Tongue tie, hidden tongue tie or lip tie. Need help?
Tongue and lip tie
A baby is born with a tongue that can move optimally for feeding. Every baby has a tongue frenulum, this can be too tight or extend as a thin membrane towards the tip of the tongue. A tongue tie can also be hidden and only visible during a mouth examination by an expert. A tongue tie often accompanies a higher palate, resulting from insufficient upward pressure of the tongue against the palate.
Tongue Tie
A baby with a tongue tie often experiences several issues. Maintaining a vacuum on the breast or bottle is challenging. The coordination of sucking, swallowing, and breathing may be altered, leading to a risk of choking, ingesting air, and various sounds while feeding. Many of these children often suffer from reflux-like symptoms. A white coating on the tongue is also common as the tongue cannot effectively clean itself against the palate. This coating is sometimes mistaken for thrush. Babies may also struggle with proper growth due to the energy loss in an inefficient feeding process.
Mothers often experience painful and even cracked nipples from the postpartum period. The nipples may become deformed after feeding because the tongue doesn’t make the correct movements, and the baby attempts to maintain a vacuum on the breast by clenching with its jaws. This can result in the lips being drawn inward, causing suction blisters. Deformed nipples increase the risk of blockages and breast inflammation. Milk production may not start well or may decrease over time.
Lip Tie
Occasionally, there isa lip tie. A lip tie is almost never seen on its own; there is almost always some degree of tongue tie present.
Tongue tie and lip tie can be addressed in various ways if necessary. The release is called clipping or frenotomy. The best option is in a specialized clinic. There, an examination is first conducted by a doctor and a lactation consultant/preverbal speech therapist together, and a feeding session is observed. Only then, a decision is made with you on whether treatment is necessary. In most clinics, the procedure is performed with surface anesthesia and an electrocautery tool, which minimizes blood loss. A specialized clinic will also provide you with a follow-up appointment. These clinics offer careful and multidisciplinary care.
In several hospitals, there are also pediatricians, ENT specialists, and midwives who perform this treatment. They use scissors for clipping, and there is no follow-up. More information about frenotomy can be found here.
Advice
Baby & Borstvoeding is skilled in examining the baby’s mouth for a tongue and/or lip tie. Together with you, we will assess what is necessary and desired, depending on the type of tie and the existing symptoms. Clipping is an option, but improvements in latching technique and feeding methods can also be beneficial, and clipping may not be immediately necessary. Feel free to contact us!
Baby & Borstvoeding has a network for referrals to assess and treat the tongue and/or lip tie. The referral destination depends on the type of tie and your preferences. If a tie has already been treated and it was not done correctly or did not heal properly, it cannot be immediately clipped again. Clipping in a healing wound or scar tissue can cause complications. We will refer you with utmost care to the right expert and provide appropriate advice to facilitate feeding as effectively as possible. After treatment, follow-up care from a lactation consultant is always recommended to ensure the (breast)feeding process. A baby often needs time to learn to use its new tongue.
© Baby and Breastfeeding Lactation Consultants Leidsche Rijn | Utrecht
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