A Beginners Guide to Infant Tongue and Lip Ties


Why infant tongue and lip ties became important to me

Like many new mothers, one of the things I couldn’t wait for when I was pregnant with my son was the experience of breastfeeding. I had watched my sister in law a few years earlier have a beautiful breastfeeding journey with her daughter and I couldn’t wait to share that bond with my little guy. When my son was born, my sister in law was the only person I knew who had breastfeed and she luckily hadn’t experienced any challenges with her daughter. So I was thinking breastfeeding my son would be natural, easy, joyful and painless. Unfortunately, our breastfeeding journey was going to start out much different! While there are a number of reasons why breastfeeding can be challenging, I’m going to spend today discussing one in particular that caused the majority of our early struggles: tongue and lip ties!

A rocky start

When my son was born, he couldn’t seem to latch on correctly. With him arriving at 8:21 pm, we also didn’t have access to a lactation consultant until late morning of the next day. So that night he cried almost the entire time because I couldn’t figure out how to get him properly latched and his poor belly was craving that liquid gold known as colostrum. By late afternoon / early evening the next day the lactation consultant was worried because he still couldn’t latch properly and had not passed a bowel movement yet.

They suggested supplementing a little with formula and by this point I was so nervous and tired I agreed. They did use a supplemental nursing system, you can find more information on them here, to help still encourage nursing which I appreciated. I was extremely nervous to be released and head home because we still had yet to achieve a good latch and I wasn’t feeling any milk let downs. It also hurt, a lot, every time my son did try to latch on and suckle. Once home things got worse, because milk wasn’t being properly removed my milk didn’t fully come in for almost a week. When it did finally come in, it resulted in clogged ducts that lead to mastitis. The antibiotics for the mastitis lead to a yeast infection for me and thrush for my son, both of which then had to be treated with more medicine.

For information on how to treat mastitis more naturally check here, how to treat yeast infections more naturally check here and how to treat thrush more naturally check here. *As with any medical condition always check with your doctor/health care provider/midwife before starting any treatment.

Trust your gut mama

After a few weeks of nothing improving (my son was nursing for about an hour, taking maybe a 20-30 min break then nursing for another hour around the clock, I wasn’t sleeping at night at all, my nipples were cracked and bleeding, I still wasn’t feeling strong let downs and nursing caused extreme pain) I started doing research. I found online breast feeding communities and started asking questions. One of the best ones I joined was The Leaky Boob. They confirmed what I already was thinking, possible tongue and lip ties.

Unfortunately, due to formula being widely used in our country over the last 2-3 generations, so much knowledge concerning tongue and lip ties has been lost. Many ties used to be discovered because they cause problems with breastfeeding and it’s rumored many of the midwives from generations ago actually kept their pinkie finger nail filed sharp to “cut” ties right after birth.

When large majorities of women use formula for 60+ years, many practitioners become uneducated on signs and symptoms of ties, along with how to properly fix them in infants and children. Over the course of 3 months we had 4 different pediatricians and 2 lactation consultants examine our son and tell us he had no tongue or lip ties (he actually had both). Many made comments like “breastfeeding doesn’t work for everyone, just switch to formula” or “it may be easier for you to just pump and bottle fed”. My mommy instincts (along with close to 15 years of working in the dental field as an assistant/dental hygienist) were screaming that something was wrong. I finally found a lactation consultant to give us a referral to a children’s EN&T specialist (ear, nose and throat).

I was so frustrated when that EN&T also did a quick peek inside my son’s mouth and was ready to send us on our way while saying there was no problems. I turned into that momma bear and basically blocked the door while telling him we weren’t leaving until he completed a finger sweep under my sons tongue. And sure enough, he was surprised to find a “posterior tongue tie”. He revised it that day (no local anesthetic needed, I stayed in the room and my son nursed right after) but recommended waiting to do anything about the lip tie (at that point I was just so relieved the tongue tie had been addressed). Trust yourself. You know your child better than anyone else ever will and you will always be their strongest, loudest advocate.

Breastfeeding life after the tongue tie revision

Within 7-10 days of the tongue tie being released by son was latching on properly like a pro! There was absolutely NO PAIN with nursing anymore! He was able to drain my breasts of milk effectively and in half the time, had less gas and fussiness!! After 3 months of hell I finally felt like this was what breastfeeding was suppose to look/feel like! We were lucky enough to continue nursing on demand until my son was almost 3 years old and he over about a 6 month period self weaned!  I also found this Facebook Group, which has so much more wonderful information concerning tongue and lip ties, along with this Providers List (where you can type in your zip code and find providers near you who actually specialize in infant/child tongue and lip ties – many using a laser technique to complete revisions resulting in faster healing!). Dr. Bobby Ghaheri MD is also currently one of the most knowledgable doctors working with infant/child tongue and lip ties, he also responds personally to emails (and questions in the above mentioned Facebook Group). His website and contact information can be found here.

Throughout all of our research we found some developing information on how tongue ties can adversely affect the Vagus Nerve. This nerve runs under the tongue and basically connects the digestive system to the brain. Tongue ties prevent the Vagus Nerve from being stimulated properly, which can negatively affect the digestive process and mess up the “hunger” feeling. This could be one reason for failure to thrive and/or reflux problems. For an informative article that’s more in depth on this check here.

Signs and Symptoms

So how do you know if tongue and/or lip ties are something that need addressed with your little one? While not every infant/child will have the same signs or symptoms (bottle feeding and breast feeding will both also give different ones as well) there are some common things you can look for. ** These signs and symptoms do not always mean there is a problem with a tongue and/or lip tie. If you or your little do have one or more of these signs/symptoms, reach out to your doctor/pediatrician/lactation consultant/midwife along with the resources mentioned above to determine the next best steps for your family.

Mom Symptoms: pain during breastfeeding (from compressed nipples, nipples with the “new lipstick tip” shape, to cracked/blistered/bleeding nipples etc), thrush, clogged ducts, mastitis, sleep deprivation (babies with ties usually nurse for longer periods and more often – especially at night), compromised milk supply.

Baby Symptoms: trouble latching/staying latched, latching then unlatching then re-latching often, “biting” or gumming nipples, shallow latch, choking during milk let downs or during bottle feeding, unlatching to gasp for air, a clicking sound while trying to nurse, inadequate or slow weight gain, nursing or bottle feeding more often and for longer periods of time, drooling a lot during nursing or bottle feeding, extra gas, reflux, colic.

Toddler Speech Symptoms: showing problems pronouncing certain sounds (especially l,r,t,d,n,th,sh, and z which all need tongue mobility) and parents having trouble understanding toddlers when they speak (should be 75-100% understood when talking by age 3 – Weiss, 1982).

For more in depth information on signs and symptoms check here ( <—– one of my absolute favorite posts on tongue and lip ties that also has a lot of pictures) and here!

Additional information and food for thought

Recent studies are beginning to link tongue/lip ties (and other midline defects) with MTHFR gene mutations and some estimates are projecting up to 50% of the population has at least one form of the mutation. The Mommypotamus Blog has a wonderful beginners guide to understanding MTHFR gene mutations here!

I hope this information was helpful! Many babies might also latch ok (and mom’s might not have pain during nursing) but may not transfer milk well – this can be an indicator of ties not just “your milk never coming in”. It’s also important to be aware even after a revision/tie correction with a knowledgeable provider not all problems may go away (there may still be underlying additional issues) and it’s important to work with your pediatrician/lactation consultant/midwife etc moving forward. The journey into motherhood can be so challenging and I’m so grateful we eventually found the information and support systems we needed to get our sons ties corrected! If you have any other questions please feel free to email or leave a comment!