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What Are Tongue and Lip Ties in Babies? What You Need to Know

Baby Mouth

While tongue and lip ties are common, there’s a good chance you’re unclear on what to look for in your baby. Here’s what you need to know.

Go to any parenting message board, and you will see talk of tongue ties. Everyone has an opinion on whether or not they are real, if treatment is warranted, and their at-home remedies to deal with the pain of feeding a child with a tongue or lip tie. 

Chances are that before giving birth, you had never really heard about tongue ties unless you knew someone who had one (or you happen to be a specialist in the area). Keep reading to learn more about what you need to know about tongue and lip ties in young babies.

Baby Mouth

How common are lip and tongue ties?

The fact is, tongue ties are quite common, ranging in prevalence from 3-16% worldwide (and in approximately 4.5% of newborns in the United States) Ricke, Baker, Madlon-Kay (2005).

Although you may not have heard of tongue ties before giving birth, this is not a fad. There are reports of midwives in the Middle Ages using a long pinky nail to perform a frenectomy (or tongue-tie release) on newborn babies.

In the United States, with a shift to formula feeding in the 1950s, bottle-feeding became the norm, and there were fewer diagnoses of tongue and lip ties. As the pendulum has swung back to favor breastfeeding, more parents are discovering the feeding difficulties associated with tongue and lip tie and are searching for answers.  

What are tongue and lip ties?

Tongue and lip ties are also called tethered oral tissues (TOTs) and are restrictions of one or more of the following: lip, tongue, or cheeks. These restrictions cause decreased mobility, which can lead to feeding difficulties or pain during breastfeeding.

As children grow, it can also lead to difficulty swallowing solid foods and speech (articulation) difficulties. The severity of tongue-tie can be determined by measuring the degree of restriction (or “Class”) or by assessing loss of function (Kupietzky & Botzer, 2005). Together, these measures help guide treatment decisions, such as the need for therapeutic or surgical intervention.

How do I know if my baby has a tongue or lip tie?

For new parents who are experiencing difficulty with breastfeeding, tongue and lip ties are often an overlooked solution. The most outward symptom of a tongue tie is bowing at the front of the tongue, which makes the tongue tip appear like a heart.  Not all TOTs are so visually apparent, however.  

Other issues that may have an underlying cause of a tongue tie are a weak suck or difficulty latching, a clicking sound during feeding from the breast or bottle, and little to no weight gain in the early weeks of life. Also, a baby with a tongue or lip tie may lose liquid from the sides of the mouth due to an incomplete seal or cause nipple pain and/or mastitis due to compensatory oral movements for breastfeeding.  

Parents may also notice that their child experiences colic or gas due to taking in too much air, reflux, or difficulty sleeping. So, yes, a tongue and lip tie can cause gas in babies.

Of course, tongue and lip ties are only one possible cause for these issues, and you should always consult with a specialist if you notice any of these symptoms. 

Another clue: transitioning to solids

It is possible that a tongue or lip tie was overlooked during the early months of life, and you notice that your child is having difficulty transitioning to solid food.

When solids are introduced, you may see that food is pocketed or held in the front of the mouth due to poor mobility or that a lot of food is spat back out due to a tongue thrust. Also, you may see that your child has excessive gagging when introducing solid foods.  

It may also be the case that your child had a tie treated during infancy, but there are now problems with solid foods. In this case, your child would benefit from some tongue mobility exercises to restore the appropriate range of motion and make sure that your child can safely enjoy eating new foods. 

Feeding Baby with Tongue Tie

How do you treat a baby’s lip tie?

In general, treatment involves a release of the tethered tissue using either laser or scalpel. The procedure is done as an outpatient procedure and is generally accomplished in less than 10 minutes without anesthesia because the tissue is so thin. 

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Following treatment, the doctor will provide you with mobility exercises that will need to be done several times per day over the next few weeks to ensure that the tie does not grow back. 

For children older than four months, you may choose to do exercises before a release to ensure a successful procedure.

When to look for help addressing tongue and lip ties

If you are experiencing any of the following, it is essential to seek consultation from a Preferred Provider: 

  • Pain during breastfeeding
  • Poor weight gain
  • Reflux
  • Loss of liquid during feeding
  • Clicking while eating

Who to turn to for help

Diagnosis and treatment of TOTs is specialized training, and as such, families should seek professionals with specific training in this area. A pediatric dentist or ENT performs the release of a tongue or lip tie. 

Post-op treatment and exercises are essential for continued success and may be offered by one or more of the following professionals:

  • Craniosacral Therapist (CST)
  • Lactation Consultant
  • Speech-Language Pathologist (with OMT training)
  • Occupational Therapist

Additional support

Jocelyn offers a monthly free live series to help parents support their child’s speech and language development. Also, she has a parent coaching program called the Tiny Talker Toolkit designed to help parents find their child’s unique learning style and enhance their language learning potential.

Hello Postpartum readers receive a $50 discount with code postpartum50 at checkout.

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