Tongue Tie in Infants – what you need to know!
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If you’re sitting here wondering what the heck a tongue tie is, don’t worry. I will break down EVERYTHING you need to know about tongue ties in infants and why they’re so important to catch early on!
For me, my experience with them happened with my first son. It started after a VERY rocky breastfeeding experience.
He wouldn’t latch no matter how many breastfeeding positions I tried. He’d swallow lots of air ending up crying non-stop from gas. He’d bite down with his gums so hard in an attempt to latch onto me that it would make my nipples so painful and sore.
After countless trips to the lactation consultant through our insurance and pediatrician, we were told to “just keep practicing” because “breastfeeding takes time.” Mind you, we were about 2 months into breastfeeding by now.
Now, before we get into the specifics, I just want you to know that if you feel like something just isn’t going right – please don’t be afraid to advocate for yourself and for your baby. Don’t accept “just keep practicing” as an answer.
So that’s what I did. I decided to find a lactation consultant out of our insurance network and THANK GOODNESS we did. She was the very first person to do such a thorough exam on my son and diagnosed him with having both a lip and tongue tie.
So….what the heck are tongue and lip ties?
Disclaimer: I’m NOT a medical professional. I am a mama to two little boys sharing her experience in hopes to help another mama so she does NOT go through the same struggles we did! Should you need medical attention, please see your physician right away!
What is a tongue tie?
A tongue tie is when the tissue (frenulum) underneath the tongue is attached too tight to the floor of the lower jaw. This disables the tongue from being able to move properly.
Keep in mind everyone has some variation of a tongue tie. However, it’s the extent of how tight the ties are and how they alter the normal functionality of the tongue that can be problematic.
Imagine you had a rubber band looped around your 2 index fingers – if you tried to separate them, there’d be some slack. If you replace that rubber band with a thick rope – try to move them, they wouldn’t be able to move. This is similar to how a tongue tie is.
There are 4 classes of tongue ties:
- Class 1-3 are ANTERIOR ties.
- Class 4 is a POSTERIOR tongue tie.
These classes identify how far the tissue extends on the tongue. For the purpose of this post, we don’t get too much into the classes of tongue ties.
Tongue tie symptoms in infants:
One of the most common symptoms of a tongue tie in infants is that they have difficulty breastfeeding or sucking a bottle. Other symptoms can include:
- Detaching from breast or bottle frequently (‘breaking suction’).
- Unable to latch & suck nipple or bottle efficiently.
- Making continuous clicking sounds while nursing or bottle-feeding.
- Excessively long feedings (due to inability to latch and eat efficiently – sometimes falling asleep and tiring out during a feed).
- Baby not gaining weight.
- A mother experiencing low milk supply (due to breasts not being emptied appropriately or clamping at the nipple to try and stay latched).
- Painful & sore nipples due to pore latching for mom
The photo below shows my 2nd son’s lip & tongue tie BEFORE he had his ties repaired.
If your infant is displaying any of these tongue tie symptoms, it may be a good idea to reach out to your pediatrician or an IBCLC (International Board Certified Lactation Consultant).
What is a lip tie?
Similar to a tongue tie, a lip tie is when the tissue behind/under the top lip is too thick and/or too tight against the gums. This causes the top lip to be unable to freely move.
In terms of breastfeeding or bottle-feeding baby, it can prevent them from being able to form a proper seal around the nipple with their lips.
Lip ties tend to be less common but have very similar symptoms and treatment options as the tongue tie. It is also possible for a baby to have both lip and tongue tie (like both my boys did).
Sometimes, lip ties don’t even need to be repaired. However, when the tie is excessively tight or thick, it can cause that restricted movement of the lips which then poses an issue for baby.
Lip tie symptoms in infants:
- Detaching from breast or bottle frequently (‘breaking suction’).
- Unable to latch (form a seal) around breast or bottle.
- Unable to open mouth fully to take a bottle or breast.
- Lip blistering
- Shallow latching
- Excessive gas and/or colic
How to tell if baby is tongue tied
As mentioned above, babies with a tongue (or lip) tie can struggle trying to form a good latch. This has to do with their tongue and/or lips being unable to freely move into the motions necessary to do so.
When sucking, the baby’s tongue should extend out and below the nipple, and drawing the nipple back while extracting the milk.
With limited tongue movement, they’re unable to extend their tongue where it needs to be. Sometimes, babies will try so much that they end up tiring themselves out. This causes them to “fall asleep at the breast“.
You can also take a look in their mouth for yourself! Do you see a thick band underneath their tongue causing restricted movement? If you do, make note of it and let your pediatrician or lactation consultant know.
You may also feel them trying to suck “harder” or even begin to “clamp down” in an effort to stay on the breast while they’re breastfeeding. In turn, this can lead to nipple pain, and if prolonged, nipple damage for mom.
Aside from direct nipple trauma, moms may experience clogged ducts or mastitis in a worst case scenario.
As a mama who experienced severe nipple pain due to my boy’s ties & inefficient latching, the following products listed below helped me keep that pain under control before serious damage could be done:
- Hydrogel Pads (keeps your nipples cool, hydrated and free from irritation)
- Earth Mama Nipple Butter (soothed dry & cracked nipples)
- Lansinoh Dual Compresses (helped me to ice to my nipples when they were red and irritated from poor latching and I could also use these to warm compress my breasts before feeding to help my milk flow out better and prevent any clogs)
As a tip, from one mama to another, it’s important to have some kind of breast pump readily available to you JUST IN CASE things like this occur. You always want to have an effective way to empty your breasts to prevent any milk from getting stuck inside and potentially risking clogged milk ducts.
Breastfeeding baby with tongue tie (or bottle feeding baby with tongue tie)
As mentioned above, babies with a tongue tie or lip tie can really struggle breastfeeding or bottle feeding.
In this section, we’re going to talk about some tips you can do in this interim time until baby’s tie is fixed. If you elected to hold off on treatment, these tips can help you too!
Breastfeeding/Bottle Feeding Tips with tongue tie in infants:
- If the breast is very full, try pumping or hand expressing some of the milk out before latching. This will soften the breast and allow baby to not need to lift the upper lip as much as opposed to a full breast.
- Try using a bottle with a more narrow nipple, such as the Lansinoh Breastfeeding Bottles (seen above) This can help baby make a better seal with their lips.
- Try different feeding positions. Some babies can get a better latch when laying on top of mom and others do best being cradled. Use a sturdy nursing pillow and play around with positions, to see what works best during this rough patch.
These are the tips that were provided to us as we awaited my son’s tie release appointment. However, if I’m being honest, none of them really helped with the exception of using a narrow nipple bottle.
Tongue Tie Release Treatment
Having your baby’s tongue-tie released sounds like a very scary process. I won’t lie, I was pretty terrified to have anything done. But once we learned about the long term side effects that could happen if we didn’t do treatment, I decided to suck up my worries and do what I felt was best for our son.
The 2nd time around (with my 2nd son) – I didn’t even hesitate to get his ties released. After dealing with the experience the first time around and knowing the issues ties can cause, I was not going to mess around and wait it out.
Treatment for a tongue tie or lip tie is called a “Frenotomy” when scissors are used to ‘cut’ the ties and a “Frenectomy” when a laser is used to remove the ties.
Scissor vs Laser – which one is better?
I’m pretty biased towards the laser procedure (when done correctly) because I find it’s more accurate and a lot less traumatic for everyone involved.
With a scissor release, depending on the tie, you may not be able to completely release the tie to the full extent that’s needed. Not to mention in a squirmy little baby, it can be tough to make the cut accurately so that the tie is released efficiently. Plus, the chances of reattachment tends to be higher with a scissor release.
With the laser release, they’re usually able to remove the ties (for a full release) much more accurately. There’s also little to no bleeding involved and the procedure itself is over in about 10 minutes or less.
Some insurances will cover the repair, however, I am a bit weary with any repairs done in the medical office due to our bad experience with a scissor repair that led to us needing a laser revision anyways.
What to expect after tongue tie release:
After your baby has their tongue tie release (removal), you’ll usually be sent home with some baby tylenol and stretching routines to do at home.
The stretching routines may differ depending on where you get your baby’s release done, however for us, they we’re pretty similar both times around.
For the tongue tie, the goal is to maintain the ‘diamond’ scar by using your finger to press up and back against the wound. This helps prevent any reattachment of tissue while healing in that nice open diamond shape (see AFTER photos above for reference).
For the lip tie, the goal is to stretch the lip and prevent any kind of reattachment. To do this, we’d gently glide our fingers along the wound while rubbing up and down to gently stretch the area.
It’s important to note the stretches should ALWAYS be done with clean hands. Using coconut oil helped by creating less friction and a more smooth glide with the stretches.
And lastly, we had to do these stretches every 4 hours for 3-4 weeks. Then we transitioned to a more basic ‘massage’ of the repaired areas 3 times a day for the next 2 months.
Out of the entire process, the first week of stretches was the hardest. This was because baby was still sore from the procedure and here I was manipulating their wound sites. As a first time mama, it broke my heart knowing I was doing something uncomfortable to my baby, but the 2nd time around it was much easier since I knew the benefit and how much it would help him.
Breastfeeding after tongue tie release:
Breastfeeding (or bottle feeding) after my son’s tongue tie release was a NIGHT AND DAY experience.
I walked in with sore, bleeding nipples on the verge of ending our breastfeeding journey and I walked out with a baby able to latch on and withdraw milk from my breasts without causing me pain!
Having my boy’s ties released literally saved our breastfeeding journey which is why I’m such an advocate in helping mama’s learn about these ties and how they can affect your breastfeeding journey!
Long Term Effects of an UNTREATED Lip Tie or Tongue Tie in infants can include:
- Difficulty starting solid foods.
- Difficulty eating from a spoon.
- It can usually affect both the ability to breastfeed and bottle feed.
- Increase in colic or reflux.
- Speech delays or onset of inability to formulate words.
- Some babies can develop crooked teeth (teeth come in crooked).
- Higher chance of cavities due to being unable to ‘clean mouth’ with the tongue.
- As an adult, it can carry out speech issues, dental problems and also the inability to use tongue such as french kissing.
OUR tongue tie repair and tongue tie revision story:
To keep a long story short, we were referred out to an EENT Specialist (through out insurance) who refused to repair my son’s lip tie and only did a “partial tongue tie repair”. This means the thick band under his tongue that was causing restriction was cut halfway with scissors.
As you can imagine a screaming inconsolable baby, pooping his pants, bleeding from his mouth AND not getting a full repair, leaving the office with NO discharge instructions, just an “Ok you’re done” – I was livid and horrified for my son.
We had my IBCLC examine him the day after his repair who confirmed the partial repair would NOT work. My son wasn’t able to suck efficiently (usually, they will start sucking better right away or even just a couple of days later). Being that his lip tie wasn’t touched, she highly advised us to see a Pediatric Dentist, one who specializes in this repair via laser frenotomy and have it revised correctly.
We went to Healthy Grins, pediatric dentistry in El Cajon, CA (if you’re local, I highly recommend Dr. Chan – she was amazing and we had a NIGHT & DAY experience here). The 4 week recovery period was rough. Our son HATED the stretches, however, his nursing ability from both breast and bottle was so much better.
With our 2nd baby, I immediately checked him for ties and found out he had even worst ties than my first! I notified the hospital pediatrician who told me he didn’t necessarily believe lip ties affected breastfeeding, but due to the tongue tie he would have the hospital IBCLC come visit us in the morning.
Thankfully, the IBCLC agreed BOTH his ties were problematic and recommended we get them repaired ASAP. Unfortunately, due to COVID-19, almost all the places offering repair were closed or not performing this service.
We ended up being referred out to a company called “Team Tongue Tie“. Now, I thought my experience with my first was great, but Team Tongue Tie was even 10 times better!
They’re staffed with a pediatrician, pediatric dentist, and lactation consultant (though they’re all IBCLCs). Having that support from each staff member was beyond helpful, even as a 2nd-time mama with more experience. I cannot thank them enough for not only their amazing service but for helping my little guy be able to breastfeed like a champ!
Recommended Posts You’ll Also Enjoy:
>> Breastfeeding items to make your life easier!
>> How to get started with exclusively pumping for your baby
>> Breast milk storage guidelines so you NEVER waste a drop!
Thanks for reading ‘Tongue Tie in Infants’!
Have you had experience with lip or tongue ties and your baby? I’d love to hear your experience in the comments below!