Tongue strap cleavage

Cleavage of the hyoid

It may have been brought to your attention by the midwife or other health care provider that your baby has a short tongue. Below we will explain what this means and what can be done about it. We are trained to perform this operation, you can always contact us by phone. Also if you are under care elsewhere you can contact us about cleaving.

What is a short tongue?

The tongue belt (frenulum linguae) is the membrane that attaches the tongue to the bottom of the mouth. We speak of a short tongue tie when the tongue tie is very tight or short or when it extends to close to the tip of the tongue. This often manifests as a deformation of the tongue into a V-shape when lifted or into a heart shape when protruded. A short tongue belt may result in limited mobility of the tongue.

Problems that can occur with a short tongue length

A short tongue can cause problems with breastfeeding and drinking from a bottle. It is important to recognize this condition early, to avoid further problems with breastfeeding and unnecessary switching to artificial infant feeding. Splitting the short tongue can also prevent various long-term problems not specifically related to breastfeeding. These include breathing problems, problematic mouth motor skills, unfavorable palate formation, snoring, tooth decay and speech problems.

Symptoms that may further indicate a short tongue are:

Noisy drinking with a clacking sound
Frequent loosening of breast or bottle because baby cannot hold vacuum
Poor growth due to inability to drink effectively. Painful nipples and/or nipple fissures in the mother Congestion or just insufficient milk production Mastits (breast infection)

Advantages and disadvantages of tongue cleaving

Advantages

When there is a short tongue, the advice is to cleave as soon as possible, preferably within 24 hours. The child can then immediately learn a good sucking technique which will prevent feeding problems in the child and discomfort for the mother (as described above).

Longer-term benefits are:

less difficulty in pronouncing certain letters better hygiene of the teeth because the tongue can easily pass along and behind the teeth good formation of the palate by correct pressure of the tongue better oral motor skills such as being able to stick out the tongue or lick ice cream less respiratory disorders due to correct tongue position in the mouth

Possible disadvantages

The risk of complications is very small since the tongue is only a thin membrane connecting the floor of the mouth and the tongue. If the midwife is in doubt or if there is a thicker tongue belt with blood vessels running in it, she will refer you to a plastic surgeon for further treatment.

Complications that may occur are:

More than normal bleeding, normally no more than a few drops of blood will occur Infection of the wound In a few cases, it will be necessary to repeat the treatment later in life when there has not been sufficient result

Cleaving the tongue

Cleaving the tongue is a minor procedure. Your baby will be swaddled so it cannot move its arms. The maternity nurse or one of the parents will hold the head still. The midwife will insert a spatula into the mouth, exposing the tongue strap and protecting the tongue. Most children do not like this action and will often cry for a while. Next, the midwife gives one or two nips to cleave the tongue belt to the base. Any drops of blood are wiped away with gauze after which you can pick up the child immediately and comfort him or her. Our experience is that children are very quickly satisfied again and do not experience any disadvantages from the cleft. After the cleft, the child can be fed again directly from the breast or bottle.

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