Tongue and Lip Ties in Babies: How The Breastfeeding Center in Sacramento Can Help
Tongue and Lip Ties in Babies: How The Breastfeeding Center in Sacramento Can Help
While breastfeeding is a normal, biological process, it often comes with challenges. Some lactating parents experience pain, cracked or bleeding nipples, plugged ducts, or mastitis. Meanwhile, babies might have poor weight gain, reflux, colic, or inability to stay awake while nursing.
In some cases, tongue and lip ties can cause these breastfeeding difficulties. Anytime you experience problems, we encourage you to seek help from an International Board-Certified Lactation Consultant (IBCLC). At The Breastfeeding Center, conveniently located within The Birth Center in Sacramento, we can help you resolve breastfeeding issues. The Birth Center Owner/Director and Certified Nurse-Midwife Ruth Cummings is also an IBCLC who, as a licensed Nurse Practitioner (NP), is trained in diagnosing and treating tongue and lip ties, which are common but relatively little known impediments to breastfeeding success for lactating parents and their babies. Ruth learned from Bobby Ghaheri, M.D., an otolaryngologist and ENT surgeon who is widely regarded as a leading expert on tongue and lip ties and their impacts on breastfeeding.
But how do you know if you need a consultation? In this blog, we’ll give you the basics of tongue and lip ties, what to look for in your baby and your lactating body, and how to get help. Let’s dive in!
What is a Tongue Tie?
Movement of the tongue is extremely important when it comes to the mechanics of breastfeeding. To breastfeed well and to achieve the appropriate suction, a baby needs to be able to move their tongue freely. In fact, they should be able to extend the tongue over the lower gum with the mouth open wide.
A tongue tie is when the movement of the tongue is restricted because the lower frenulum, or the tissue that connects the tongue to the floor of the mouth, is too tight or short. When the baby attempts to lift the tongue or move it forward, a tight frenulum will cause the tongue to look short or heart-shaped. This is because the frenulum is pulling the center of the tongue down.
What is a Lip Tie?
It’s no secret that a baby being able to open their mouth wide is crucial to a good latch. A key requirement for the wide-open mouth is that the baby is able to flange their upper lip outward. This allows the mucous membrane part of the lip, not the dry, outer portion, to come in contact with the breast. This contact creates the best possible seal, generating the negative pressure needed for successful breastfeeding.
A lip tie occurs when the upper frenulum, or the tissue that connects the upper lip to the gum, is too short or tight. This causes the lip to be pulled downward, making it difficult for that upper lip to flange out. The result is that the baby has a smaller mouth opening, creating a shallower position on the breast. It’s important to note that a lip tie makes it uncomfortable for the baby to flange the upper lip outward. Even when the lactating parent manually flips it out, the baby tends to revert back because it’s more comfortable.
What are the Signs of Tongue and Lip Ties?
While the possibilities for tongue and lip ties are assessed separately, the breastfeeding problems they cause are often similar. In addition, research has shown that in babies with tongue ties, 37 percent also had an upper lip tie. Our IBCLC checks for both. Here are some of the most common signs and symptoms we see in babies and lactating parents when tongue or lip ties are present.
Baby’s Symptoms
Poor latch
Falls asleep while attempting to latch
Slides off the nipple when attempting to latch
Colic
Reflux
Poor weight gain
Gumming or chewing of your nipple when nursing
Unable to hold pacifier in their mouth
Short sleep episodes lasting 15-20 minutes only before feeding again
Parent’s Symptoms
Creased, flattened, or blanched nipples after nursing
Cracked, bruised, or blistered nipples
Bleeding nipples
Severe pain when your baby attempts to latch
Poor or incomplete breast drainage
Infected nipples or breasts
Plugged ducts
Mastitis or nipple thrush
What is the Treatment for Tongue and Lip Ties?
When a tongue or lip tie — or both — is causing breastfeeding problems, the treatment is a procedure called a frenotomy, which divides the tongue or lip tie by cutting the frenulum with a pair of sterile scissors or cauterizing it with a laser. The procedure is simple and quick, lasting only a minute or two.
Why treat a tongue or lip tie? Evidence suggests that a frenotomy improves breastfeeding comfort and efficiency for both the parent and the baby, especially if the treatment is prompt. Many babies experience dramatic improvement in weight gain after the procedure. The earlier a tongue tie is divided, the easier it is to resolve breastfeeding difficulties.
Takeaways About Tongue and Lip Ties
When you have breastfeeding difficulties, it’s important to get help quickly from an IBCLC. In many cases, problems are the result of improper latch and positioning, and an IBCLC can provide guidance in these areas that will improve comfort and lead to a better breastfeeding experience for both the parent and the baby.
However, tongue and lip ties affect about 4-11 percent of newborns. It’s crucial to understand that lactation consultants (IBCLCs) are experts on the physiology and mechanics of breastfeeding. They have the necessary skills to recognize potential issues with tongue and lip ties, however, only lactation consults that are also licensed medical providers (such as an NP) are permitted to diagnose and treat tongue and lip tie. If a lactation consultant cannot treat the anatomical problem, they may be able to refer you to someone in the community who is licensed, trained and skilled in assessment and treatment.
At The Breastfeeding Center, our IBCLC is also an NP, trained in the diagnosis and resolution of tongue and lip ties that can get in the way of successful breastfeeding. To schedule a personal consultation, email [email protected] or call 916-344-1860.