Tongue tie (or ankyloglossia) is an increasingly common condition in newborns consisting in an unusually thick and/or short lingual frenum (the band of tissue connecting the tongue to the floor of the mouth) that restricts movement of the tongue. According to the point where the frenum attaches, the tie is more or less evident (and problematic; the most evident ties are the easiest to revise).
Tongue-tied babies usually have trouble breastfeeding as they cannot use their tongues to squeeze the nipples against the roof of their mouth, resulting in a shallow latch. Many tongue-tied babies also have lip ties, where another frenum connects the upper lip to the upper gum just between the two front teeth, making it hard for them to flange their lips when nursing and therefore unable to effectively create a seal. When nursing a tongue tied baby, the shallow latch will cause pain and a compressed (misshapen and/or blank) nipple, mom is at a higher risk of mastitis and plugged ducts as the breasts cannot be emptied, and supply is bound to gradually decrease till it dries up altogether. Other tell-tale signs of a tongue tie include baby making clicking sounds when nursing and being unable to lift their tongue to the roof of their mouth when crying.
Some mothers (especially those with oversupply) succeed in exclusively breastfeeding tongue-tied babies, but they are a minority. Many wonder whether to intervene or not, as most doctors are convinced the problem will solve spontaneously with time, but again this happens only in a minority of cases, if ever. Tongue tie also affects digestion, pronunciation, teeth and facial structure, and possibly brain development. If you suspect your baby is tongue-tied, please consider investing some time and resources into getting professional help as soon as possible and solving the problem once and for all. The earlier you intervene, the easier it will be for your baby to regain full mobility of the tongue.
A few ob-gyns all over the country (including Dr Chung at Mediflower and midwife Rosa Kim will revise ties even right after birth, but if your baby has a posterior tie and/or a lip tie, Yoon ENT Clinic in Ansan (윤이비인후과) appears to be your best option, although they often schedule appointments when baby is at least 4 weeks old. The procedure involves laser and takes only seconds; babies don’t suffer much — laser is an anesthetic in and of itself — and are encouraged to nurse right afterwards. No anesthesia is necessary.
Following the revision (and if possible just before too), visiting a chiropractor is recommended, seen as babies compensate for the restricted movement in their tongue with tension in their entire jaw and shoulder area. Chiro adjustments are recommended within 24 hours of the revision and at least a couple of times per week for a few weeks afterwards, to improve latch and help restore optimal function. Also, the revision site should be stretched and massaged a few times a day for a couple of weeks to prevent reattachment of the tie and to make sure the tissue does not shrink when healing recreating a restriction.
Instructions on how to perform stretches can be found here.
To keep up supply, mums should pump with a hospital-grade pump after each feed. Korean brand Cimilre has good quality, inexpensive pumps, and Medela rents them out too.
Supplementing at the breast is recommended if intervention is delayed; moms can choose between a Lact-Aid (shipped from the US) and a Medela SNS (somewhat less practical but available in Korea; contact email@example.com to order one). A tutorial on how to use these devices is available here.
If necessary, galactagogues (supply-improving herbs) can also be taken; these include Motherlove’s MoreMilk Special Blend, Shatavari, Goat’s Rue, and Moringa Oleifera (mostly available on iHerb).
Tongue tie is a very common problem and on the web there is a lot of info about it; the most reliable sources include the following: