One of the complaints from breastfeeding mothers is that babies have difficulty in achieving a good latch at the breasts during breastfeeding. Dr. Ghaheri and Kotlow write blogs and articles on both the lip and/or tongue ties that restrict the movement of the lip and tongue and cause problems for the baby to latch on the mothers’ breasts incorrectly during breastfeeding. Some moms describe the latching as weak or shallow. How does weak or shallow latching at the breasts affect the breastfeeding babies? Some babies swallow an excessive amount of air, which reaches the stomach and causes abdominal distension, gassiness, and pain. Some parents describe their babies having symptoms of reflux; difficulty sleeping when lying down, problems swallowing, spitting up, and constant crying among other symptoms.
What is aerophagia?
Aerophagia originates from the Greek word aerophagein, which means to “eat air,” is the excessive swallowing air (Chitkara et al., 2005; Courtiol, 2100; Fernando, 1998: Loening-Baucke, 2000). Babies with lip tie attempt to latch the mother’s breasts; the upper lip frenum restricts the upper lip to flange outward and the baby will either pop off the breast completely or briefly relax and latch off the breast. Tongue tie babies have a difficult time lifting the tongue; the frenum restricts the movement of the tongue and causes problems for the baby to latch onto the mother’s breast during breastfeeding. Tongue and/or lip ties may cause incorrect latching. The consequences of an incorrect latch at the breast during breast feeding may include poor suck, poor seal around the breast, loud clicking noises, extended feeding times, poor infant weight gain, infant fussiness, and irritability during and after breastfeeding.
An inadequate seal around the breasts during breastfeeding may cause the baby to experience aerophagia, swallowing or sucking air into the stomach. The babies may experience these symptoms:
· abdominal distension
· gassiness (flatulence)
· belching (burping-swallow excessive air)
What is reflux?
*Reflux or GER (gastroesophageal reflux) in a baby may show up as irritability and pain, sometimes with constant or sudden crying, or colic-like symptoms. Babies can be inconsolable, especially when laid down flat.
Signs & symptoms:
· Difficulty sleeping when lying down
· Arching their necks and back during or after feeding
· Problems swallowing, gagging, coughing
· Hiccupping and drooling
· Feeding refusal or constant feeding
*Normal movement of the tongue is difficult or impossible if the tongue is tethered to the floor of the mouth *Clinical Lactation 2011, Vol.2-4
Treatment
Aerophagia and reflux symptoms are experienced in lip and tongue tied babies and can be misdiagnosed as Gastroesophageal Reflux Disease (GERD). Unfortunately, some babies are treated with prescription medications, such as Zantac or Prevacid to reduce the reflux symptoms.
* Dr. Larry Kotlow’s article, Infant Reflux and Aerophagia Associated with Maxillary Lip-tie and Ankyloglossia (Tongue-tie), suggests that a maxillary lip and/or tongue ties may be a contributing factor of babies’ inability to create an adequate seal for correct latching at the breasts during breastfeeding.
**There is a lack of literature and research looking at a potential causal relationship with aerophagia and reflux in breastfeeding infants. More studies and researches are needed.
*Clinical Lactation 2100, Vol.2-4
**Int J Clin Pediatr.2016; 5(1):6-8
How to treat lip and tongue tied babies?
Both lip and tongue ties can be treated in quick procedure that is nearly painless, it usually may not require anesthesia. The procedure is called frenectomy; the removal of frenum that connects to the lip or tongue. Frenectomy can be performed with the following instruments:
· Scissors-bleeding
· Scalpel or sharp surgical knife-bleeding
· Laser-minimal bleeding, faster surgical time, decreased postoperative pain, quick healing
Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA. Dr. Anna Lee is an experienced provider for Laser lip and tongue tied frenectomy (releases). If you have any questions about lip and tongue tied frenectomy, please visit us at www.annaleedds.com or call for a consultation at 626-335-5114.
