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Common problem or old wives’ tale?
The resurgence of interest in breast feeding has been accompanied by a lively debate about the significance of “tongue tie” or ankyloglossia. Symptoms attributed to tongue tie include nipple pain and trauma, difficulty in the baby attaching to the breast, frequent feeding, and uncoordinated sucking. These problems may result in the mother deciding to terminate breast feeding prematurely, slow weight gain for the baby, and even hypernatraemic dehydration. Speech defects have also been attributed to tongue tie. Strong views have been expressed by many eminent authors on the subject (box 1).
Box 1: Quotes from the past
“In observing a very large series of newborn babies, we have never seen a tongue that had to be clipped” (McEnery and Gaines, Chicago,1940)
“While tongue tie is not nearly as common as members of the public believe, nevertheless a genuine case is occasionally seen and the condition is not entirely mythical although surrounded by an aura of superstition and old wives’ tales” (Cullum, UK, 1959)
“Tongue tie…has been described as a myth of hoary antiquity…but it is probably wrong to suggest that it never causes symptoms. A case is reported in which a tight fraenum ruptured spontaneously during feeding…this baby remained a slow feeder and…(had not been) disabled by his tongue tie” (Smithells, London, 1959)
“Tongue tie is a rare but definite congenital deformity” (Browne, London,1959)
“Tongue tie is a rare cause of dysarthria, though it is often blamed for slow speech development…most patients who have real limitation of movement as a result of tongue tie have a history of difficult milk feeding” (Ingram, Edinburgh, 1968)
“I have never seen feeding difficulties in the first year resulting from tongue tie and I doubt whether it is ever necessary to carry out an operation on it till …
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