL/min at 1 week postop. Tongue tie release improves breastfeeding efficiency.
Besides nipple pain, measures of infant reflux symptoms and maternal breastfeeding self-confidence can improve following full release of the lingual frenulum.
Babies who were treated for tongue tie were more active in feeding (less fatigue, more rhythmic, more orderly), had a physically faster sucking motion (more efficient feeding speed), less rigid feeding patterns and greater feeding skill, and were able to physically suck more frequently than the untreated controls. Treatment of tongue tie reduces infant fatigue at the breast.
There is a real, immediate improvement in breastfeeding, detectable by the mother, which is sustained and does not appear to be due to a placebo effect.
52% of infants treated for tongue tie showed improvement or complete reversal of symptoms of reflux to the end point of cessation of reflux medication. 28.3% had no change in reflux, and 19.1% showed post-surgical improvement in post-feed irritability and less reflux symptoms but not successfully weaned off medications. Treatment of tongue tie often helps improve symptoms of infant reflux.
Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.
Mills et al (2019)
The tissue that makes up the lingual frenum does not stretch!
Treatment of tongue-tie in infants suggests improvements for breastfeeding mothers, including reduced nipple pain and improved latching onto the breast. Younger infants and those with more severe tongue-tie had the greatest improvements in GI and GER symptoms. Infants with tongue-tie and symptoms of GI tract distress may experience improvement in symptoms after frenotomy.
The research on tongue ties is increasing year after year. These are just a few of the articles on the subject of tongue tie and how it can negatively affect breastfeeding. The PDF versions of the articles are downloadable (when available) if you click on the icon next to the summary.