Call the Provider: Tongue Ties with Dr. Begun

“We recently discovered that our newborn has a tongue tie. What does this mean and do we need to do anything to fix it?”

Answer: “To snip or not to snip,” that is the question I get from new parents as they struggle with breastfeeding and try to figure out if their baby is tongue tied, or has ankyloglossia, the medical term for this finding, which is present in 3-5% of all newborns, and some estimate as high as 10%. But really all babies have some degree of “tongue tie” and the only question is whether it affects feeding – either breastfeeding or bottle feeding.

As a hospital and office-based pediatrician, I am confronted with newborns with varying degrees of tongue ties from mild forms to severe. A tongue tie is present when the anterior bands of skin restrict the movement of the tongue and impact the ability of a newborn to latch on and maintain that latch to successfully feed.

After it is determined that the tongue tie is affecting breastfeeding or bottle feeding, I discuss the risks and benefits of the procedure. I advise parents that it is a simple procedure with extremely low risk, and the potential benefits are great. My medical assistant or nurse holds the baby securely while I make a small snip with a pair of sterile scissors under the tongue to release the tension of the strip of skin between the base of the mouth and the tongue. Minimal bleeding follows after which the baby breastfeeds, takes a bottle or sucks on a pacifier for several minutes, which generally stops the bleeding quickly. Frequently mothers immediately report vast improvements in breastfeeding and more stable latches. 

I instruct mothers to perform massages to the area three times a day for 10 seconds, pausing at the end of the stretch with the tongue lifted up. Follow-up is recommended three weeks after the procedure. Usually, mothers report an improvement in the latch and more successful breastfeeding, translating to good weight gain and a better bonding experience between mother and baby. I prefer to snip the tongue tie in the first week of life, but if the tongue tie is thin enough, I will snip it up to two months of age. For thicker, more complicated cases I refer to an experienced ENT as there may be more bleeding which can be better managed with a ears, nose and throat specialist.

Dr. Jay Begun has provided pediatric primary care for over 20 years. Hehas a special interest in the care of newborns, including the evaluation and treatment of tongue ties. He also has experience treating children with chronic conditions, genetic diseases, and dermatological conditions, including warts and molluscum contagiosum.

Dr. Begun sees patients once a week at RefuahHealth’s Twin Avenue location.