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When a baby has a restrictive or tight frenulum (tongue tie), it can impair the ability of the tongue to move properly to effectively breastfeed. The frenulum is a piece of tissue that attaches the tongue to the floor of the mouth.
You can see your own frenulum in the mirror by opening your mouth and sticking your tongue out and up. The frenulum looks like a string that holds the tongue in place.
Tongue tie is just one reason a baby may be experiencing difficulty breastfeeding. It can be difficult to diagnose a baby as tongue-tied and assess if this condition has an impact on breastfeeding. For that reason, it is vital that you obtain an evaluation by a lactation consultant experienced in evaluating the frenulum if you think your baby is tongue-tied.
A restrictive frenulum may cause any, or all, of the following symptoms:
- Heart-shaped tongue tip. The tip of the tongue may be heart shaped or have a “v” shape indentation in the center when the baby sticks out the tongue or cries. (It is possible to have a restrictive frenulum without this classic symptom or to have a tongue that functions adequately, yet has the heart shaped tip.)
- Square or round tongue tip. The tongue looks square, or round, on the tip instead of pointed when extended.
- Difficulty extending the tongue. If your baby is tongue tied Your baby has difficulty extending the tongue past the gum line. Tapping the tip of the tongue should cause the tongue to come forward, where it should cross the gums.
- Tongue does not cup well. When your little one sucks on your finger the tongue should wrap around it like a hot dog bun wraps around a hot dog.
- Difficulty moving tongue from side to side. If you rub your baby’s lower gum, the tongue should follow your finger, side to side.
- Frenulum is attached very close to the tip of the tongue. Some babies have frenulums attached near the front, but the frenulum is very elastic and allows effective breastfeeding without treatment.