SEATTLE -- "Hi! Kyleigh! Do you want to stick your tongue out at me?" asked Seattle Children's Neonatologist Dr. Isabella Knox. She is an associate professor of pediatrics at the University of Washington.
Five week old Kyleigh, the subject of Dr. Knox's attention, seemed a little underwhelmed as she yawned in her mother's arms. She doesn't know how close she came to missing out on a baby's best nutrition.
"Your main problem was pain?" Dr. Knox asked Amy Young.
"Lot's of pain," Young replied.
In fact, that pain almost led Young to give up on breast feeding baby Kyleigh.
"I have had three other children that nursed and so I knew the tricks to try to get her to open her mouth really big and get her to latch on correctly. But she just wouldn't do it. And I was having so much pain," Young explained.
It turned out, the problem was under Kyleigh's tongue. It's called tongue tie. The medical term is ankyloglossia.
"This is that web that's almost to the tip of the tongue," said Dr. Knox, showing a slide of an infant with tongue-tie.
The condition was easy to spot in the slide. But it can be subtle as Dr. Knox explained.
"A band of tissue way at the back, and it's just as much of a problem I think because the back of the tongue has such important work to do during breastfeeding," she said.
Dr. Knox believes parents and doctors should check for tongue tie when a baby won't nurse. And she said the remedy is quick.
"The procedure involves lifting up the tongue, taking some tiny scissors, making a snip in that," said Dr. Knox.
"It's like, snip snip and we're done. And the parents are usually shocked that it's so fast," she said.
Amy Young was nervous about the procedure. Anesthesia has risks, so it isn't very often used. She described what happened the day she decided to have the treatment done for Kyleigh.
"They said get ready to feed her, so that you can comfort her, and by the time, I wasn't even ready, they were done. She cried for about thirty seconds. And then she latched on and she was completely fine," she said, clearly relieved.
That little snip made a big difference.
"She immediately at the first feeding, looked more relaxed. It's almost like she sighed, and took a deep "whew". She was getting more milk," Young said.
Why is breastfeeding so important to her? A mother's milk is tailored to her own child explained Dr. Knox.
"This is so miraculous, but the mother's body senses what bacteria are in the environment, makes specific antibodies against those, and puts them in the breast milk," said Dr. Knox.
That nutrition and the immune protection get a baby off to a healthy start.
Some pediatricians may not link tongue tie to trouble breastfeeding. One reason said Dr. Knox is that when she went through medical training just twenty percent of moms breastfed. Now, she said, that's up to eighty percent.
It turns out tongue tie runs in families. If it isn't corrected in infancy, children may need it reversed if they're fitted for braces later on.