It’s a common problem for newborn babies and mamas. Baby is hungry and Mom is ready to nurse, but something isn’t quite working. Despite the nursing mom’s best efforts, the baby struggles to latch on. While many women face challenges when they first begin to breastfeed, with time and maybe the gentle guidance of a lactation consultant, soon the issue is resolved and nursing goes well. In the case of lip and tongue tie, however, this resolution doesn’t always come so simply. While a recent study in 2014 found that lip and tongue tie serious enough to affect breastfeeding is only present in 3.5% of infants, the mothers of those infants need information and solutions. One of these is a lip and tongue tie revision.
What is a lip and tongue tie revision?
Baby lip tie and tongue tie is a condition that occurs when the connective tissue between the upper lip and upper gum or the lower lip and the floor of the mouth is connected more closely closer and tightly to the front of the mouth. The connective tissue in the lip is called the labial frenulum. The one connected to the tongue is the lingual frenulum.
We all have these connections, so seeing this connection in your baby’s mouth is normal. What presents challenges is a lip and tongue tie that is too tight. This can prevent proper movement of the mouth for breastfeeding. There are four types of baby lip and tongue tie.
Class 1
This type of tongue tie indicates that the lingual frenulum is attached to the very tip of the tongue. Most people speak of a Class 1 tongue tie when they identify any lip and tongue tie.
Class 2
The tie is located further behind the tip of the tongue.
Class 3
Located closer to the base of the tongue, this type of tongue tie may not cause any difficulty with breastfeeding at all.
Class 4
This type of tongue tie occurs underneath the mucous membrane and must be felt to be diagnosed. Babies with this type of tongue tie are often misdiagnosed as having a short tongue.
Lip ties are classified in a similar manner, with the most minor cases tied farther away from the upper lip.
Lip and tongue ties are also known as midline defects. This is an inexact name that includes in the same category cleft palate, cleft lip, cleft chin, extra or missing teeth, nasal atresia, and deviated septum. They are not caused by any action on the part of the mother but are considered genetic conditions.
What are common lip and tongue tie symptoms?
Baby lip and tongue tie is usually diagnosed when breastfeeding difficulties arise.
In a baby without lip and tongue tie, the mouth forms a seal over the mother’s breast. This allows the baby to create the suction needed to nurse successfully. For babies with lip and tongue tie, this suction isn’t possible. It can result in the following signs of a possible problem:
- Difficulty latching on: While most babies and mothers struggle with this at first, babies with lip and tongue tie may never quite get it right
- Cracked, bleeding, or sore nipples: Babies will suck harder to try to get more milk, resulting in soreness
- Excessive gas: The baby is sucking more air than milk as they nurse
- Poor weight gain: Not enough milk means not enough weight gain
- Fussiness: All babies fuss, but babies who are hungry for lack of adequate nutrition and excessive gas may be even fussier
- Poor milk supply: Milk supply depends on demand, so if the baby is not able to drain the breast at a feeding, supply may drop
It is important to note that all babies and mothers experience some challenges as they begin to nurse. For those babies with lip and tongue tie, these issues may not resolve with time. This can result in a mom who stops nursing, due to extreme discomfort, dwindling supply, or just feeling like she is not capable of it.
A surgical procedure called a lip and tongue tie revision, discussed below, can help alleviate any difficulties or challenges from this condition.
What does a lip tie look like in a newborn?
In all but a Class 4 tongue tie, a newborn’s connected frenulum can be visually diagnosed.
Take a moment and feel the thin piece of connective tissue that attaches your tongue to the floor of your mouth and your upper lip to the top of your gum. These are visible when you peel back your lip or roll up your tongue.
A pediatrician, dental specialist, or lactation consultant can see if your infant’s frenumlum are causing issues with breastfeeding or eating.
What are my options for treatment?
For both parents and child, the best resolution to this condition is one that is as gentle as possible.
In the past, lip and tongue tie revision surgery – known as frenectomy – involved severing the tie with a scalpel or scissors. This procedure had a higher risk of infection and significant pain. A more gentle option is a laser lip and tongue tie frenectomy. This procedure uses a laser to sever the tie while simultaneously healing the wound to minimize the time in surgery and the chance of infection.
While the idea of surgery on their baby is frightening to every parent, left untreated, lip and tongue tie can mean more trouble down the road. Lip tie problems later in life can include
- More orthodontia procedures as the lip tie pushes the front teeth apart (even after braces)
- Difficulty chewing and swallowing food, which can lead to digestion issues
- Risks of speech impediments or delayed speech
And, while these are more serious, even the simple pleasure of licking an ice cream cone may not be possible with an unresolved tongue tie. Early treatment of baby lip and tongue tie is less traumatic and offers many benefits to your growing baby.
Dr. Janne Lynch is a Phoenix area family dentist who can gently and safely treat your baby with a lip and tongue tie revision. Contact us today for a full evaluation.
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