Tongue-tie care steps for the best outcomes
by Laura Gruber, IBCLC
If you suspect that your baby has a lip or tongue-tie, take a deep breath and read this whole article before scheduling a tongue or lip tie consult with a dentist or ENT. Trust us, following the care-steps discussed below (with rationale explains) will genuinely optimize your baby’s feeding outcomes:
1. Slow down. Learn the basics about infant oral restrictions—and then let the experts guide you. Avoid building anxiety surrounding your baby’s mouth or feeds, and lean on others who are experienced and professionals in managing feeding challenges…there is always a way to stabilize and optimize feeding, we promise. Rest assured that you are not alone and that breastfeeding isn’t over or permanently impacted because your baby has an oral restriction (remember that oral restrictions don’t go away just because you decide to bottle feed…bottle fed babies also need the same level of support so finding good general support is imperative).
2. Before rushing to see a pediatric dentist (or ENT, in some markets), and regardless of whether your baby breast or bottle feeds, see a lactation consultant who practices from a rehabilitative perspective…this means she will know how to assess and correct breast and bottle feeding in the context of oral-restrictions (not all IBCLCs are trained or experienced with oral restrictions and that is ok, but if your concern is an oral restriction, seek one out with established experience examining infant mouths/bodies and creating care plans for babies with varying degrees of oral-motor challenges). By seeing an oral-rehabilitative IBCLC first, not only will she help stabilize your breastfeeding and milk supply potential, she will also help strengthen and optimize your baby’s oral-motor abilities so that once a procedure is done, your baby recovers and nurses better faster (BUT OFTEN, she could optimize your breast or bottle-feeding to the point your baby can nurse without a procedure. Yes! That’s an actual possibility!).
Equally as important, your lactation consultant will know which providers have the best long-term outcomes, low reattachment rates, be a better match for a particular type of oral-restriction, etc.. An experienced lactation consultant will also have a network of other providers she will refer you to for supportive care based on what she identifies will help (infant speech paths, OT/PT, chiro, etc.). Ideally, your baby won’t need all the things but if they do, someone who knows the scene will be able to refer you to who is best at what your sweetpea needs.
3. An oral-rehabilitative IBCLC should teach you mouth-strengthening and massage techniques tailored to your baby to help prepare them for their pediatric-dental/ENT assessment (pro-tip: An IBCLC needs to enter a baby’s mouth to fully understand what’s going on in and around it…if she doesn’t offer a thorough oral-assessment, consider consulting someone who will.).
Babies who see frenectomy providers after oral-strengthening present stronger oral muscles, better coordination and less overall tension, often giving dentists and ENTs more accurate assessment-fields and a better representation of what a baby CAN do instead of what they CAN’T do, which helps provides better plan their procedures and care.
4. Once your baby and your breastfeeding have received a proper assessment, and once a strengthening and coordination plan has been followed for as long as suggested, it’s time to see the pediatric dentist for an assessment, and possibly a frenectomy or revision (terms that indicate the procedure that releases a frenulum or oral tie).
5. Once the procedure has been had (or once your baby’s dentists determines they don’t need it, or that they need it after further habilitiave-steps are taken), make sure to see your lactation consultant within days to reassess latching, tie up loose feeding ends and help you plan for the quickest yet lasting recovery for your baby’s mouth.
Whether you schedule your lactation care with The Breastfeeding House or with another IBCLC, we hope that this article not only offered you baby-steps for developing a standard for your baby’s oral-motor care, but has also offered you general wisdom in navigating your breast or bottle feeding-troubleshooting journey.
🤱🏽
Laura Gruber, IBCLC has been working with tongue-ties infants since 2010. She’s help curate the local expert scene among frenectomy providers by not only encouraging their training and development in a field that SA desperately needed developing, but also by collaborating with other providers to teach them about how oral restrictions impact breastfeeding.
If you suspect that your baby has a lip or tongue-tie, take a deep breath and read this whole article before scheduling a tongue or lip tie consult with a dentist or ENT. Trust us, following the care-steps discussed below (with rationale explains) will genuinely optimize your baby’s feeding outcomes:
1. Slow down. Learn the basics about infant oral restrictions—and then let the experts guide you. Avoid building anxiety surrounding your baby’s mouth or feeds, and lean on others who are experienced and professionals in managing feeding challenges…there is always a way to stabilize and optimize feeding, we promise. Rest assured that you are not alone and that breastfeeding isn’t over or permanently impacted because your baby has an oral restriction (remember that oral restrictions don’t go away just because you decide to bottle feed…bottle fed babies also need the same level of support so finding good general support is imperative).
2. Before rushing to see a pediatric dentist (or ENT, in some markets), and regardless of whether your baby breast or bottle feeds, see a lactation consultant who practices from a rehabilitative perspective…this means she will know how to assess and correct breast and bottle feeding in the context of oral-restrictions (not all IBCLCs are trained or experienced with oral restrictions and that is ok, but if your concern is an oral restriction, seek one out with established experience examining infant mouths/bodies and creating care plans for babies with varying degrees of oral-motor challenges). By seeing an oral-rehabilitative IBCLC first, not only will she help stabilize your breastfeeding and milk supply potential, she will also help strengthen and optimize your baby’s oral-motor abilities so that once a procedure is done, your baby recovers and nurses better faster (BUT OFTEN, she could optimize your breast or bottle-feeding to the point your baby can nurse without a procedure. Yes! That’s an actual possibility!).
Equally as important, your lactation consultant will know which providers have the best long-term outcomes, low reattachment rates, be a better match for a particular type of oral-restriction, etc.. An experienced lactation consultant will also have a network of other providers she will refer you to for supportive care based on what she identifies will help (infant speech paths, OT/PT, chiro, etc.). Ideally, your baby won’t need all the things but if they do, someone who knows the scene will be able to refer you to who is best at what your sweetpea needs.
3. An oral-rehabilitative IBCLC should teach you mouth-strengthening and massage techniques tailored to your baby to help prepare them for their pediatric-dental/ENT assessment (pro-tip: An IBCLC needs to enter a baby’s mouth to fully understand what’s going on in and around it…if she doesn’t offer a thorough oral-assessment, consider consulting someone who will.).
Babies who see frenectomy providers after oral-strengthening present stronger oral muscles, better coordination and less overall tension, often giving dentists and ENTs more accurate assessment-fields and a better representation of what a baby CAN do instead of what they CAN’T do, which helps provides better plan their procedures and care.
4. Once your baby and your breastfeeding have received a proper assessment, and once a strengthening and coordination plan has been followed for as long as suggested, it’s time to see the pediatric dentist for an assessment, and possibly a frenectomy or revision (terms that indicate the procedure that releases a frenulum or oral tie).
5. Once the procedure has been had (or once your baby’s dentists determines they don’t need it, or that they need it after further habilitiave-steps are taken), make sure to see your lactation consultant within days to reassess latching, tie up loose feeding ends and help you plan for the quickest yet lasting recovery for your baby’s mouth.
Whether you schedule your lactation care with The Breastfeeding House or with another IBCLC, we hope that this article not only offered you baby-steps for developing a standard for your baby’s oral-motor care, but has also offered you general wisdom in navigating your breast or bottle feeding-troubleshooting journey.
🤱🏽
Laura Gruber, IBCLC has been working with tongue-ties infants since 2010. She’s help curate the local expert scene among frenectomy providers by not only encouraging their training and development in a field that SA desperately needed developing, but also by collaborating with other providers to teach them about how oral restrictions impact breastfeeding.
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