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  • Writer's pictureKaleem Joy, Licensed Midwife

Tongue and Lip Ties, oh my!

Click image to go to my Live recording!

Tongue and Lip Ties, oh my! Why so many babies have them and what do they really have to do with the well-being of their entire body and life in the future.

What's a tongue tie anyway?

Tongue ties are called ankyloglossia, however let's use terms we can easily work with. Under your tongue there is a connection from the floor of your mouth to the tongue. Many babies are born with a short "frenulums". This can interfere with their ability to use their tongue to maintain an appropriate suction on the breast, and yes even on a bottle. Because the tongue often either has a bowl, heart shape or arches in the back, it causes rubbing on moms nipples too. OUCH! This can crease pain and injury which no one is fond of.

How do I tell if my baby has a tongue tie? First, when they cry, look under the tongue. It should come up to the roof of the mouth and make that easy. If not, there is likely a tie. Second, is to gently begin to explore your baby's mouth with a clean finger. Have them suck on your finger and see if you can feel their lower gum against your finger as they suck, suggesting the tongue can not come forward and maintain suction. What you do want is their tongue to cup your finger well. Third, you can take both of your index fingers and gently go under baby's tongue on both sides and push toward their throat. You will see a membrane that is white or fleshy pink and white pop up between your fingers. Your baby may fuss as you try to do this. Just talk to them and go gently but quickly and look.

Be sure to check out my live on this whole topic at Natural Childbirth 101 on Facebook and Instagram from 8/28/23.

Symptoms include: difficulty lifting the tongue, milk supply issues, injured nipples, blanched and chapped lips as baby uses them to try to maintain suction, clicking as they feed, gassy/colic, reflux, nursing blisters on the lips, shallow latches, arching of their backs, difficulty passing stool, feeding very frequently, jaw fatiguing/ quivering, chocking on milk let down, gaging, snoring, sleep issues due to obstruction of the tongue and vomiting on solids, speech issues, and more.

Take a look at some youtube to help:

What kind of Tongue ties are there? Anterior meaning the membrane is attached closer to the tip of the tongue and may cause the tongue to appear heart shaped and it comes in 3 levels. Posterior which means it attaches further back in the mouth and sometimes cannot be seen as easily without doing the 2 finger look.

Why do they happen? One reason in due to genetics. If the parents have them, then likely they will pass along this to the children. Second, is due possibly to a deficiency in folate which is a B vitamin. 40 or more percent of the population has a mutation of a gene known as MTHFR. It cause them to have difficulty with methylation, or the ability to use certain nutrients in the body and especially of folate. Most people are familiar with folic acid. This has been added into foods since the 60's because they learned that mid-line issues for babies such as cleft lip and palates and chromosomal issues like Down Syndrome were reduced with folic acid. Unfortunately, if you happen to have the MTHFR gene mutation, your body actually can't use folic acid because it is synthetic. Most prenatal vitamins are changing to include methylated Folate. Be sure to take 800-1000mcg a day to help reduce the risk.

Diet is important too. Avoid folic acid enriched foods which usually are on the shelved in boxes and focus on fresh foods with folate in them. Eat organic as much as possible as they don't "enrich with folic acid" these foods.

What are the solutions for tongue tie? Usually it involves having them revised. A pediatric dentist specialist will assess your baby and revise their tongue, lip and even a buccal tie ( this is where the cheek gets attached to the gum line). They usually use a water lazer to do the procedure and it is very quick. Sometimes they will clip instead. Following the procedure, you want to breastfeed your baby if at all possible. I know what you're thinking, "I don't want to hurt my baby". I totally get it however, if baby is struggling to eat, and later on solids will cause them to gag, vomit and have difficulty, its actually coming from your desire for what will help them best.

Watch the revision and see how simple it is:

Here is one of the keys to the success of the procedure. Do the post stretches in their mouth and have your baby worked with by a pediatric cranial sacral or massage therapist. The ties create tension in their body and they need help to release it.

Watch this great lactation therapist teach a parent how to do the stretches kindly.

Why have massage and bodywork for an issue in the tongue? Because there is a fascia that connects from their toes, up the back of their legs, buttocks, back, neck and into the tongue. This needs help to let go of tension and stretch. What I love is also the parents doing massage on their baby to help them maximize the growing of muscles and prevention of the tension becoming an increasing issue. This fascia can cause arching, lack of crawling well, difficulty sleeping, irritability and so on. Fascia is like a shrink wrap that is over the muscles.

Natural Childbirth 101 is coming out with a parent class this year to teach you how to do the massage to help your baby. Stay tuned and check back with us in late September.

They can be seen by looking under their upper lip and seeing the frenulum connecting their lip to the gum. if it goes all the way to the edge of their gum or even half way, their is a tie that may need revised. Some are thick and some are thin. Without revision, the teeth will come in with a gap in the middle. Save yourself the challenges of feedings now and the financial outlay of dental work and braces later.

One last note... Pediatrician are not specialists in ties and breastfeeding unless they have specifically attended conferences and focused on these issues. Pediatric ENT ( Ear nose and throat) doctor may also not be the specialist who understands the feeding issues. It is best to seek out a lactation specialist and or a pediatric dentist who is known to specialize in newborns and infants with ties. Unless the physician understands whole pictures with feedings and overall body issues, they may only see the tie and think "it's not that bad". When you are breastfeeding 12 times a day, your nipples may not agree with their assumption or opinion.

Check out my Natural Childbirth 101 Complete Premium Program which includes, pregnancy, nutrition, supplements, mindset, care providers, lab test and birth stages, how to prepare, prevention of complications, newborn care, breastfeeding basics and challenges and postpartum expectations and ways to create your best first 6 weeks with your baby. My complete premium program will give you a midwife on your team and support your best experience whether you are planning a home, birth center or hospital birth. Thanks for reading and please feel free to share.

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