Successful breast-feeding depends on multiple factors. One issue that can adversely affect the newborn's ability to obtain a correct latch is the presence of a tongue or a lip tie. The flap of tissue under the upper lip and under the tongue is called a frenum. The attachment under the upper lip is the maxillary labial frenum and the one under the tongue is the lingual frenum. An overly attached frenum may cause nipple pain, compressed or injured nipples and even mastitis. In addition, the newborn may make clicking noises with nursing, may have prolong feeding sessions, may have inadequate weight gain or may demonstrate irritability during and after breastfeeding. In newborns, the lip or the tongue frenum can be removed with a procedure called a frenectomy. The use of a laser to perform this procedure reduces discomfort and bleeding during and after the frenectomy. In the newborn, a topical anesthetic is sufficient to complete the procedure. In older children, a local anesthetic may be used. It is not necessary to put the child to sleep with a general anesthetic to have the frenum removed. Rarely does the child need any type of pain medication afterwards.
For more information Tongue-Tie and Breastfeeding.