Introduction

The birth of a child into a family brings about much excitement in terms of a blessing and growth. Nonetheless, rearing the infant to the point where they become independent in carrying out activities is associated with a myriad of challenging tasks. For instance, when the baby cries, it is difficult for the parents to identify the problem or what it wants. Therefore, most mothers conclude that the baby might be hungry or need a diaper change. The breastfeeding process to most mothers entails a painless and stress-free experience (Ritter, 2013). However, research indicates that there are instances when women feel pain when breastfeeding immediately after the child is born. The painful experience serves as an indicator of a problem that requires prompt attention with breastfeeding assistance. Resolving the issues regarding the painful latching process necessitates assistance from a lactation consultant who may guide the mother on the improvement procedures. Nevertheless, there are times when the latch appears bigger but still causes major pain to the mother. The occurrence of such a situation indicates the possibility of a tongue tie condition. According to research, the diagnosis of the tongue tie condition has become a common occurrence these days and the determination of its cause leads to a variety of conclusions (Ritter, 2013). The essence of this paper entails determining what the tongue tie condition is and whether it affects the breastfeeding process. Additionally, it will discuss why the condition has become prevalent over the past few years. These will be followed closely by elaboration on the potential treatment methods that may be applied.

Discussion

The phrase tongue tied brings about a mental depiction of an individual facing the challenge of speaking eloquently to the public through loss of words and stammering. Contrastingly, the tongue tie condition entails a medical condition that creates significant effects too many people through the implications that occur when breastfeeding the infant. The clinical term used to describe the condition is ankyloglossia which occurs as a result of a long thin, thin piece of tissue located under the baby’s tongue, the frenulum (Ghaheri et al., 2016). This piece of tissue fails to stretch or becomes shorter than the required length thus hindering the tongue from moving around freely. The babies with the tongue tied condition; the frenulum becomes attached to the varying parts of the tongue and the floor of the mouth. For instance, there are some whose frenulum is attached to the tip of the tongue while in others it is located further back thus causing shortness or tightness (Ghaheri et al., 2016). Over the years, the diagnosis and treatment of this condition occurred at birth with the aim of preventing difficulties in breastfeeding and speech in babies. However, during the 1940s and 1950s people detested the breastfeeding process thus leading to a decline on the treatments procedures. However, as the process became resurgent, the tongue tie condition became identified as a potential problem. Researchers thus focused on the subsequent identification of diagnostic and treatment procedures suitable for supporting breastfeeding mothers.

Under normal circumstances, the features of the frenulum include thin, elastic or long in a way that facilitates free movement of the tongue past the lower lip. Additionally, the unrestricted movements of the tongue allow the baby to breastfeed or speak properly (Kumar and Kalke, 2012). Nevertheless, the occurrence of the tongue tie condition in the infant is characterized by a short and tight frenulum that inhibits him/her from breastfeeding properly. These characteristics lead to the compression of the mother’s nipple when they are breastfeeding the baby which results in severe pain. Moreover, research indicates that such incidents occur in about 4 to 11 percent of new born babies and mostly in male infants. In some of the cases reported or encountered, babies with the tongue tie condition have the ability to attach to the breast and feed properly. Contrastingly, most of these infants encounter various challenges while breastfeeding (Kumar and Kalke, 2012). These challenges include damage to the mother’s nipples, low rates of weight gain for the baby and poor milk transfer which leads to a recurrent blockage of the ducts, also known as mastitis, which emanates from ineffective ways of removing milk.

Research reveals that the assessment procedures of whether a baby has a tongue tie condition applied over the years have necessitated the observation and examination of their tongue’s movement. The presence of the tongue tie condition leads to recommendations of ways of improving the latch as well as referral to physicians and dentists specialized in the frenotomy procedure (Emond, 2015). This procedure focuses on the removal of the frenulum through cutting with a pair of scissors or in some cases a laser which allows free movement of the tongue and hence breastfeeding. According to research-based on the procedure, the process does not require anesthesia in that it entails the performance of a task for less than a minute (Emond, 2015). After cutting off the frenulum, the baby is immediately placed on the mother’s breast and the feeding process occurs normally with a reduction or complete eradication of the pain.

Most importantly, studies based on the human anatomy indicate that the length of a normal baby should be about 16 millimeters by the time he/she attains 18 months of age. Under these circumstances, the tongue should have the ability to extend beyond the lower lip to facilitate licking and lift at the front part/ tip to touch the roof of the mouth (Douglas, 2013). However, in the presence of a tongue tied situation, the tongue lacks the ability to extend beyond the lower lip and its tip may be forced downward. Tightness in the tongue leads to elevation of the rear part while the tip is left tied down to the floor of the baby’s mouth. This condition is referred to as tongue humping in which attempts to lift the tongue results in the development of a dent at the tip similar to the top shape of a heart. Furthermore, movement along the sides of the tongue would lead to more lift as opposed to the center (Douglas, 2013). When babies with the tongue tied condition attempt to reach any side of the mouth, they may twist the tongue thus causing an inability to bring the tip to the back of the gums. The severity of the condition hinders the baby from moving the tip of the tongue towards the ridge of the lower gum (Douglas, 2013). Similarly, when the tongue is positioned over the ridge of the gum, it hinders the bite reflexes of the baby. When the mother’s breast touches the baby’s bare lower gum, the latter’s reflexivity will drive them to bite it.

Besides, research indicates that information regarding the tongue tied condition and its adverse effects to breastfeeding are new encounters in the healthcare literature and most of the times practitioners fail to realize or recognize it. Nonetheless, contemporary studies in the United States, as well as the United Kingdom, have focused on the identification of its effects and the use of frenotomy in resolving the issue (Boyle, 2013). For instance, in a study aimed at determining the why the tongue tie condition affects breastfeeding, the researchers found that babies require the ability to cup the breast with their tongues. This ability facilitates the removal of milk from the breast in an efficient way. However, anchorage of the tongue to the mouth of the floor hinders the baby’s ability to suck the milk in that they lack the ability to open their mouths wide enough to accommodate a mouthful of breast tissue (Boyle, 2013). Resultantly, the baby feeds from the nipple because it is not deeply launched into the back of their mouth and rubs against his/her palate from time to time during the process. The prevalence of such circumstances brings about nipple trauma for the mother.

Some of the reasons behind recent cases the tongue tie condition includes the fact that previously, only the anterior incidents would be recognized. The conditions were easily identifiable as it started at the tip of the tongue. Nonetheless, most doctors were not willing to snip or cut the tie thus leaving mothers to suffer the pain or switch to feeding their infants through the bottle (Ito, Shimizu, Nakamura, and Takatama, 2014). Contrastingly, over the past few years, incidents of posterior tongue tie have emerged and physicians have also developed advanced ways of treating the condition through lasers for the most delicate surgeries. Further research in this field has diverted its attention to environmental factors with the association of specific gene mutation as the major cause of the condition. Some of the other common methods used in identifying the prevalence of tongue tie include looking at the baby and sticking your tongue out. Most infants develop the tendency of imitating others and such behavior will facilitate the determination whether he/she has the ability to extend their tongue outwards (Ito, Shimizu, Nakamura and Takatama, 2014). Most importantly, some of the signs and symptoms outlined through research include pain or damage of the mother’s nipple, loss of suction while feeding and the presence of a clicking sound. These may be followed closely by the presence of a striped mark on the mother’s nipple or a flattened appearance after breastfeeding the infant and a significant loss of weight for the baby.

Diagnosis and Treatment Procedures

The identification of a tight or short frenulum in the baby should serve as an indicator of tongue tie and the parents need to consult their doctor for evaluation purposes. Although the number of practitioners willing to handle such conditions is few, there are some who have the ability to snip the frenulum without causing any effect to the baby’s feeding or speech. Similarly, the determination of whether the baby needs evaluation for treatment depends on the efficient functioning of the tongue (Griffiths, 2013). In instances where the frenulum appears very tight but does not affect the baby’s feeding, swallowing of gaining weight, there is less concern. The specialized practitioners who have the ability to deal with restrictions in the lingual frenulum include otorhinolaryngologists. They deal with issues associated with human ears, noses, and throats, also known as ENTs. These may be coupled with oral surgeons, general dentists, and pediatricians. These specialists utilize different treatment options in dealing with the tongue tie condition. One of these options, mostly the simplest and common methods, entails frenotomy which results in less bleeding and reduced risks (Griffiths, 2013). Nevertheless, infants react differently to this procedure as there as some who may breastfeed immediately while others take about more than one week.

Most importantly, practitioners may assist mothers through the provision of support and information regarding the treatment options (Barton, 2014). In the event that a child has undergone tongue tie treatment and needs assistance in breastfeeding, the mother may consult the myofunctional, lactation or feeding therapists. These specialists may assist the mother in treating the sore parts of her breast as well as those of the infant.

Conclusion

The baby’s tongue plays a significant role during the feeding process in that it facilitates the pulling of the breast into the appropriate position inside their mouth. The tongue also furrows in a way that makes a channel through which the breast is placed inside the infant’s mouth. The furrow further facilitates catching of the milk and holding it at the back of the tongue before it is swallowed. According to research conducted through ultrasounds and cineradiography studies (motion picture x-rays), the tip of the tongue brings about elevation and entrapment of the milk in the front part of the breast. This is followed closely by a wave that brings about a compressed movement to the back of the tongue thus leading to swallowing of the milk. These aspects occur as a result of the ability of the tongue to move around freely. However, restrictions of the tongue due to a short or tight frenulum hinder achievement of vital procedures in the breastfeeding processes. These procedures bring about other effects such as the development of mastitis, severe pain, loss of weight for the baby, just to mention but a few. However, the identification of the condition at an early stage would facilitate an easier treatment. Therefore, further research needs to be conducted on the other factors leading to the occurrence and prevalence of the tongue tie condition.