Could your baby have a tongue or lip tie?

Search "tongue and lip ties" and you will get numerous articles claiming it is the cause of breastfeeding issues or fussy babies. However, there is little evidence to support it. So who is right? Is it worth investigating? This article discusses what is important to assess when feeding your baby.

common concerns

• Baby is not able to stay latched or not latching to breast deeply, becoming unsettled/upset
• Maternal nipple pain with feeding or damage or compressed nipple shape after feeding
• Baby is not able to remove adequate milk volume; very long feeds or very short feeds; baby may fall asleep at breast due to fatigue or not being able to get milk flowing well
• Weight loss/poor weight gain in baby
• Excessive gas
• Decreased milk supply
• Tension in oral cavity, oral motor dysfunction; tension in back or neck, open mouth at rest

lactation support

First, we suggest trying non-invasive measures to address any issues. Some of the issues commonly thought to be attributed to ties can be greatly improved with oral exercises and massage, in addition to breastfeeding positions, techniques and supply management. A thorough breastfeeding assessment, pumping guidance/assessment, oral assessment, supplementation guidance, and bottle-feeding technique guidance/assessment, if needed, is important to help get to the root cause of the issue(s).

"tongue and/or lip tie" procedure

Sometimes it is necessary to have a lip or tongue frenotomy (the procedure in which the lip or tongue tie is cut). This can be an immediate game changer for some, and of great help for current and longer-term issues. However, releasing a tongue tie or lip tie may only be the first step in getting the baby to actually use their new anatomical ability. They likely also need a combination of lactation support, “body work” (stretching/massage/etc.), oral exercises/suck training, and time to learn a new oral motor pattern. Many babies have developed compensations related to their tongue or lip tie that continue as muscle memory and have leftover muscle tightness that continue to impact feeding.

get help

Whether it is uncertain if an anatomical “tie” exists or if one has already been diagnosed and referred to an ENT or dentist, lactation support can usually help improve feeding issues in the meantime or even eliminate the need for a procedure and/or improve the outcome after a procedure.

At Dayton Children’s, our outpatient lactation clinic specializes in helping with feeding issues. Our staff has additional training in oral exercises and infant massage/relaxation/range of motion and tummy time techniques to help improve feeding issues.

Schedule a consultation with a lactation specialist online today.

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