Everything New Parents Need to Know About Lip and Tongue Ties

During the week following your delivery, you’re going to start picking up on your baby’s habits, feeding and sleeping schedule, and triggers for fussiness. While it’s normal for there to be an adjustment period, especially in regard to nursing, there are some instances that can indicate a problem. If you notice any signs of discomfort while feeding your baby, difficulties with nursing that persist after leaving the hospital, pain while breastfeeding, or slow weight gain, your baby may have a lip tie or a tongue tie. While there are several reasons that these problems could be occurring, physical characteristics of your baby’s mouth need to be addressed to ensure that they’re receiving the nutrients they need to develop. To help you further understand this physical anomaly, here’s everything new parents need to know about lip and tongue ties.

What Does it Mean to Be Lip or Tongue Tied?

Your tongue is held in place by a membrane that’s known as the lingual frenulum. This is the membrane that stretches along the underside of your tongue and connects to the floor of your mouth. Everyone has a frenulum that secures your tongue and helps facilitate speech, but sometimes it can be too tight, too thick, or too short. In these instances, movement is restricted, and the lingual frenulum interferes with regular functions of a newborn’s tongue. When this occurs, it’s called ankyloglossia, which is commonly referred to as tongue tie.

Causes of Tongue Tie

Tongue ties are present before your baby is born. In babies without ankyloglossia, the lingual frenulum shortens, stretches, and partially disappears while they’re still in the womb. The frenulum is still attached, just more prominently at the back of the tongue rather than the front. This facilitates greater ranges of movement that can help secure a baby’s latch and support easier communication as they age. There are various types of tongue ties that are used to classify how severe the connection is. However, it’s difficult to pinpoint a definitive cause of ankyloglossia. It seems to have something to do with genetics and boys are often more affected than girls, but research is still needed to further classify the underlying cause.

Lip tie occurs when the tissue that connects your upper lip to your mouth is too short or tight, which results in limited movement of the upper lip. The affected tissue is called the maxillary labial frenum, which can be felt when you extend your tongue up between your front teeth and your lip. The cause of lip ties is similar to tongue ties. It stems from fetal development, has genetic implications, and tends to affect boys more often.

Signs of a Lip or Tongue Tie

Signs and symptoms of lip and tongue ties can affect both mom and baby. During breastfeeding, mothers may experience any of the following:

• Sore, blistered, cracked, or bruised nipples
• Mastitis and blocked ducts
• Misshapen or blanched nipples after feeds
• Low milk supply
• Over supply of milk
• Exhaustion
• Distress and overwhelm

   

  Some common signs of lip or tongue ties that occur in babies include:

   

• Poor weight gain
• Trouble staying latched on
• A clicking sound while nursing
• Sputtering or choking with fast flowing milk
• Excessive breathing through the mouth
• Gassiness
• Colic or fussiness
• Frequent feedings
• Forward head posture during nursing
• Clenching of the jaw
• General problems with breastfeeding
• Jaundice

It should be understood that if your baby is tongue tied or lip tied and does not experience any problems, the condition is harmless. As long as they’re able to latch properly, get enough food, and don’t show signs of discomfort, treatment isn’t necessary. As your baby gets older, you may notice some difficulties with speaking, but these can be addressed with a speech therapist and practice.

Do Lip or Tongue Ties Affect Breastfeeding?

Due to the anatomy differences in a baby who is lip or tongue tied, breastfeeding is inevitably affected. A tongue tie reduces your baby’s mobility of their tongue, which can make it difficult or impossible to properly latch during breastfeeding. The impact this anomaly has tends to depend on the extend of the restriction, so it’s important to monitor your baby for hunger cues and signs of fullness. While lip ties can still have an effect on breastfeeding, they’re often not as debilitating as tongue ties. Again, the degree breastfeeding is affected depends on the severity of the tie. The biggest problem with lip ties is a shallow latch, which can restrict the amount of milk that your baby gets during feedings.

Diagnosing a Tongue or Lip Tie

The best way to clearly identify a tongue tie or lip tie in your baby is to get the proper diagnosis. Due to the physical nature of lip and tongue ties, the diagnostic process is simple and straightforward. Your baby’s tongue will be examined to see how restricted the frenulum is, range of motion will be tested, and latching problems will be identified. Many lactation consultants are able to perform an accurate diagnosis and help mitigate any breastfeeding problems that children are experiencing. Undergoing a prompt diagnosis is the best way to address the problem early and ensure that your breastfeeding relationship does not become strained or impossible to continue.

Treatments for Lip and Tongue Ties

After undergoing a professional diagnosis, your doctor or lactation consultant may recommend undergoing surgery to fix the problem. In this case, you’ll be referred to an Ear, Nose, and Throat (ENT) doctor to discuss your options. Some of the most common treatments for lip and tongue ties include a frenotomy and a frenuloplasty.

• Frenotomy – also known as a frenulectomy, this surgery is performed by a licensed doctor who snips the frenulum using a scalpel, laser, or special scissors. It’s a quick procedure that can be performed without anesthesia in young babies because their nerve endings haven’t fully developed yet. While it might seem a little scary as a new mother, the earlier you do this, the better. It can be performed as an outpatient procedure, and you can return home the same day with minimal recovery.

   

• Frenuloplasty – after your child surpasses the three-month milestone, a frenuloplasty should be performed. Since the frenulum has now thickened and developed more nerve endings, this option ensures that the process is pain free. Frenuloplasty surgery is performed under general anesthesia and the process requires stitches for the incision to properly heal. The stiches are dissolvable so that no follow up treatment is required to finalize the process.

You may also be able to improve your baby’s latching success by taking the time to soften your breast before feedings. Softening your breast involves pushing fluids away from the nipple so that your baby can develop a strong latch. To do this, place your fingertips around the base of your nipple and apply a gentle, yet steady, pressure for a minute or two. You can also take steps to improve your baby’s tongue mobility by reclining back with your baby on top of you. The natural gravity of this position can help improve the success of a latch. Practice sticking your tongue out at your baby to ignite imitation and try to encourage your baby to lick milk from their lips or from your nipple before and after feeding to help lubricate the area. If you’re still struggling and want to try all possibilities before surgery, talk to your lactation consultant about using special nipple shields that can facilitate a stronger latch.

Babies who are born with a lip or tongue tie often grow up and have no further problems or complications. As long as the anomaly doesn’t cause problems, treatment isn’t needed. In some cases, children who have lip or tongue ties can have difficulties speaking clearly, but there are plenty of options for speech therapy during development. Since each child is different, work with your doctor to determine the best course of action. In the meantime, to help ensure that your baby is getting the nutrients they need for a healthy development, Byram Healthcare offers a wide selection of insurance covered breastfeeding pumps to new and expecting moms. Browse our breast pump product selection guide and get started with our easy, three-step ordering process today.