Don’t ever let anyone tell you breastfeeding is easy. It’s not. It may be natural and it may be a good thing, but it is not something that either you or your baby inherently knows how to do perfectly from the start. It is a learned art form and both you and your new baby have to practice to get it right. Unfortunately, there are some things that are completely out of your control that may impede a successful breastfeeding relationship. One of the more common obstacles is tongue and/or lip ties.
What is tongue & lip tie?
A tongue tie is a lingual frenulum (the membrane under the tongue) that is either too tight or too thick that causes the baby to not have the proper range of motion in the tongue to attach to the breast, suck and swallow effectively. This condition can cause a wide range of issues when breastfeeding such as a baby who can’t maintain a latch long enough to take in a full feeding, to a baby who stays on the breast for a long period of time without taking in a lot of milk.
Similarly, a lip tie is an abnormally tight membrane connecting the upper lip to the upper gums. Babies with a lip tie can have trouble creating a good seal with their lips at the breast, which can cause the baby to swallow a lot of air during breastfeeding which often makes these babies gassy and fussy.
Babies can have one or both of these conditions, but more often than not, both are present.
How is it diagnosed?
Some of the common first indicators to watch out for include sore, cracked or bleeding nipples, recurrent plugged ducts or mastitis, a baby who isn’t gaining well, has difficulty latching, makes clicking sounds when nursing, or chokes frequently. The best person to correctly diagnose a tongue and/or lip tie is a lactation consultant. There is a very specific protocol for checking for a tongue or lip tie, and you can find a good guide here.
How is it treated?
Fortunately, having a tongue or lip tie revised is a quick and easy procedure. Talk to your lactation consultant and ask for a referral to an ENT or a pediatric dentist who has been trained to do a frenotomy or frenectomy. Some doctors use lasers and some use specialized scissors to cut or remove the membrane which releases the tongue or lip and allows for free range of motion. Some doctors will use a local topical anesthetic but general anesthesia is not necessary for the procedure.
Can I just ignore it?
You can, but depending on the severity of the tie, it may not be a good idea. The potential problems for infants with unrevised lip and tongue ties include orthodontic problems, dental decay, speech problems and esthetic problems. As an adult, a lip and/or tongue tie can cause periodontal disease, esthetic problems with smile lines and poor oral hygiene.
I know finding out your perfect, precious baby has something “wrong” with them can be scary, but this is something that can be quickly and easily remedied. Both of my babies had tongue and lip ties. For the longest time after my daughter was born, I couldn’t figure out why we had such trouble with breastfeeding. For over a year, she and I struggled to breastfeed (we found a way to make it work but I suffered with painful cracked and bleeding nipples and she had colic, reflux and choked a lot while nursing). It wasn’t until I consulted with a lactation consultant who was trained to look for tongue and lip ties did I find out what our issue was.
At 14 months old, my daughter had her ties revised by laser. I wish I had done it so much sooner, but I ultimately chose to have it done despite her age because I didn’t want her to have dental and speech issues. When my son was born two years later, we had him evaluated immediately and his ties were revised (with a laser) when he was three days old. It made a world of difference in our breastfeeding journey.
If you feel like your child may have a tongue or lip tie, do not hesitate to consult with a lactation consultant. You don’t have to live so long with pain or infections, struggling to nurse your baby like I did. Getting your child’s ties revised as soon as possible will be the best thing you can do for your breastfeeding relationship!