Whenever you think of breastfeeding issues you most likely think of issues mom is having with supply or correct latching techniques. Although those are common and can usually be fixed relatively easy, it is not always the case.

Another issue that is getting more attention in recent years is tongue- and lip-ties in babies. These can cause a myriad of problems for both mom and baby if not diagnosed correctly and addressed.

Identifying Tongue- and Lip-Ties

The first thing you need to know is what it means to have a tongue and lip tie because there is often some confusion.

A tongue tie is the common name for ankyloglossia, or when the thin tissue (lingual frenulum) that attaches the tongue to the floor of the mouth is too tight or short. A tight frenulum can restrict the mobility of the tongue which can affect both breast and bottle feeding or the ability to take a pacifier.

Babies that have a tongue-tie may not be able to lift up their tongue freely or past the lips. Tongues with a tight frenulum may be heart shaped due to the frenulum pulling the tip of the tongue down. There may also be firm tissue where the tongue meets the floor of the mouth.

A lip-tie is different in that it is a tight labial frenulum (the tissue that connects the upper lip to the gums). As with a tongue-tie, the frenulum is too tight or thick and causes difficulty lifting or moving the upper lip. This causes the upper lip to be unable to open wide and fully grasp the breast.

There are varying levels of tongue- and lip-ties. It is important to receive a proper diagnosis so you can explore your options. Contact an IBCLC near you so they can examine your baby and talk about all of the issues you have been having.

Symptoms of Tongue- and Lip-Ties

Besides the presence of tight frenulums, there are other signs that ties might be present.

Symptoms in the mother:

• Pain while nursing
• Sore or cracked nipples
• Engorgement, blocked ducts, or mastitis
• Low milk supply or oversupply

Symptoms in the baby:

• Difficulty latching or a shallow latch
• Loss of suction and clicking noises while feeding at the breast
• Frequent but short feeding sessions
• Falling asleep at the breast
• Difficulty gaining weight
• Fussiness at the breast or colic

If a tie is severe enough many of these symptoms will affect breastfeeding, but it is possible for a mild tie to not have any symptoms or affect breastfeeding at all.

Treatment Options

If a tongue- or lip-tie is causing pain while breastfeeding and making it difficult for the baby to latch properly, it is recommended to have the tie examined by a lactation consultant or medical professional.

In some cases a thin tongue-tie can be resolved through gentle stretching practices or it will break on its own. You may even be able to breastfeed normally with changes to position and latch. An IBCLC can show you different techniques to encourage a deeper latch and positions that are more comfortable for both you and your baby.

If the tongue- or lip-tie is causing excessive pain and your baby is fussy or not gaining enough weight, you should talk to a lactation consultant or health professional about an option called frenotomy. This is a procedure that divides the membrane under the tongue or upper lip by using a laser, scalpel, surgical scissors, or cauterization. When the frenulum is released for either a tongue- or lip-tie, the baby should have better mobility of their tongue or lip which will make it easier for them to get a proper seal and latch around the breast.

When a tie is revised in a baby under 6 months of age, there is usually no anesthesia necessary. The procedure is done in a few seconds and returned to the parents within minutes. Babies are able to breastfeed right after the procedure to help with the pain and encourage healing. Some healthcare professionals may suggest an infant pain reliever for the first day or two after the procedure when the area will be most sore. It may take a week or two for your baby to adjust to the new range of motion, but the pain should decrease as you learn how to latch.

It is best to have a tongue- or lip-tie diagnosed as early as possible so you can weigh all of your options. Whether you decide to get a tie revised or not, it is still important for you and baby to learn proper breastfeeding techniques. Schedule a Video Consultation with one of our RN/IBCLC or CLC to discuss any issues you are having and have your questions answered by a dedicated and knowledgeable lactation expert. We will guide you in the right direction so you can continue with your breastfeeding journey.