Tongue Ties and Lip Ties

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What are lip ties and tongue ties?

LIP TIE:    A tight upper lip frenum (maxillary labial frenum) may restrict lip flanging, appear tense during breastfeeding, and cause a shallow latch. The tight upper lip may trap milk, resulting in decalcification (soft spots) and tooth decay. If the frenum attaches close to the ridge and is thick, a future diastema (gap between the teeth) can occur.

TONGUE TIE:    A tongue-tie (ankyloglossia) is an embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal movement. It may appear as a cupping or heart-shaped tongue when the tongue lifts. This can result in an inability to get the tongue under the nipple to create a suction to draw out milk. Long term, a tongue-tie may result in speech or feeding problems.  A tongue-tie may hinder the development of proper adult swallow, and be associated with a high palate, narrow dental arches, and crowded teeth.   Research has shown that approximately 5% of babies are born with tongue ties.

What symptoms are associated with lip ties and tongue ties?

To know if the ties are a problem, helpful questions include “Is baby getting enough to eat?” and “Is nursing comfortable for the mother?”

Baby’s symptoms can include: poor latch, slides off nipple or falls asleep while attempting to latch, colic symptoms, reflux symptoms, poor weight gain, continuous feedings, gumming or chewing of the nipple, clicking sound while nursing, unable to take a pacifier or bottle, upper lip curled under while latched, upper lip does not flange, coughing or choking while nursing, and milk runs out the side of the mouth while latched on the breast or bottle.

Mother’s symptoms may include: creased/cracked/bruised/blistered/bleeding nipples, severe pain when baby latches, poor or incomplete breast drainage, infected nipples or breasts, plugged ducts, mastitis, nipple thrush, low milk supply, and frustration or disappointment with breastfeeding.

What is a frenectomy?

A frenectomy or frenotomy is a procedure used to correct a congenital condition in which a frenum is too tight, causing restrictions in movement and function.

Some infants will show immediate improvement with breastfeeding after the procedure.  Most mothers find breastfeeding improves within 2-4 weeks.  Babies need time to learn how to use their newly released tongues and/or lips effectively.  It can take time to strengthen the muscles that were not used before the procedure.

What other therapies are recommended?

Releasing a tongue-tie or lip tie is only a piece of the puzzle. Babies may need additional attention from other providers especially if they are older and improper breastfeeding techniques have been established. It is important to follow up with a knowledgeable IBCLC (International Board Certified Lactation Consultant). Many tongue-tied babies benefit from bodywork or therapy from a knowledgeable chiropractor, cranial sacral therapist, occupational therapist, or physical therapist to address functional compensations affecting feeding. Older children and adults may benefit from seeing an Orofacial Myofunctional Therapist (OMT) and/or a speech and language pathologist (SLP).

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