What is a tongue tie?

Tongue-tie (ankyloglossia) is a condition that restricts the normal mobility and function of the tongue. The frenum is unusually short, thick, or tight and tethers the tongue to the floor of the mouth.

What is a lip tie?

Similar to a tongue tie, a lip tie is a short, thick, or tight frenum that restricts the movement of the lip. Did you know, most infants have a low-connecting upper lip frenum. A gap between the two front teeth (often up to 10 years of age) is developmentally appropriate! “A gap” alone does not require a lip tie correction in young children.

When should my baby have a frenectomy?

A frenectomy (surgical release of a tie, also known as a frenotomy or frenulectomy) is recommended in the presence of tongue tie. The symptoms caused by a tongue-tie vary depending on the age of the person. Tongue-tie is diagnosed on a case-by-case basis; there is no routine protocol for diagnosis and in most cases it can not be diagnosed simply by looking. Usually between birth and 2 months old is the easiest time to treat a tongue tie, but there is no age limit. Tongue ties can be treated at any age with the right treatment plan.

What are common symptoms seen in a breastfeeding dyad when baby has a tongue tie?

Baby’s Symptoms

  • Slides of the nipple while attempting to latch
  • Poor latch
  • Falls asleep quickly while attempting to nurse
  • Gumming or chewing of the nipples while nursing
  • Clicking sounds while nursing
  • Milk leaking from the sides of mouth while nursing
  • Swallowing problems
  • Short sleep episodes requiring feeding every 2-3 hours
  • Unable to hold a pacifier in the mouth
  • Colic symptoms
  • Reflux/vomiting/spitting up
  • Gas
  • Taking prescribed or over the counter reflux/gas medications
  • High gag reflex
  • Open mouth breathing
  • Breathing sounds (snoring, snorting, general noisy breathing)
  • Breathing problems/sleep apnea
  • Congestion
  • Jaw spasms
  • Poor weight gain
Mom’s Symptoms
  • Creased, flattened, lipstick shaped, and/or blanched nipples after nursing
  • Cracked, bruised, and/or blistered nipples
  • Bleeding nipples
  • Severe pain when latching or attempting to latch
  • Severe pain once latched
  • Poor or incomplete breast drainage
  • Plugged ducts
  • Nipple or breast infections
  • Mastitis
  • Thrush on nipples

What happens during a frenectomy?

Dr. Tara uses a LightScalpel CO2 laser for tie releases due to its ability for precision, bleeding control, as well as decreased pain. Due to the use of the laser, parents are not allowed back in the surgery room. Dr. Tara will carry your baby back to the surgery room and swaddle them. Before and after pictures will be taken. Specialized laser safety glasses will be placed on your child. The actual surgical portion takes less than 30 seconds. The total time away from your baby is less than 5 minutes. Please be ready to nurse (or bottle feed) your baby after the procedure. The long term goal of a frenectomy is to allow optimal oral function and prevent oral dysfunction.

Will the frenectomy solve our problems?

The Three Pillars of Pre- and Post-Frenectomy Care for Babies: Lactation Support, Bodywork, and Oral Motor/Feeding Therapy Success of a tongue tie release is dependent on addressing ALL THREE PILLARS! One of the biggest misunderstandings about frenectomies is that the actual procedure is all that is needed to “fix” a baby with tongue tie. The goal when treating ties is to restore optimal oral function; however, in most cases, in addition to the frenectomy, both the parents and the child will need the help of multiple specialists in order to achieve this goal. Finding the right help is important - the MOST important quality to look for, no matter which type of provider you are searching for, is to make sure that they are educated in the problems related to ties and oral dysfunction - this means they have taken EXTRA education in these areas. Do not assume that these types of providers automatically know about ties and oral dysfunction. Lactation Support - help with breastfeeding issues, as well as pumping and bottle feeding issues. Bodywork - if there are oral restrictions, there are whole body restrictions - bodywork allows for full and symmetrical motion of the head and neck which will improve motion in the jaw and mouth. More info: http://www.ankyloglossiabodyworkers.com/benefits-of-bodywork.html Oral Motor/Feeding Therapy - retraining the tongue and other oral muscles is IMPERATIVE to see good results. In order to have optimal function, baby must be evaluated and treated by a specialized therapist.

Why did my medical professional say there was no tongue tie?

Unless your pediatrician, dentist, ENT, lactation consultant, speech therapist, or other medical professional has taken an extensive amount of continuing education about tongue ties and oral function, then they are not a reliable source for diagnosis or treatment. You wouldn't ask your cardiologist to treat a broken bone. Do not assume that your medical professional understands proper function of the tongue!

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