Will Tongue-Tie Surgery Help Your Baby Breastfeed?

You want to breastfeed your newborn baby, but they just won’t latch. Maybe their attempts to latch are even hurting you. Could a tongue-tie be the problem?

“A lingual frenulum is a band of connective tissue, almost like a small string, that connects the base of the tongue to the floor of the mouth,” explains pediatrician Heidi Szugye, DO, NABBLM-C, IBCLC.

“Sometimes, the lingual frenulum causes the tongue to not move well, which can cause latching difficulties, breastfeeding issues or a painful latch that we call ankyloglossia, or a ‘tongue tie.’”

The procedure to clip and correct tongue-tie has become increasingly common in newborns. It’s been shown to help with breastfeeding — but it’s not always the answer.

Dr. Szugye explains the advantages and disadvantages of the tongue-tie procedure and what to consider first.

Pros and cons of tongue-tie surgery

If your healthcare provider suspects that a tongue-tie is the cause of your baby’s latch issues or your nipple pain, they may suggest a tongue-tie surgery, which has been reported to improve both. This procedure is also sometimes called a lingual frenotomy or just a frenotomy.

It’s a quick procedure, done using medical scissors or a laser, and it removes the connective tissue.

“This essentially frees your baby’s tongue for a broader range of movement and, hopefully, an easier time latching,” Dr. Szugye says.

But there are a number of factors to consider before having it done.

It may help your baby breastfeed

Not all babies with a tongue-tie have breastfeeding difficulties, but breastfeeding difficulties are more frequently reported in babies with tongue-ties. And if a tongue-tie is at the root of your baby’s breastfeeding problems, a frenotomy may very well solve the problem.

“A tongue-tie can limit the movement of the baby’s tongue,” Dr. Szugye says. “If it’s attached at the very tip of the tongue, it can pull your baby’s tongue into a heart shape.”

This prevents them from being able to make movement needed for pain-free and effective feeding, like:

• Sticking their tongue out past their lower gum line.
• Lifting their tongue.
• Moving their tongue from side to side.
• Cupping their tongue (moving it into a bowl-like shape).

In this case, once the connective tissue is removed, your baby can freely move their tongue again — and start latching better.

It comes with minimal risks

A frenotomy is a quick procedure that takes just a few minutes, but as with any surgery, there are potential risks. Though rare, possible risks of tongue-tie surgery include:

• Bleeding.
• Infection.
• Pain.
• Damage to the saliva ducts or nerves under the tongue.
• Oral aversion (reluctance to feed).

Your child may not be a candidate for it

Not every baby is a candidate for tongue-tie surgery. There are some reasons a baby should not have a frenotomy, including certain bleeding or neurologic disorders.

It might not solve your breastfeeding issues

In general, Dr. Szugye says that more parents than not report an improvement in their child’s pain and latching abilities after tongue-tie surgery. But there’s a chance the procedure will not help improve breastfeeding — in which case, you’ll have to continue to pursue a solution.

Other causes of their feeding issues may include:

• Improper feeding positioning or latch.
• Oversupply or undersupply.
• Breast anatomy.
• Parental infection.
• Craniofacial anomalies.

“If the tongue-tie isn’t what’s behind your baby’s pain or breastfeeding difficulties, it’s not likely to help,” Dr. Szugye clarifies, “or it may be a piece of the puzzle but not the complete fix.”

What to try instead of tongue-tie surgery

Before you pursue a frenotomy for your baby, it’s important to rule out other possible causes of latching difficulties. See a professional who’s trained in lactation and can assess a feeding.

“We always want to investigate and eliminate other causes of poor latch or nipple pain before attributing it to a baby’s tongue-tie,” Dr. Szugye says.