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Ankyloglossia
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- Numerous newborn babies have a strand of tissue (frenulum) underneath the tongue that anchors the tip of the tongue to the floor of the mouth. This might restrict the protrusion of the tongue when the baby cries. The tongue might not protrude past the gum line or protrude from the mouth during crying.
- Many years ago it was common to have a minor surgical procedure to clip the frenulum, with the intention of preventing breast-feeding problems and speech problems. After the frenulum was clipped, the tongue could protrude more.
- This minor surgical procedure is done only rarely now in the United States, because it is felt that the growing child is quite able to protrude the tongue, even though it looks like the tongue cannot protrude in the newborn nursery.
- This is a much-debated condition among parents, physicians, lactation consultants, and speech pathologists. Some feel that the procedure is not done often enough now, and that the child is forced to wait until speech problems develop, before the frenulum is clipped.
- If the frenulum can "stretch," or is very thin, as it usually is, the tongue can protrude past the gum line, even if the baby appears to have a short frenulum.
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- Inability to protrude the tongue past the gum line where the lower teeth would be located. During breast-feeding, the tongue does not protrude forward enough to make a tight seal on the mother's nipple. The baby's mouth falls off the breast frequently. The baby does not get enough milk, despite breast-feeding many times per day.
- The mother might have cracked, sore nipples.
- The baby might not suck well on the breast.
- The baby might have poor weight gain.
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- Diagnosis requires that the inability to protrude the tongue actually interferes with breast-feeding, or speech.
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- The frenulum can be clipped as a surgical procedure, usually with local anesthesia for pain relief. This procedure is rare in the United States.
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- If an infant actually is tongue tied, this could interfere with breast-feeding, or speech, as mentioned.
- Excessive bleeding is a complication of the surgical procedure to clip the short frenulum.
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- Discuss the tongue protrusion, or lack of tongue protrusion, with your child's physician. The physician will probably want to see evidence that a short frenulum is actually causing a problem with breast-feeding or speech.
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