Ankyloglossia (or short frenulum) is the presence of a tissue under the tongue that joins it to the lower part of the mouth restricting its movements.
Formerly the child was diagnosed and remedied at birth, but with the decline in the popularity of breastfeeding in the 40s and 50s, treatment ceased to be common.
With the return to the natural diet the short frenulum has been identified again as a problem and therefore it has been diagnosed and treated again.
The tongue plays a very important role in breastfeeding because it helps to properly breastfeed and is responsible for making wave movements, from front to back and compress the milk from the areola to the nipple.
In case there is ankyloglossia these wave movements or the same extraction of the tongue is very difficult. This makes the shots be long, tired and less efficient.
Babies compensate for the short bridle in several ways:
- Using the jaw to increase pressure on the chest, causing a sensation of biting or chewing (the nipple comes out of the deformed, compressed or pinched child's mouth).
- Using lips instead of tongue to express milk.
Even doing this often hurts and causes cracks, since finding a suitable position is more complicated than with babies without this problem.
What seems to be a good position for these babies is something like "a horse" (see photo). Sitting on the mother's legs and directing the nipple to the upper lip so that it opens the mouth wide, make a slight extension and place the breast with the lower lip and the tip of the tongue as far from the tip of the nipple as possible.
If the baby chokes in this way, the same maneuver can be performed while the two are lying down so that the stream of milk does not go directly to the throat.
A baby with a short bridle runs the risk of growth retardation if you have strict schedules or if your chest shots are limited.
It is important (and urgent) to diagnose and treat it as soon as possible. It is not a matter of life or death, but if it makes breastfeeding difficult, it is hindering the proper feeding of a newborn baby. If it also hurts and causes cracks, added to the duration of the shots, it becomes a perfect "discouragement" (I invent the word) of nursing mothers.
The treatment is very simple. It is called a phrenotomy and involves cutting the frenulum with sterile scissors under local anesthesia. It causes very little bleeding and is a procedure with very few risks. The baby can almost always start breastfeeding immediately after the operation and the mother notices the difference right away.
The problem is that it is not usually considered an urgent problem and it is up to the pediatrician (or the mother) to move heaven and earth to find someone to do it as soon as possible.
I even know the case of a pediatrician (Luís Ruiz) who after trying to convince surgeons that it was an urgent intervention for a long time decided to learn to do it himself.
I am the father of a child who was born with hookworm and I could see my wife's face when her brace was cut a month later and she sucked without causing pain or cracks. Imagine the face of relief and the "Ohh, this is something else."
If we had known before ...
