Breastfeeding: Does tongue-tie affect nursing?

My second child, now four months old, is tongue-tied. He is feeding well (regained his birth weight plus 12 oz. by his two-week check -- 16 lbs. now), but seems to have a lot of gas, despite diligent burping during and after feedings. I am wondering if his being tongue-tied may be a cause of the gas. He does not make noises while nursing, but does seem to release more often than my first child did. He also feeds for much longer at each feeding than my first did. Could that mean his sucking is less efficient? How might being tongue-tied affect nursing?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

When a baby is born tongue-tied, it can be very difficult for him to nurse, depending on the degree to which he is able to extend his tongue to cup and milk the breast.

Ankyylglossia, or tongue-tie can definitely impact breastfeeding. Babies who are tongue-tied often have difficulty latching on to the breast and the mother may experience nipple pain and/or trauma. These conditions can lead to other breastfeeding problems, such as slow weight gain and/or failure to thrive in the baby and ultimately a poor maternal milk supply and untimely weaning. Many health care providers only diagnose the most severe tongue-ties, so this condition is often underdiagnosed. This condition is more common in boys than in girls and appears to be genetic in origin.

Your little guy sounds like he has been doing well at the breast, despite this problem. He has learned to compensate. He may need to periodically release from your breast because his tongue may be a little sore from keeping it extended as he nurses. This of course results in an poor seal which could be causing him to gulp in air as he nurses, resulting in his gassiness.

His longer feeds indicate to me that he needs to stay at your breast longer to get the amount of milk he needs to thrive. He is probably nursing more because his suck is less efficient.

As you said, since your son has been growing well at this point, and he is already four months old, I would just keep an eye on his pattern of weight gain. Normal weight gain for babies from four to six months old is three to five ounces per week.

If you do begin to see your baby's tongue-tie interfering in any way with his growth, breastfeeding, or with his speech, it is very important to discuss this matter with his health care provider. Best wishes!

Reference: Pediatrics Vol. 110 No. 5 November 2002, pp. e63

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