Answering All Your Questions About Tongue-tie and Lip Ties -How They Can Affect Breastfeeding
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BREASTFEEDING AND TONGUE-TIE
TONGUE TIE, LIP TIE AND BREASTFEEDING – ANSWERING ALL YOUR QUESTIONS
Chances are good that you know someone who has been told they have a baby who is tongue-tied. That person may even be you. You may have heard conflicting information about breastfeeding and tongue tie.
Babies who have a tongue-tie often have difficulties with breastfeeding. However, the approach to it has changed over the years.
In this blog post I will answer all the common questions about tongue ties and other ties that can affect breastfeeding.
DIFFERENT TYPES OF TIES
While tongue-tie is the most common type of oral tie there are two other types of tie identified.
Lip ties and cheek ties. These types of ties are a fairly recent diagnosis within the last ten to fifteen years.
INCIDENCE OF ORAL TIES
The incidence of tongue and other ties has increased over the years I have been a lactation consultant.
This may be because we are aware of how they can affect breastfeeding as well as other things. When there is a problem we may be checking more often for a tie.
Or there may be some reason for the increase.
At the breastfeeding support group that I facilitate, and on the social media sites I am a member of ties are very commonly reported. They seem to be responsible for every breastfeeding problem. Sore nipples? Poor weight gain? Unrelieved engorgement? Moms are often told that a tongue-tie is probably the reason.
Tongue-tie definitely exists. And treating it can help certain breastfeeding problems.
I believe it should be treated sooner rather than later, especially when it appears that it could be the reason for a breastfeeding problem.
I will say that I am concerned that this is something that may be getting over-diagnosed, and worse, over-treated.
Let’s look at how often tongue-tie occurs, and how it can be treated.
The research reports an occurrence rate of just under 5%.
Some practitioners report a higher incidence. The reason they see a higher incidence is because they are seeing moms who are having problems. Most lactation consultants don’t see moms who are doing wonderfully.
When I see a mom and baby in the hospital, I don’t check the baby’s tongue unless there is a need to. It is rare that a mom comes to me as an outpatient just to make sure everything is going ok. I love it when they do, but it’s rare.
The vast majority of moms who are seeking out breastfeeding help is because they have a problem.
This is even more true with ENT’s and pediatric dentists. They only see babies who the doctor or the LC has concerns about, and suspect there is a tie that needs attention.
That may account for some practitioners who think the rate is higher.
WHAT IS THE MEDICAL TERM FOR TONGUE TIE AND LIP TIE?
Let’s talk about the different terms that you might hear that are used to talk about tongue-tie, as well as other ties.
A tongue-tie can be referred to by these terms:
- Short or tight frenulum
- Lingual frenulum
Tongue-ties can be classified, but since this isn’t a medical article, I’m not going to go into that.
Sometimes moms will refer to it as just a “tie.”
The medical term for an upper lip tie is a labial frenulum.
The medical terms for a cheek tie are buccal frenna, lateral frenna or possibly just buccal tie.
THE EFFECT OF TIES ON BREASTFEEDING
The impact that a tie can have on breastfeeding can be significant. Having it treated can sometimes make the difference between a successful breastfeeding journey and one that never gets going.
Prompt treatment is also important.
A tongue-tie that is visually obvious almost always has some kind of effect on breastfeeding.
Ties can affect breastfeeding in a variety of ways.
- Sore nipples
- Poor milk transfer
- Dehydration in baby
- Poor weight gain
- Low milk supply
Ties can decrease the amount of milk a baby can get milk out of the breast. This in turn can affect weight gain and milk supply.
Ties can affect nipple pain because the baby can’t get a proper latch.
OTHER THINGS THAT TONGUE AND LIP TIES CAN AFFECT
Ties can affect speech. If you try to speak without extending your tongue past your lower gum, or lower lip you will see how difficult that can be to speak normally.
They can affect dental health because we use our tongues to get food out of our back teeth.
It is believed that tongue-tie can cause reflux (Source).
A tongue-tie can even make it hard or almost impossible to lick an ice cream cone or lollipop.
People with tongue-ties have been described as not being very good kissers.
DO TIES ALWAYS CAUSE PROBLEMS
There are also ties that just don’t affect breastfeeding at all. Usually, they are not the ones that, as I put it, you can see from across the room.
A tie that does not affect breastfeeding is more likely to be a posterior tongue-tie or a labial tie.
WHAT DOES A TONGUE TIE LOOK LIKE?
A tongue-tied may reach all the way to the tip of the tongue.
It can cause a heart-shaped or notched tongue.
You may only notice it when a baby cries, or you may notice he is unable to lift his tongue up very far when he cries.
Just about every baby has some degree of lip tie, which, in the opinion of a pediatric dentist who spoke about it, probably means that some degree of lip-tie is normal.
Lip-ties can be the cause of nipple pain, and they can also result in a gap between the front teeth.
Some moms will notice that their baby’s upper lip rolls under when he breastfeeds. If there is no other problem, I think these ties should be left alone. Lip rolling like this can also be caused by low lip tone.
For more pictures of tongue-ties, you can Google the term and click on Images.
HOW IS TONGUE TIE TREATED?
If you are told, or if you think that your baby has a tongue tie, you can choose to do nothing, and take a wait and see approach. Not every tie needs treatment.
Ties can be released surgically, with scissors. That’s not quite as scary as it sounds. It is usually only 1-3 snips, and some babies don’t even cry. S
ome practitioners use some local anesthetic while others don’t.
Another popular treatment is using a laser to release the tie.
Doing stretching exercises after a tie is released can help ensure scar tissue doesn’t form, so be sure to ask about this.
OVER-TREATING TONGUE AND LIP TIES
Just as some health care providers will rarely treat a tongue or lip tie, others over-treat.
As a lactation consultant there are times when I am very confident that a tie is causing breastfeeding problems. There are other times when I am not sure if something needs to be treated but do think that a baby needs to be assessed.
It’s always up to the doctor or dentist to decide if and what kind of treatment is indicated.
If you are told nothing should be done but are still having breastfeeding problems I encourage you to get a second opinion.
WHAT TO EXPECT AFTER TONGUE TIP OR LIP TIE RELEASE
Improvement with latch and nipple pain may happen immediately. Moms have described it being like night and day after the tie is released.
A baby who was not getting enough milk out of the breast may also do much better after the procedure.
Health care providers often like moms to breastfeed immediately because this can help minimize bleeding.
Bleeding is typically minimal. A q-tip is all that is needed to clean it up.
I recommend following up with a lactation consultant if ties resulted in your baby not being able to get enough milk out of your breasts. The consultant can evaluate if that has improved and can help with strategies to improve milk supply if it was low.
If nipple pain was the only problem you were having and this goes away, there is usually no need for follow-up.
FINAL THOUGHTS ON BREASTFEEDING AND TONGUE TIE
If you are a breastfeeding mom dealing with tongue or lip tie I encourage you to do some research on your own. Especially if there is disagreement from everyone involved about what to do.
If you are having a problem, getting your baby’s tongue looked at by a specialist who would treat it, getting educated is a good idea.