Tongue Tied - Having a Frenulum Is Not a Crime
Have you heard of tongue ties? Lip ties? Buccal ties? Yes, they’re all a real thing, and they can cause a myriad of issues during lactation, feeding, sleep, and speech.
It can be one of the most common questions once issues in lactation arise, and while it’s not always the cause, it’s indeed worth ruling out during assessment of breast/chest feeding.
The key, however, is finding someone who is qualified to asses your baby. A CLC or IBCLC or pediatric dentist are usually qualified, although not always, and if not, they can certainly refer you to someone who is, but your pediatrician, sadly, is probably not qualified, and it’s unethical for someone not trained in ties to do an assessment.
So let’s say you’re having some issues, and you’ve peeked inside your baby’s mouth, and you’re not sure what you’re looking at, or looking for!, but you’re wondering if maybe there’s a tie involved because you can see a bit of ligament stretching from your baby’s tongue down to the floor of the lower jaw.
Here’s the thing, though, having a frenulum (the bit holding the underside of the tongue to the mouth) isn’t the problem. Having a frenulum that’s too tight, or too short, or otherwise interfering with healthy oral-motor function is the problem, but this is where you need professional experience for a thorough oral assessment.
But that’s not to say that there aren’t other signs that you, as the parent, can be looking out for in order to help your care provider evaluate your situation.
Here are some other common signs and things to look out for that could be related to an oral tie:
Your nipple comes out of the baby’s mouth squashed, pinched, misshapen, and/or with a white line across the tip.
You experience pain during latch and feeding.
A deep latch where most of the areola is covered by the baby’s mouth is hard to achieve.
Your baby easily slips off your breast/chest during a feed and has to re-latch frequently during the feed.
Your baby snores.
Your baby primarily breathes through their mouth.
Your baby develops a “milk blister” in the center of their upper lip.
Thick milk build-up develops on your baby’s tongue.
Your baby is fussy, gassy, and unsatisfied after a feed.
Your baby’s upper lip is difficult to pull out and flange over the breast/chest during latch.
Your baby’s lower lip and chin have a hard time reaching the breast/chest and making contact.
Your baby’s chin is tucked back towards their neck.
Your baby’s body is generally stiff and tight.
Your baby’s tongue is heart shaped with the tip pulled back in towards their jaw.
Your baby’s tongue is pulled back and cupped when they cry.
You know of siblings with ties, or other family members with oral ties.
And in older children and adults, signs of an oral tie may be:
Speech issues or delays
Snoring or mouth breathing
TMJD
Feeding issues or gagging
Aversion to solids
Aversion to upper front teeth cleaning
It’s a long list, I know! And there are more, I’m sure, but if you notice any on this list, and suspect a tie, they’re all good clues that add up when having your baby assessed.
This is not to say that one sign equals a diagnosis of an oral tie, but the oral assessment combined with any of these other signs is a better way to go about looking into the issue rather than a one-sided, doctor-led approach that might otherwise be taken without parental involvement.
I hope you feel empowered with this information, and are able to advocate for yourself and your baby, if needed, during an oral assessment; knowledge is power.
