What is a Lip/Tongue Tie?

There is a small bit of tissue underneath your tongue and lip called the frenulum. When the tissue is too short or thick, it can restrict the movement of the tongue or lip. This can make it difficult for babies to eat, which can harm their growth and nutrition. If the issue is not corrected, it can continue to affect them as they age, impacting their quality of life and development, such as speech delays and dental problems.

What are the Signs of a Lip or Tongue Tie?

Many children are diagnosed with lip or tongue tie shortly after birth. There are several signs your child may have the abnormality, such as:

• Poor latch when nursing.
• Slides off nipple or falls asleep when trying to latch.
• Colic or reflux symptoms.
• Poor weight gain.
• Gumming or chewing on the nipple while nursing.
• Unable to hold a pacifier in the mouth.
• Unable to use a bottle.
• Difficulty lifting or sticking the tongue out.
• Tongue has a heart-shaped appearance.

Mothers may experience signs of lip/tongue tie. These include:

• Sore or cracked nipples.
• Low milk supply.
• Inflammation of the breasts.

My Thoughts as a Pediatric

Dentist and as a Mother

When I had my first child, everyone said pain with breastfeeding is “normal.” I looked for guidance on so many things as I learned how to be new mom.  Breastfeeding was the biggest challenge of all.  I was in pain 5.5 months.  I knew frenectomies were controversial and I didn’t want to put my baby though a procedure if I could avoid it - if it was only me that might suffer but not him.  I did bring him to a frenectomy course I had to see what instructors had to say.  They all agreed he had a posterior tongue tie and recommended removal.  At this point the pain was decreasing and he was eating solids so I still did not have it done.  And he was fine.  He ate fine, his face is great, etc.  That is his story.  That is not true for all kids or moms.

I have seen children that are healthy weights with moms willing to continue with the pain but breastfeeding frequently and what's most worrisome - having kids gag on every food they try, over and over again.  My doing a frenectomy on this very orally restricted child helped him tremendously with eating and the parents felt more at ease.

For my second child, I knew I had mastered the art of technique with breastfeeding and yet it was all happening again.  At 1 week I did the frenectomy and she breastfeed great thereafter - better feeding, less waking, great.  But it was sad seeing her suffer as she healed.  I tried out a diode laser with her as that is the only laser our office had.  I had heard that healing was not as good with a diode - more painful due to a burning effect it uses (different from CO2 laser).  I had my husband use it on my frenums too so I could know what the healing process/pain was like.  It was very painful for 2 weeks, and just uncomfortable the 3rd.  I vowed to never use a diode laser.  Surgical instruments or CO2 lasers are known to have better healing.

My third living child was a premie.  After 2 months of going back and forth to the highly experienced lactation consultant, he still had not gained 1 pound since birth.  She recommended the frenectomy as we had tried everything.  I was a little worried as premies have trouble figuring out nursing and I knew with healing sometimes children have trouble nursing as they heal.  I sought out a dentist with a CO2 laser.  His nursing did not improve at first.  Everyone (the pediatrician, my mom, etc) seemed to tell me “just give formula” rather than struggle with all the pumping as he stopped nursing completely.  It was honestly good advice for me but I still had a flicker within that I knew I could try longer.  However, daily I would try to latch and eventually after maybe 6 weeks my baby was latching and only needing some formula supplementation every day and I could avoid the pump!

My point is every story is different.  I feel passionately about remembering the risk to benefit ratio and am interested in hearing your story.  If I can help you, I will.