Caring for Your Tongue-tied Baby
Tongue-tie, or ankyloglossia, is a tightness of the frenulum affecting 4-10% of the population. It prohibits full range of motion in the tongue. It is common, but the degrees to which it affects a person varies. Both lip-ties and tongue-ties can affect different things such as ability to nurse for babies, speech development, and even something as simple as licking an ice cream cone later in life.
Maureen Thompson is a Mississippi mom who learned firsthand what it’s like caring for a lip-and tongue-tied baby. She shared her experience with Mothers & Babies to hopefully help those in a similar situation.
Mother of two
My daughter was lip- and tongue-tied. I knew something was wrong when nursing hurt to the point of tears. She couldn’t latch properly, so was clamping down during feeds. Unfortunately, no one in the hospital was qualified to diagnose the ties. It was suggested that I just needed to ‘toughen up my nipples,’ but that was misguided advice. Within a few weeks of leaving the hospital I bought some pumping supplies and rented a hospital-grade pump to ensure my body would keep producing milk.
Getting a lip- or tongue-tie professionally evaluated is not easy. Typically, only certain dentists and lactation consultants are thoroughly educated in this area. It was very challenging to get the answers needed. My spouse and I debated about the validity of limited research and whether a frenectomy (a surgical procedure that involves the removal of one or both frena from the mouth) was worthwhile to us. We researched our options – surgical scissors vs laser – and went with laser. We were not fully prepared for what that process would be like, despite all my googling. For the sake of brevity, I’ll just say that the experience was somewhat a disaster. Between the surgery and the required aftercare (waking your baby and rubbing the wound every few hours), it was torture for all. The worst part was it didn’t fix the ties in her case. Despite that, I breastfed my daughter for 21 months, alternating between breast and bottle.
Throughout our journey, I reached out to many providers and support groups for help. The Le Leche League, International Board-Certified Lactation Consultants, and a medical supply place that let me rent a hospital-grade pump, were vital in my breastfeeding goals. Facebook groups and the Kelly Mom site were also beneficial. No matter how you feed your baby or what you decide to do, please know there are support groups and resources out there.
Though figuring out how to care for our lip- and tongue-tied baby was a traumatic experience and we wish we had more information and better support, we learned a lot from this experience and came out stronger. The good news is we are all more educated and everyone is healthy.
If you or someone you care about it struggling with breastfeeding, please don’t be discouraged. I am tongue-tied. My daughter is tied. My son was also evaluated and determined lip-tied (it causes a gap between his front teeth). My daughter requires speech therapy. I will probably get my tie addressed at some point with the dentist that evaluated my son. ‘Why would you do that?’ you may be asking. After seven years of Spanish classes I’d really like to be able to roll my Rs!
Registered nurse, specializing in maternal/child nursing and International Board-Certified Lactation Consultant. She owns Gulf Coast Breastfeeding Center, LLC, and has helped over 2000 babies with oral restriction (tongue and lip ties) in the last 5 years.
Many parents have no idea their infant has a tongue- or lip-tie. They do know that feeding often is a struggle, be it breast and/or bottle-feeding, and one that continues despite all they do to address it. Others may suspect ties, but when they address them with their providers, they are often told either it’s not there, or “it isn’t enough to cause issues,” even though the whole reason parents bring it up is they are having issues with feedings, often significant issues.
If parents are struggling, they should continue to look for answers. They should reach out to others that may have had the same issues and find someone who is experienced in screening and diagnosing oral restrictions and also can provide referrals to those providers who can revise them.
Not every baby with oral restriction/ties needs revision. They may benefit from help mitigating the symptoms that accompany ties, such as reflux, colic, gas, etc. They may need other therapies such as bodywork that includes, but isn’t limited to, pediatric chiropractic care, myofascial therapy, cranial sacral therapy, speech/language therapy or a combination of these for optimal outcomes.
If a revision is required, it depends on the type and degree of restriction as to the procedure and the aftercare performed. For instance, if it’s a Posterior Tongue-Tie, laser revision by a preferred provider is recommended.
Emilee Peeples Milling
Pediatric Dentist at Milling Pediatric Dentistry in Jackson
Q Is surgery required every time for a lip or tongue-tied baby, if the child is able to feed? Can untreated condition lead to dental problems later in life?
A According to the American Academy of Pediatric Dentistry, the appearance of the tongue- or lip-tie alone does not necessitate surgery. If symptoms such as reflux, difficulty feeding, failure to thrive, or painful breastfeeding for the mother are present the infant may benefit from a minor surgical procedure to relieve the tongue- or lip-tie, also known as a “frenectomy.” If none of the aforementioned symptoms are present, then surgery is not indicated in a child with a tongue- and/or lip-tie. It is possible that in the future, a frenectomy may be recommended if the child’s speech is affected, gingival recession is noted, or as part of an orthodontic treatment plan.
Q If the child does undergo a surgery, will dental hygiene be different from that of a child born without lip- and tongue-tied condition?
A Several case studies have shown that children with a maxillary lip-tie have a higher rate of decay of the anterior maxillary teeth due to residual breastmilk or formula being retained in the area following feeding. Dental decay can occur for many reasons, so further research is necessary to find a direct correlation of a lip-tie and dental decay.
Q Any words of encouragement for new parents who just found out their child is born with this condition?
A In recent years, a 90% increase in the frenectomy procedure has been seen. Many children with a lip- and/or tongue-tie do not have any negative symptoms associated with this condition and are fine to proceed without surgical intervention. Infants and children that do have associated symptoms may benefit from a frenectomy. The procedure itself is safe and unlikely to cause post-operative problems. The topic of frenectomies remains a controversial issue among professionals because the procedure’s success varies from patient to patient. If parents are concerned about their child’s lip- or tongue-tie, opening up the conversation to the child’s pediatrician or pediatric dentist is a great first step in determining if the child would benefit from a frenectomy.