What is Tongue/Lip-Tie?

“To understand what you’re looking for, you must first understand the basics about tongue and lip ties. Medically, this condition is usually known as “Tethered Oral Tissue”. Tongue ties are also referred to as “Ankyloglossia”.

Tongue and lip ties are caused by thick or malformed oral tissues. Tongue ties are caused when the lingual frenulum (the membrane which connects the tongue to the floor of the mouth) is thick, short, or otherwise malformed.

Lip ties are, essentially, the same thing. This condition occurs when the frenulum which connects the upper or lower lip to the gums is thick, too short, or is otherwise improperly formed, causing mobility issues with the lips.”

-Colorado Tongue Tie website

What Are the Common Signs That My Baby Has TLT?

A baby may be experiencing any of the following:

• Be unable to latch onto the breast at all

• Be unable to latch deeply onto the breast, causing pain to the mother’s nipple(s)

• Have difficulty staying on the breast, making clicking noises during feedings

• Cannot handle a fast flow or letdown and starts spluttering or choking

• Breastfeeding constantly to get enough milk

• Fatigue or restlessness during feedings

• Poor weight gain or need to supplement to maintain and gain weight

A mother may experience:

• Pain during the feedings, possible nipple damage

• Nipple may be creased down the middle or look lipstick shaped when baby unlatches

• Blocked ducts, mastitis, engorgement issues

• Oversupply due to frequent pumping to stimulate the breasts or baby feeding so frequently to get enough milk

• Frustration or discouragement

• Early end to breastfeeding

How Can We Correct TLT?

As an IBCLC, I can not diagnose Tethered Oral Tissues (TOTS) but I can tell you what I am observing during my assessment and give you the proper referrals to receive the formal diagnosis.

It all begins with our consultation together, I will go over feeding history with you and we will discuss anything out of the ordinary and start pulling information together. I will observe a breastfeeding session and/or bottle feeding session and point out different things about latch, baby’s position, the way their jaw is moving, the way their lips are positioned and let you know what I want to see and what I don’t want to see during a feeding session. Once a feeding is done, I will do a complete oral exam that assesses tongue and lip movement, underneath the tongue and lip, inside the cheeks, and will check baby’s suck reflex and how their tongue is moving during that. As I go along during the observation, I will point out what I am seeing and feeling and we will also take a few pictures so I can point to exactly what I am observing.

I will offer you a customized plan of oral exercises and stretches for your baby to help prepare you and your little one leading up to the revision date. These are important for several reasons and help aid in the process. The tongue is a muscle and we need to strengthen it!

A tongue (lingual), a lip (labial), and buccal (cheek) ties can be revised in a few different ways, the dentists that I refer patients to use a CO2 laser for the procedure and you can read more on their websites.

We will go over education, I will answer questions, and then we will discuss the next steps. The journey towards a revision is not a one stop shop, we need to build a team along the way.

The first step will be choosing which provider you are wanting to go to for the revision itself and the second step will be choosing which and what type of bodyworker you would like to have treat your baby. Oftentimes, the bodyworker will let you know during your visit or reach out to me, as your lactation consultant, with how many visits they are guessing your baby might need leading up to the revision. I will then send my referral paperwork to the release provider of your choice. I like to see you and your baby at least once again prior to the revision and then will see you at least once 1-3 days post-revision. This continuity of care is important in making sure we give your baby the best possible start to healing properly.

Who is Involved in the Correction?

• Lactation Consultant - ME!

• Dentist that is skilled and trained in TOTs (tethered oral tissue) revisions

• Bodyworker - a chiropractor trained in treating newborns, craniosacral therapist, occupational therapist, physical therapist, or a skilled osteopath. “The bodyworker administers this physical therapy in order to relieve tension in the baby’s body, which strengthens and lengthens the muscles – especially those associated with breathing and breastfeeding. Bodywork also helps support neurological integration, the process by which the baby learns to control and move their body. There can be issues with reduced neurological in Caesarean or mechanically assisted births, so bodywork can help redress this issue by giving the baby the natural stimuli that they may have missed due to the birthing process.” - KidsTowndentist.com

How Long Does it Take?

As much as I wish it was as quick as the snap of my finger for everything to be perfect and “normal,” it is going to take some time. While we may see some initial changes, it is normal for baby to go back to their known/comfortable way of breastfeeding. Usually we see that about 4-6 weeks from time of revision to when we start seeing the benefits and up to 6 months for full benefits.