While the lip is important in breastfeeding, the role of the tongue is even more vital. A tongue-tie can be a big obstacle to successful breastfeeding. Recent research has led to a change in the understanding of the mechanics of breastfeeding. We now know that the tongue creates negative pressure in an infant’s mouth. This negative pressure is what causes the nipple to open up and allow milk to flow into an infant’s mouth. This negative pressure is what we typically associate with a baby sucking. While nursing, the tongue is meant to be able to pull the mother’s areolar complex to the palate and then lower, thereby creating the vacuum.
When an infant has a tongue-tie, it lacks the proper mobility to elevate the posterior and sometimes the anterior portion of their tongue to create a sufficient vacuum. This is why some infants will nurse for extended periods of time with only the smallest transfer of milk. This not only causes issues of undernourishment, but can either cause a mother’s milk supply to decrease or the milk to stagnate and become infected, resulting in blocked ducts, mastitis, or blebs/milk blisters. Another common problem with a tongue-tie is that, when the tongue can not move properly, the baby will use their lower gums to chew on the nipple to get the milk out, causing the mother significant levels of pain and the baby’s jaw to develop improperly.
The good news is, when the tongue-tie and/or lip-tie is released, a breastfeeding relationship can be significantly changed and symptoms mitigated. In our office, we will assess the ties as well as the symptoms both baby and mother are experiencing. If it is a combination of the lip and tongue-ties that are causing the problems with breastfeeding we will recommend that both ties be released.