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Tongue-Tie Wisdom
Photo courtesy of Jaye Simpson,
CLE, IBCLC, RLC, CIIM, BT, BC
"Does my baby have a tongue (or lip) tie?"
If you're curious about whether or not your baby has a tongue or lip tie, you're in the right place for some words of wisdom from an IBCLC experienced in working with tongue and lip tied babies!
While IBCLCs cannot diagnose your baby with lip or tongue-tie, we can help you understand if the impact of your baby’s oral tethers can be mitigated for breastfeeding with positioning/hold, or if the tethers are symptomatic enough to to your nursing journey to require an appointment with an expert assessor/diagnoser/treater of tongue and lip tie, since experienced assessors such as pediatric dentists and ENT who have studied infant oral structure can tell you if early feeding is all that will be impacted by your baby’s oral restriction. Some types of oral restrictions impact other area of life and are first seen with how a baby feeds so consulting an expert for any “degree” of restriction in your baby’s mouth is important.
Tongue-tie outcomes are greatly optimized by working with a tongue-tie knowledgeable IBCLC before getting an assessment from a pediatric dentist or ENT. From knowing the local tongue-tie care landscape, to helping coordinate and strengthen baby’s oral muscles to help avoid a tongue-tie release or minimize procedure impact, to making the right referral to the provider that can best assess your baby (not al providers are versed in all types of oral tethers), seeing an experienced IBCLC (like yours-truly) before and after a frenectomy (release of tongue-tie) will help your baby heal faster, decrease a baby’s chance of reattachment, and will help families avoid unnecessary steps
Interestingly, some tethers aren’t obvious to untrained parents or medical staff, but an experienced IBCLC who listens to a parent’s report of pain, assesses nipple-injury patterns and watches baby’s oral and body movements at the breast can help families to form a game plan-and that game plan can range from helping a baby to loosen their whole body vía massage, helping a baby to strengthen their oral muscles, or the game plan could be see an expert and licensed expert on tongue and lip ties.
During an “investigation”, an IBCLC will help manage, stabilize and protect breastfeeding (latch, nipple pain, milk supply, etc.) so that once oral issues are resolved, original breastfeeding goals can still met.
Also, a point to ponder is that what may seem like a “tie” may simply be restricted/sore muscles from a difficult birth, swaddling and other positional issues.
Avoid taking shortcuts...
For the best outcomes, don't take shortcuts in tongue-tie care. Too often we work with families who only go to whoever is easiest to see, and skip visiting experts because they are out of network or have a cost. The end-result can be bigger eventual expenses from unaddressed ties, ties which were not properly released, and a continuation of symptoms such as nipple pain, decreased milk supply and weight issues with baby.
Tongue-ties matter to both breast and bottle fed babies!
Because tongue or lip tie is something that a baby is born with, both breast and bottle-fed babies can be affected.
Babies who nurse are able to stretch their tongues and lips to an extent with nursing, yet babies who bottlefeed don't always use the same vigor and work the same muscles. So while some may think that tongue tie isn't a big deal in bottle-fed babies since mom isn't being injured and her supply may not be at-risk, it's incredibly important (if not more important) to have a lactation consultant who also works with bottle-feeding babies investigate your baby's mouth and feeding if you suspect that your baby may have a tie…lactation consultants can help strengthen and coordinate leaky bottle latches, decrease increased gas from bottle-feeding, help you find a bottle that works well for you baby, and so much more.
And finally...
Before continuing your Google-journey, we invite you to read our blog post "5 Myths About Tongue-Tie" to help you understand what is and isn't important about ties.
While IBCLCs cannot diagnose your baby with lip or tongue-tie, we can help you understand if the impact of your baby’s oral tethers can be mitigated for breastfeeding with positioning/hold, or if the tethers are symptomatic enough to to your nursing journey to require an appointment with an expert assessor/diagnoser/treater of tongue and lip tie, since experienced assessors such as pediatric dentists and ENT who have studied infant oral structure can tell you if early feeding is all that will be impacted by your baby’s oral restriction. Some types of oral restrictions impact other area of life and are first seen with how a baby feeds so consulting an expert for any “degree” of restriction in your baby’s mouth is important.
Tongue-tie outcomes are greatly optimized by working with a tongue-tie knowledgeable IBCLC before getting an assessment from a pediatric dentist or ENT. From knowing the local tongue-tie care landscape, to helping coordinate and strengthen baby’s oral muscles to help avoid a tongue-tie release or minimize procedure impact, to making the right referral to the provider that can best assess your baby (not al providers are versed in all types of oral tethers), seeing an experienced IBCLC (like yours-truly) before and after a frenectomy (release of tongue-tie) will help your baby heal faster, decrease a baby’s chance of reattachment, and will help families avoid unnecessary steps
Interestingly, some tethers aren’t obvious to untrained parents or medical staff, but an experienced IBCLC who listens to a parent’s report of pain, assesses nipple-injury patterns and watches baby’s oral and body movements at the breast can help families to form a game plan-and that game plan can range from helping a baby to loosen their whole body vía massage, helping a baby to strengthen their oral muscles, or the game plan could be see an expert and licensed expert on tongue and lip ties.
During an “investigation”, an IBCLC will help manage, stabilize and protect breastfeeding (latch, nipple pain, milk supply, etc.) so that once oral issues are resolved, original breastfeeding goals can still met.
Also, a point to ponder is that what may seem like a “tie” may simply be restricted/sore muscles from a difficult birth, swaddling and other positional issues.
Avoid taking shortcuts...
For the best outcomes, don't take shortcuts in tongue-tie care. Too often we work with families who only go to whoever is easiest to see, and skip visiting experts because they are out of network or have a cost. The end-result can be bigger eventual expenses from unaddressed ties, ties which were not properly released, and a continuation of symptoms such as nipple pain, decreased milk supply and weight issues with baby.
Tongue-ties matter to both breast and bottle fed babies!
Because tongue or lip tie is something that a baby is born with, both breast and bottle-fed babies can be affected.
Babies who nurse are able to stretch their tongues and lips to an extent with nursing, yet babies who bottlefeed don't always use the same vigor and work the same muscles. So while some may think that tongue tie isn't a big deal in bottle-fed babies since mom isn't being injured and her supply may not be at-risk, it's incredibly important (if not more important) to have a lactation consultant who also works with bottle-feeding babies investigate your baby's mouth and feeding if you suspect that your baby may have a tie…lactation consultants can help strengthen and coordinate leaky bottle latches, decrease increased gas from bottle-feeding, help you find a bottle that works well for you baby, and so much more.
And finally...
Before continuing your Google-journey, we invite you to read our blog post "5 Myths About Tongue-Tie" to help you understand what is and isn't important about ties.
What is a tongue tie, and how can it affect breastfeeding?
Common reasons to have a tongue or lip assessed for ties*:
Baby:
Mom
- Difficulty with latching to breast or bottle
- Hovers over areola but doesn't draw in nipple
- Tires easily
- Slow weight gain, or weight loss
- Clicking when feeding from the breast or bottle
- Clamps mouth on nipple, collapses bottle nipple
- Low milk transfer from breast or bottle
- Prolonged feeds
- Persistent or frequent thrush
- Unable to hold in a pacifier
- Reflux and excessive fussiness; sounds "wet" in throat or gurgley when swallowing
- Gags a lot
- Issues accepting solid foods
- Future speech issues
- Cavities
Mom
- Very sore, cracked, raw or bleeding nipples (sometimes doesn't have soreness)
- Compressed-looking nipples after latching
- Low milk supply over time
- Bacterial and fungal breast infections which fester after tongue tie injury
- Early weaning and feelings of disappointment in mom
Online Resources
Remember, for tongue/lip-tied breastfeeding infants, it's recommend to have a consult with a board certified lactation consultant experienced with tongue-tied babies prior to and after having a tongue/lip frenelum released in order to gauge and track symptom improvement, healing and reattachment.
Photo courtesy of Jaye Simpson,
CLE, IBCLC, RLC, CIIM, BT, BC
www.BreastfeedingNetwork.net
