Hi everyone! I’m back to talk tongue-ties again. I see this problem a lot because I’m a lactation consultant. People usually call me when something isn’t going well. Lots of times it is Not a tongue-tie! Phew. But sometimes it is. I know it can be an exhausting and frustrating topic. Let’s get to the bottom of what you really need to know as a parent facing this issue.
Let’s get some myths out of the way…
MYTH: Tongue-ties are a fad
Nope. They are being recognized more often due to increased breastfeeding initiation rates in our country and better training.
MYTH: My baby can stick their tongue out of their mouth so they don’t have a tongue-tie.
Maybe. But the extension of the tongue is only one motion of the tongue that is evaluated and elevation is critical to many functions especially breastfeeding.
MYTH: My baby’s doctor said my baby does not have a tongue-tie.
Maybe. Has your doctor had extensive training in identifying a tongue-tie? What screening tools did they use to evaluate your baby’s tongue? Did they watch a whole breastfeeding session and take a full feeding history? Were their suggestions helpful in resolving your concerns? If not, seeking out an IBCLC can be key.
Now onto the good stuff. If you suspect that your baby has a tongue-tie, please consult an IBCLC (International Board Certified Lactation Consultant). We do not diagnose conditions but many of us are trained to assess for these issues and know when to refer to a trained MD. Also please find out if your IBCLC is experienced with tethered oral tissues. (TOTS)(tongue-tie, lip-tie)
Common Symptoms of Infant Tongue and Lip Tie
Poor Latch/inability to latch
Sliding off the nipple
Fatigue during feeds
>12 feeds in 24hr-endless feeding
<8 feeds in 24hr
Poor weight gain
Clicking during a feed
Maternal nipple pain and damage(compressing, chewing, gumming, pinching, scraping the nipple)
Increased maternal nipple/breast infections
Low milk supply
Dribbling milk at the breast/bottle
Digestive issues (gassiness, ‘reflux’ due to extra air being swallowed and poor control of the milk during swallowing)
Various other feeding challenges
*Keep in mind that you can experience some of the above symptoms for other reasons as well. Your IBCLC will be able to figure out the cause with your help.
Your IBCLC is your Quarterback on this journey. An IBCLC trained in TOTS will be invaluable for you and your baby’s journey to better health. Since tongue-ties can potentially lead to challenges with other issues throughout the lifespan it is worth having this addressed even if you elect not to directly breastfeed. And yes, we help with bottle skills, pumping, and safe formula preparation too!
Imagine that you have a limp and discover that you need some surgery on your knee. You go to the orthopedist and they repair your knee. They hand you a prescription for physical therapy and say, “you must complete 20 sessions of physical therapy to ensure proper healing, maintain range of motion and return to full function”. After having undergone the procedure you dutifully report to PT and slowly improve. What would happen if you skipped PT? You might experience stiffness, difficulty walking, continued pain and it’s possible you would not improve at all or end up feeling worse.
This is similar to a tongue-tie release which is called a Frenectomy. The tongue is connected to the floor of the mouth and the muscles and fascia of the body. The tongue has not been lifting in a natural way due to the restriction. Therapy to address the overall body tension or compensations is critical to a good release and recovery afterward. Specific tongue exercises are necessary to gain the best function and results after the release.
Manual therapy is recommended in a sandwiched approach. This may be done by a chiropractor, osteopath, craniosacral therapist, or physical therapist who is specially trained in very gentle approaches for infants and newborns. It is best to do this before and after the release. The tongue exercises are directed by your IBCLC and chosen specifically for your baby to assist in their individual challenges.
Your IBCLC will have observed a feeding or several and examined your baby. They will be able to guide you on the timing of these appointments and what professionals may or may not be necessary in your specific case. IBCLC’s help you manage the breastfeeding and milk supply throughout this process, carefully adjusting your care plan as needed. We monitor you and your baby’s progress through these steps. We partner with the Doctor who performed your baby’s Frenectomy. We partner with any additional professionals you consult to ensure more informed and wraparound care.
The takeaway? There are a few needed steps for good results from a tongue tie release. This process does not need to be stressful or full of mystery. If you have an IBCLC on your team, you can focus on enjoying your baby! Isn’t that what it is all about?