The effect of lip and tongue ties on breastfeeding

The effect of lip tie on breastfeeding

Lip tie is a band of thick tissue that connects the underside of the lip to the gums and restricts the normal movements of the lip.  Dr. Ghaheri wrote and explained the effect of upper lip tie on breastfeeding on his blog to the parents on March 6, 2014.   He wrote that the lip tie can affect the baby’s ability to flange the upper lip during breastfeeding:

·       “The shorter and tighter the frenulum the more uncomfortable it is for the baby to flange the lip outward. The baby would either pop off the breast completely or would briefly relax and latch off the breast. Mom would have to flip the lip upward and get the baby latch on repeatedly. ”

·       “Upper lip tie affects breastfeeding is based on muscle flexibility.   The muscle around the lip of an upper lip tie cannot be pushed up toward the nose. This puts an unnatural amount of tension on the muscle of the lip. The baby cannot and would not open widely if the lip is tense.”

The effect of tongue tie on breastfeeding

Tongue tie is a band of thick tissue that connects the bottom of the tongue’s tip to the floor of the mouth. Tongue tie restricts the movement of the tongue and causes problems for the baby to latch onto the mother’s breast during breastfeeding. Ultrasound studies have shown that the tongue movements of tongue tied babies are different from those without tongue ties. The studies showed that tongue tied babies had difficulty in achieving a good latch during breastfeeding.  They were not able to drain breast milk effectively from the breasts and caused nipple pain and damage.

Lip and tongue tied babies may exhibit some of these symptoms during breastfeeding:

·       Difficulty in achieving a good latch

·       Falls to sleep while attempting to nurse

·       Slides off the breast when attempting to latch

·       Reflux (clicking, swallowing air during nursing)

·       Gassiness, vomiting, spitting up

·       Poor weight gain

·       Short sleep episodes (feeding every 1-2 hours)

·       Milk leaking out sides of mouth during feedings

Mothers may exhibit some of these symptoms during breastfeeding with lip and tongue tied babies:

·       Painful latching of infant onto the breast

·       Gumming or chewing of the nipples

·       Bleeding, creased, cracked or blanching of nipples

·       Poor or incomplete breast drainage

·       Plugged ducts

·       Mastitis

·       Over or under supply of breast milk

These are some of the lip and tongue tied babies who are treated with laser frenectomy:

Baby Kathy

·       7 weeks old and parents wanted an evaluation of lip and tongue ties

·       History: baby had tongue tie frenectomy in the hospital before discharge. It appeared that only the anterior portion was clipped and had reattachment.

·       Baby symptoms: did not open mouth wide when latching, cupped tongue when crying, bubble palate, clicking, spitting up, fell asleep while attempting to nurse, short sleep episodes (feeding every 1-2 hours)

·       Mother’s symptoms: painful, cracked, pinched and blanched nipples, milk blebs, plugged ducts, poor breast drainage

·       Diagnosis: Lip and Tongue ties

·       Recommended treatment: laser lip and tongue tie frenectomy

·       Parents accepted recommended treatment

·       Instructed mom to perform aftercare and sucking exercises for 4 weeks

·       Parent and baby returned in one week for post treatment check up

·       Instructed mom to follow up with lactation consultant and body workers after the procedure to ensure optimal results.

1 week post treatment checkup:

·       Baby looked healthy and gained some weight

·       Both lip and tongue were healing nicely

·       Baby symptoms had improved; latching was deeper, feeding and sleeping longer and no more clicking and spitting up

·       Mom symptoms also improved; less nipple pain during breastfeeding, breast drainage got better, and mother had enough milk supply.

·        Baby had craniosacral therapy and mom reported that baby slept better.

Baby Alan

·       3 weeks old and parents wanted an evaluation of tongue tie

·       History: baby had infection in the hospital

·       Baby symptoms: shallow latching, fell asleep while attempting to nurse, slid off the breast when attempting to latch, fed every 2 hours, heavy, noisy breathing, snored, spit up 3x/day and leaked milk side of the mouth (sometimes)

·       Mom symptoms: painful latch, creased and flat nipples, clogged milk ducts, poor breast drainage, mastitis and on antibiotics

·       Diagnosis: Tongue tie

·       Recommended treatment: Laser tongue tie frenectomy

·       Parents accepted recommended treatment

·       Instructed mom to perform aftercare and sucking exercises for 4 weeks

·       Parent and baby returned in one week for post treatment check up

·       Instructed mom to follow up with lactation consultant and body workers after the procedure to ensure optimal results.

1 week post treatment checkup:

·       Baby looked healthy and gained some weight

·       Tongue was healing nicely

·       Baby symptoms had improved; baby was latching on better during breastfeeding, baby nursed about an hour per session (3 ½ oz.), baby slept afternoon and night time (3-4 hours before waking up for feeding).

·       Mom symptoms had improved; no nipple pain when breastfeeding, mastitis had resolved and no more blisters.

Dr. Anna Lee is a general & cosmetic dentist in Glendora.  Lip and tongue ties may cause breastfeeding issues for some babies and mothers.  Dr. Lee is an experienced provider for baby lip and tongue tied frenectomy.  If you have questions about lip and tongue ties, please call for a consultation at 626-335-5114 or visit us at www.annaleedds.com

Tongue and lip ties cause dental problems

Tongue and lip ties can cause dental problems in toddlers, children of all ages, and adults.  The dental problems may include dental decay, gum disease (gum recessions), gap between front teeth (diastema), crooked teeth, malocclusion, teeth grinding/clenching, and others

These are some of the dental problems that may be caused by tongue and lip ties:

Lip and Tongue Ties and Diastemas (gap between teeth)

·       Lip tie that has band of thick tissue that connects the underside of the lip to the gums can cause a gap between the upper front teeth

·       Tongue tie that has a band of thick tissue that connects the bottom of the tongue to the floor of the mouth can cause a gap between the lower front teeth

·       Pediatric dentist, Larry Kotlow, D.D.S. recommends that the best time to perform the lip and tongue tied releases for gap closure is before 18 months old or when the permanent teeth are erupting

·       Lip and tongue tied releases allow for gap closure without the need for braces

Poor oral hygiene

·       Can be painful when parent lifts the lip to assist the toddler/child with brushing.  The tightness of the lip tie hurts the child

·       Can be painful when the toothbrush hits the lip tie (frenum)

·       Difficult for toddlers/children to keep up with their oral hygiene when tooth brushing (hitting the tie) is painful

·       Food, juice, or milk  traps  in the pocket between the lip and the teeth and cause dental decay

Dental Caries

·       Lip tie can trap food between the lip and the teeth and make it difficult to brush

·       Tongue tie restricts the tongue from lifting and sweeping the food stuck between the cheeks and teeth. Tongue is restricted and unable to clean the back teeth and the palate.

·       Prolong exposure of food debris on teeth surfaces without thorough cleaning them off would cause dental decay and oral health issues

Teeth Grinding/Clenching

·       Teeth grinding may be caused by stress

·       In his book, “Tongue Tie,” Pediatric dentist, Richard Baxter, D.D.S. talks about the new thinking is that nighttime teeth grinding can be a sign of sleep-disordered breathing.

·       Dr. Baxter discussed that one possible reason children and adults grind their teeth at night may be because of airway obstruction. “If the tongue is held down by a tongue-tie, the tongue often falls backward during sleep and blocks the airway,” said Dr. Baxter

·       When the airway is blocked, the body tries to open up the airway by protruding the lower jaw and grinding teeth.  It is a body’s defense mechanism of arousing the person to breathe when the airway is obstructed. (88, 89)

88.  Kostrzewa-Janicka J, Jurkowski P, Zycinska K, Przybylowska D, Mierzwinska-Nastalska E. Sleep-Related Breathing Disorders and Buxism. Adv Exp Med Biol 2015; 873:9-14.

89.  Jokubauskas L, Baltrusaityte  A.  Relationship between obstructive sleep apnoea syndrome and sleep bruxism:  a systematic review. J  Oral Rahabil 2017; 44(2): 144-53.

Gum disease (gum recessions)

·       Gum recession is a form of gum disease

·       Gum recession is common in patients with lip, tongue and buccal ties

·       The strong muscles of the tongue, lips and cheeks pull on the gums over time and exert a traumatic force and cause the gums to recede and expose the roots

·       Tongue ties cause gum recessions on the insides of the lower front teeth

·       Lip ties cause gum recessions outsides of the upper and/ lower front teeth

·       Buccal ties cause gum recessions outside of the canines or premolars

Orthodontic treatment

·       Orthodontic treatment is often needed in patients with lip and tongue ties

·       Lip ties (band of thick tissues) can create a gap between upper and/ lower front teeth

·       Tongue ties can affect the growth of jaw bones and cause the bones to grow too little which lead to teeth crowding issues and malocclusion

·       Tongue tie restricts the tongue sitting in the palate and causes poor palatal growth. 

·       Poor palatal growth is the palate that is high arched and V-shaped (narrow) and it may be the cause of crooked upper teeth and other health problem, such as sleep apnea

·       The ideal goal is the unrestrictive tongue sitting in the palate and it should be broad and U-shaped

Dr. Anna Lee is a general & cosmetic dentist in Glendora.  Lip and tongue ties can cause dental problems in toddlers, children and adults.  Dr. Lee is an experienced provider for Laser lip and tongue tied frenectomy (releases).  If you have questions about lip and tongue ties and how they can affect your dentition and oral health, please call for a consultation at 626-335-5114 or visit us at www.annaleedds.com

What are the symptoms caused by a tongue tie in babies?

Are you breastfeeding your baby but running up against a problem? Are you unsure why your baby is struggling to latch? She/He may have a tongue tie. Here are some symptoms of a tongue tie in your baby...

          If a baby is tongue tied, he or she may exhibit these symptoms during breast feeding:

·       Have trouble lifting the tongue up or from side to side

·       Have a tongue that appears heart shaped or notched in the middle

·       Dribble milk down the side of their mouth when feeding

·       Display excessive fussiness and/or colic

·       Have digestive issues like gas, baby reflux and possibly vomiting

·       Pull off the breast/bottle, crying, hitting or tugging while nursing

·       Make clicking or noisy sucking sounds

·       Chew on the nipple or chomp down hard

·       Fall asleep while nursing (although many babies do this!)

                            If a baby is tongue tied, the mother may:

·       Have sore, cracked or bleeding nipples

·       Have nipples that appear squashed, lip stick shaped, and/or blanched (white)

·       Experience pain while breastfeeding

·       Get frequent infections or mastitis

·       Have milk supply issues due to ineffective removal