Tongue Tie: Myths and Truths (Part 1)
Traversing the minefield that Google delivers you when you’re looking for information online about tongue tie almost requires a bomb-squad. So, let’s look at some myths and truths about tongue tie.
Firstly, there are a few terms used for tongue tie, including ankyloglossia, tethered oral tissues (TOTs), oral restrictions and ties.
In the normal development of a foetus, the frenulum tissue under the tongue recedes during the first months of pregnancy. When that tissue does not fully recede, a restriction remains. This is a tongue tie.
Let's cover 3 common statements that you hear about ties. Are they myths, or are they true?
Statement 1. Ties don't exist.
This is a myth. Straight up. Let’s talk about why.
References to tongue tie date back to Aristotle in the third century BC. There are also biblical references in the books of Job and Mark. In addition, statements regarding ties and their treatment have been published by the American Academy of Pediatrics (AAP), the Canadian Pediatric Society, and the American Academy of Pediatric Dentistry.
So the evidence is quite clear that oral restrictions do exist, and have existed in humanity for a very long time. There’s a separate argument that anterior restrictions exist, but that submucosal ones don’t exist, I’ll cover that in Part 2 of this blog.
Statement 2. Ties don't affect breastfeeding.
Some medical professionals will acknowledge that ties do exist, but they'll reassure you: it’s ok because they don’t affect breastfeeding. Again, this is a…myth, and anyone currently trying to breastfeed a baby with suggested tongue tie will likely confirm this too!
Here's a list of conclusions from studies showing that ties have a negative effect on breastfeeding:
The association between breastfeeding difficulty and tongue tie has been recognised for at least 500 years (Obladen, 2010)
Tongue tie can affect the way a child eats, speaks and swallows, as well as interfere with breastfeeding. (Mayo Clinic)
Free movement of the tongue is critical to the action of breastfeeding. (Geddes, 2008)
Most important of these is the research undertaken by Dr. Donna Geddes of the University of Western Australia.
In this video, you'll notice that the tongue creates a vacuum. You can see that if the tongue is restricted in any way, it’s going to affect that action and impact on breastfeeding.
In addition, this list of symptoms was registered by mothers in a recent study.
Poor latching; falling asleep while attempting to nurse; creased, flattened or blanched nipples after nursing; gumming or chewing of the nipple when nursing; poor or incomplete breast drainage; slides off nipple when attempting to latch; severe pain when infant attempts to latch; cracked, bruised or blistered nipples; reflux symptoms; poor weight gain; colic symptoms; bleeding nipples; plugged (blocked) ducts; mastitis or nipple thrush; infected nipples or breasts. (Ghaheri, 2016)
The important thing to note is that in this study, and in every study conducted on tie release, improvements in symptoms were noted post-release for almost all participants. This means that the previously restricted tongue was definitely having a negative impact on breastfeeding.
Statement 3. Ties stretch as a child grows.
Which, you can probably guess is a… myth.
In this study from 2014, Professor Marchesan and her colleagues sought to understand the histological make up of the altered lingual frenulum.
'In ankyloglossia, bundles of elastic fibers positioned near the epithelial lining contribute to the restriction of the tongue movement, interfering with the oral functions. The highest concentration of type 1 collagen was detected in all types of lingual frenulum. Due to the fact that type 1 collagen is resistant to traction, stretching exercises may not be helpful to elongate the lingual frenulum.' (Marchasan, 2014)
The conclusion of the study was that lingual frenectomy (tongue tie release) may be considered the appropriate procedure to release the tongue in order to provide better oral functions.
So, there you have it; 3 common statements about tongue tie, and clear proof as to why they are myths.
Did you find this blog helpful? If so, I'd appreciate a like, share, or tag a friend who might need to read this information.
Have you discovered your infant or toddler has a tongue tie, and you're wondering what your options are? Don't worry, I've got that covered! You can sign up here for an instant download of my pre-recorded webinar: Navigating Tongue Tie Release.