The sublingual frenulum It is a thin fibromus membrane that lies under the tongue and that joins it to the oral cavity. Sometimes the frenulum is too short and prevents the correct exit of the tongue; this situation is known as ankyloglossia. Its importance lies in that it can hinder the initiation of breastfeeding. However, early treatment is quickly solved and successful breastfeeding can be achieved.

What is ankyloglossia and why does it occur?

The commonly called frenulum is a membrane located under the tongue, in its medial part, which joins it to the floor of the mouth. It depends on the frenulum that the movement of the tongue is adequate, and this has great importance so that the suction in breastfeeding is correct. Up to 15% of newborns may have a short lingual frenulum or ankyloglossia.

There are different types of ankyloglossia, depending on whether the frenulum is more membranous or fibrous, or if it is located in a more anterior or more posterior part, or if there is a partial or total fusion with the floor of the mouth (although this case is very rare). Even cases have been described in which it appears in several members of the same family, which could suggest a genetic origin. It is also associated with other syndromes, such as cleft palate or Fraser syndrome.

For breastfeeding to be effective the tongue has to perform four movements. If the frenulum is too short, they may be affected:

  • Extension: Extract the tongue to cover the lower gum, keeping it in this position while the shot lasts.
  • Elevation: raise the tongue in the direction of the palate to compress the mammary air and squeeze-milk the chest.
  • Lateralization: being able to move the tongue on both sides of the mouth.
  • Peristalsis: coordinated undulating movement that allows the correct swallowing of the milk.

Parents’ Guide to Tongue Tie (November 2019).