There are numerous issues a new mother can encounter when starting with breastfeeding her baby such as sore and damaged nipples, slow weight gain, and low milk supply. These can usually be attributed to improper latch – a problem that can be addressed with help from a lactation consultant if necessary. However, there are instances when a mother and her baby fail to achieve a proper latch or these issues would persist even if the baby seems to be latching well. In such instances, a tongue-tie and/or lip-tie might be the problem.
Dr. Axel Trecho-Gerochi, the head dentist at Gerochi Dental and Implant Center in Bel-Air Village, Makati City, shared her expert knowledge on tongue-ties and lip-ties.
What is a lip-tie and a tongue-tie? An upper lip-tie is when there's a piece of skin under the baby’s upper lip (labial frenulum) pinned too tightly to the upper gums.
Image from mothering.com
A tongue-tie, on the other hand, happens when a thin piece of skin under the baby’s tongue (lingual frenulum) is very short and restricts the movement of the tongue. A baby may have a tongue-tie or a lip-tie or both.
Image from tinysparkswa.org.au
What problems can these ties cause? For babies with lip-ties, the short and thick skin under the lip can result to difficulties in breastfeeding as babies may not be able to properly seal and attach to the breast. A good latch requires the baby’s bottom and top lips to be flanged out, also often called “fish lips”. Absence of this fish lip, which may happen in babies with lip-ties, may prevent the baby’s mouth from forming a good seal at the breast.
Tongue-ties can also result to breastfeeding issues by restricting the tongue’s movement and mobility which are necessary for good attachment to the breast and for adequate milk intake. Aside from a good seal at the breast, breastfeeding also requires that the tongue be able to cup the breast and make peristaltic movements to express milk. A tie will prevent the baby’s tongue from making these movements that are necessary to be able to empty the breast.
Not all lip-ties and tongue-ties result to breastfeeding difficulties. There are some mothers who successfully breastfeed their babies even if their little ones have a lip-tie or tongue-tie. However, lip-ties and tongue-ties may also result to other issues. For young children and adolescents, this can result to a gap between the front teeth or it may cause speech difficulties.
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What are the possible signs that a baby has a lip-tie or tongue-tie? If a mother and her baby are having difficulty establishing a good breastfeeding relationship because of a poor latch and inadequate emptying of the breast, it may be reasonable to have the baby checked for tongue-tie or lip-tie if some of the following are also present: • Flattened nipple after breastfeeding • Damaged nipple such as a cracked, bleeding, or blistered nipple • Clicking noise from the baby while sucking • Inadequate weight gain of the baby • Compression or stripe mark on the nipple after breastfeeding • Baby’s inability to poke his tongue out past his gums or lips • Baby’s inability to stay at the breast, gagging, and sucking in air • Excessive drooling
How are lip-ties and tongue-ties diagnosed? If a lip-tie or a tongue-tie is suspected, lactation consultants, pediatricians, and dentists are equipped to check and assess the conditions of the upper lip and tie.
Early assessment and diagnosis would help address any breastfeeding difficulties that might be caused by a lip-tie or tongue-tie. Unaddressed lip-ties and tongue-ties in babies who are having difficulty breastfeeding can result to mastitis, low weight gain, fussiness, and sore and damaged nipples.
How are lip-ties and tongue-ties addressed? Tongue-ties and lip-ties may be fixed by a minor surgery using laser or by snipping of the frenulum. This usually takes just a few seconds and does not require any anesthetic. The mother is usually advised to breastfeed the baby right after the procedure to help stop any bleeding and to comfort the baby.
If you suspect that your baby might have a tongue-tie or a lip-tie, it is best to have a lactation consultant or your baby’s pediatrician or dentist to check your baby’s lip and tongue.