Don’t ever let anyone tell you breastfeeding is easy. It’s not. It may be natural, and it may be a good thing. However, it’s not something you or your baby inherently know how to do correctly from the start. It is a learned art form, and you and your new baby must practice getting it right. Unfortunately, some things out of your control may impede a successful breastfeeding relationship. One of the more common obstacles is tongue tie and lip tie.
What are tongue tie and lip tie?
A tongue tie is a lingual frenulum (the membrane under the tongue) that is either too tight or too thick, causing the baby to not have the proper range of motion in the tongue to attach to the breast, suck and swallow effectively1. 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 time without taking in a lot of milk.
Similarly, a lip tie is an abnormally tight membrane connecting the upper lip to the upper gums2. Babies with a lip tie can have trouble creating a good seal with their lips at the breast. This can cause the baby to swallow a lot of air during breastfeeding, often making these babies gassy and fussy.
Babies can have one or both of these conditions, but both are often present.
How is it diagnosed?
Some common first indicators to watch out for include sore, cracked or bleeding nipples, recurring plugged ducts or mastitis, baby isn’t gaining weight well, has difficulty latching, makes clicking sounds when nursing, or chokes frequently3. A tongue and/or lip tie is typically diagnosed by a pediatrician, pediatric dentist, or lactation consultant. There is a specific protocol for checking for a tongue or lip tie. You can find a helpful guide here.
How is it treated?
Fortunately, revising a tongue or lip tie is a quick and easy procedure1. Talk to your pediatrician and ask for a referral to an ENT or a pediatric dentist who has the training to do a frenotomy or frenectomy. Some doctors use lasers, while others use specialized scissors to cut or remove the membrane. This will release the tongue or lip and allow for a free range of motion. Some doctors will use a local topical anesthetic, but general anesthesia is unnecessary for the procedure.
Can I ignore it?
You can, but depending on the severity of the tie, it may not be a good idea4. There are potential problems for infants with unrevised lip and tongue ties. These include orthodontic issues, dental decay, speech, and esthetic problems1. As an adult, a lip and/or tongue tie can cause difficulty speaking, eating, drinking, breathing, and kissing. Additionally, adults can have common side effects such as poor oral and dental health, tongue thrust, TMJ disfunction, sleep apnea, and reduced overall quality of life5.
Finding out your perfect, precious baby has something “wrong” with them can be scary, but this 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 from 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 trained to look for tongue and lip ties that I discovered our issue.
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. 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 think your child may have a tongue tie or lip tie, do not hesitate to consult with your pediatrician. You don’t have to live with pain or infections, struggling to nurse your baby as I did. Getting your child’s ties revised as soon as possible is the best thing you can do for your breastfeeding relationship!