Tongue or Lip Tied

Tongue-tie…. lip-tie…. say whaaauh….?? If you’re anything like me, you’ve never heard of ties. My exposure to them wasn’t pleasant but it didn’t have to be an issue. Our little Annie went through two months of colic but I knew in my gut that her gas and pain was a symptom of a bigger issue. I decided I wasn’t going to rest until I figured it out.

To save you the stress of this mess, start by asking your doctor to check your baby’s mouth before ever even leaving the hospital. Be prepared for the doctor’s hesitation to diagnose it and extend grace if they get it wrong. Ties can truly be hard to detect because there are two types; anterior and posterior ties. Since they can hide, a pediatric dentist is best qualified to identify this properly.

Before we get too much further, I think it goes without saying that the only medical degree I have is from Google. So now that we have established that I am no Meredith Grey, let’s clock in for a tongue-tie chat. Shall we?

Four reasons to suspect your child is tongue or lip tied:

  1. If you’re experiencing nursing discomfort,
  2. if they are crying or appear to have colic as a baby,
  3. they are struggling to gain weight or are losing weight at any age,
  4. or as an older child, show signs of a speech impediment.

Under the umbrella of these main issues, mothers may experience cracked or bleeding nipples, clogged ducts, mastitis, thrush or a compromised milk supply. For a baby, a latch issue may cause choking on milk and popping off the breast, making a clicking noise when swallowing, gumming or chewing the nipples and lots of drooling. This is obviously much easier to detect if breastfeeding, but it’s important to note that Annie was panicked at both breast and bottle. She couldn’t swallow, plain and simple.

What is a tongue or lip tie?

I’ll do a direct quote from the Mayo Clinic website as we agreed I’m not here to wear a white coat. “With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. A person who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows, as well as interfere with breast-feeding.” This is the gist of the lip-ties as well, tissue connecting the lip to the gum.

Does my child have a tongue or lip tie?

To know if your child has a tongue tie, stick your tongue out at them in hopes that they repeat the motion. A tied baby will have limited range of motion; for example, unable to touch front teeth with tongue, unable to move tongue side to side or unable to stick the tongue out beyond the lower front teeth. Another tell-tale sign is a tongue that appears heart shaped when it is extended. Basically, the tight tissue pulls the tip of the tongue back, ever so slightly, making the groove of the heart.

For the lip tie, one might see tissue connecting the lip to the gum, even down to the middle of the two front teeth. 

Being tied can run in families so if one of your children is tied, it might be worth checking your others.

What will they do to help my child?

I see no need to lie to you about this. They wrap those little, helpless bundles of crazy, crying joy into the tightest swaddle, put goggles on them and they “revise” the tissue with lasers. As an infant, there really isn’t much they can do to ease the pain other than anesthesia, which has problematic implications for them, so they go for it with Tylenol and milder / somewhat holistic numbing agents. The good news is that it is over just as soon as it starts and they can go straight to the breast or bottle for soothing.

For toddlers, they typically recommend leaving it alone unless it is causing speech or weight issues or until they weigh enough to lessen the risk of anesthetics. Of course, an assessment is best as each child is different. Ties can correct themselves but unfortunately, that usually comes at the cost of a face-plant and a lot of blood. It essentially just tears on its own.

What is the post-op care?

I’m sure this varies per case so again, please talk to your doctor. But to keep things from re-connecting, I was asked to stretch the tissue several times a day, for 2-3 weeks.  

I’m sorry, what’s that you say doc? You want me to pin her down, stick my fingers in her tiny mouth and rub all over her open wounds? Like you think I can actually get all of the poop off of my fingers after changing diapers for two kids all day and even if she doesn’t get an infection from her own feces, you think she is going to have anything to do with me after this harrowing experience?

Yeah, okay.

But to encourage you, I have a friend that had the procedure herself and she said that while the revision was immensely painful, it was over in 90 seconds. She said the stretches actually didn’t bother her at all and she is convinced that babies cry through them simply because big, huge, scary fingers are being stuffed down their mouths. And it makes sense because the very second I would take my finger out of Annie’s mouth, she would stop crying immediately.

The reason it continued to go undetected in Annie is because we both bypassed most of the symptoms. It truly manifested itself in her as a bad case of reflux. It would have been easy to settle on that and call it day. But momma, you’ve got to follow your gut. You know your baby so get those answers! Once discovering the ties, every doctor was blown away at how she had been able to continue gaining weight. Medical issues don’t always go by the book.

The revision was a game changer and I noticed a difference right way. The crying stopped, the gas was gone, she nursed in peace and the biggest gift of it all… she smiled for the first time at eight weeks. Bless her bones, her mouth was so tethered, she couldn’t even smile. And you know what, she hasn’t stopped smiling since. Seriously, the happiest baby I’ve ever known.

4 COMMENTS

  1. Thank you for writing about this. I am a Registered Dental Hygienist and Myofunctional Therapist here in Austin. I work with adults and kids on a daily basis who suffer from the ill effects a Tethered Oral Tie (TOT) has produced. I am elated that your baby’s tongue tie was caught early, as I am constantly educating parents about the effects of tongue tie including, narrow jaws, narrow airways, crooked teeth, open mouth posture, and open mouth breathing, TMJ, issues and sleep dysfunctions (apneas and upper airway resistance). In Brazil it is actually the law to check newborns for a tongue tie or restriction, and research has shown that their is a genetic component with tongue ties/restrictions.

    I do want to let readers know that most posterior tongue ties have anterior tie components, meaning many of those with an anterior tie also have a posterior tie. I also would like to share that having your child “stick their tongue out” is not a good indicator of a tongue tie. The true test involves the “elevation” of the tongue along with other assessments. Many children and adults are able to stick their tongues out (and some have extremely long ones), but they in fact do have a tongue tie (posteriorly).

    I also want to add that no tongue tie will correct itself…ever. However a “lip tie” which I think you meant to refer to, can on a rare occasion be ruptured upon a fall, or other injury, although it may not entirely sever.

    Thank you again for sharing, and again I am so happy that your little Annie’s TT was found early in life and not later!!!!

    Sincerely,
    Jill

    • Thank you, Jill! This is very helpful to clarify. We definitely want mommas to seek professional assessments and I hope to have simply empowered them to think outside the box of colic and gas.

      Mommas, go see Jill!!! I need a Jill for about every category on my #hotmessexpress of a train ride in this little life of mine. 🙂

  2. Thank you for posting this! My daughter was born with a tongue and lip tie and was dropping weight fast. We had a pediatric dentist revise her ties when she was 9 days old; by three weeks she was past the pain, nursing normally, and gaining weight. More doctors and parents need to be aware of ties, as they can cause a ton of problems early on and later down the road. Thanks for helping to get the word out.

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