Tight tongue tie

Due to challenged sucking technique, mother or child may experience one or more of the following:

Problems in the infant:

o The baby has difficulty getting a good grip on the nipple

o The baby may have too much grip on the nipple

o The baby may have difficulty maintaining a grip on the nipple and therefore frequently let go of the nipple

o The child makes clicking sounds

o The baby may suck in his cheeks when sucking on the breast.

o The baby is restless and/or crying when breastfeeding

o The child has insufficient or insufficient weight gain

o The child shows signs of physical discomfort with regurgitation, flatulence or signs of reflux

These problems can be experienced both when the baby is breastfed and bottle-fed.

Problems with the mother:

o Persistent pain in the nipples

o Sores on the mother's nipples

o The mother may experience the baby chewing, munching or biting the nipple

o Poor milk transfer from breast to child;

• the child does not achieve satisfaction

• the mother's breast is not emptying properly

• meals are long

o The mother does not produce enough milk due to poor milk transfer and lack of breast emptying

o Recurrent milk stasis in the mother due to the lack of emptying of the breast.

o Recurrent breast inflammation (mastitis) in the mother due to the lack of emptying of the breast.

If you are experiencing one or more of the above challenges and it is affecting breastfeeding or your baby's well-being, it may be a good idea to have your baby assessed by a specialist. We recommend that you first seek guidance from an experienced breastfeeding specialist who will examine your infant for a tight tongue & lip tie as well as any tensions or conditions that may be affecting your infant's breastfeeding, and consult with an experienced breastfeeding counselor.

Always remember to check whether your breastfeeding counselor is specially trained to treat infants and whether they have additional courses in breastfeeding.

Early intervention is crucial – research and experience show that intervention is most effective if it is done within the first two months of a child’s life. After that, the child may develop compensatory sucking techniques that may be more difficult to change.

Early treatment also provides the best chance of restoring natural tongue movement and supporting a safe and pain-free breastfeeding experience.

We always recommend an assessment by an experienced and well-trained breastfeeding counselor or other professional with experience and training in tongue-tie issues if you are in doubt.

Cutting a tight tongue tie is a quick and gentle procedure that only takes a few seconds and is carried out with great care for the child's safety and comfort.

At Charlottenlund Private Hospital, the procedure is performed under local anesthesia, which we have very good experience with.

Typically, parents are thoroughly informed about the procedure and have the opportunity to ask questions.

An assistant then holds the child's head, but the father or mother holds the child's arms and body so that the child does not move during the procedure. The doctor then applies a very small amount of local anesthetic (0.1 -0.2 ml) which needs a little time to take effect. In the meantime, you can easily hold and comfort your child. When the anesthesia takes effect, which occurs after a very short time, the procedure itself is performed.

The doctor uses sterile scissors and a tongue lifter to cut the thin strip of connective tissue under the tongue. If it is a thick posterior tongue band, the doctor cuts until the posterior tongue band is gone and the tongue muscles are visible in a rhomboid-shaped opening (called "the diamond" by some).

The cut itself takes a few seconds and usually causes minimal or no bleeding. As there are very large blood vessels in the floor of the mouth, on rare occasions you may experience heavy bleeding, which we then have to stop surgically. The risk of this is very small.

The child may briefly react to the handling itself, but rarely experiences pain, as the area has very few nerve endings and we always apply anesthesia around the posterior tongue and lip folds if these are also to be treated.

Immediately after the procedure, you will have the child brought to you as soon as the doctor deems it safe. There will typically be bleeding from the mouth, which may appear more than it is due to the saliva. We therefore do not recommend that parents show up wearing light-colored clothing, as it is impossible to avoid a little bleeding right after the procedure.

After the procedure, you will be offered a room to yourself, where the baby will be offered the breast to stimulate tongue function and create security for both mother and child.

Most children begin to move their tongue more freely immediately after, but the older the child is, the longer it takes to unlearn the compensatory techniques that the child has learned - so don't expect miracles immediately.

When parents and child are feeling well again after breastfeeding - or attempting to do so - you can go home.

As a general rule, massage or other follow-up treatment is not recommended in Denmark.

However, this is recommended in some places abroad and this simply emphasizes the large differences that exist from country to country.