*For the purposes of this blog post, we are speaking only about tongue ties in newborns/infants. As a child gets older, additional therapies and different treatment modalities are sometimes required*
What is a tongue tie?
Many people, when they hear the phrase “tongue-tie”, they think of just the tongue. But as practitioners, we know that the correct term to explain restrictions in the mouth is really “tethered oral tissues”.
There are many ties that can be present in the mouth, and a trained provider will check all of them to see if they are causing restrictions or difficulties for the baby. Each area can cause different symptoms, but let’s get back to the original question: the tongue tie.
Tongue ties are most commonly associated with trouble breastfeeding as an infant, but the elusive posterior tongue-ties, if not caught in infancy, sometimes don’t show symptoms until that child reaches adulthood.
Signs to look for in your baby that could be a sign of a tongue tie include (but aren’t limited to):
- Painful breastfeeding, hurt nipples, plugged ducts or mastitis
- Excessive spit-up or vomiting after eating
- Gassiness/colic
- Noisy sleeping, mouth breathing, restless sleep
- Poor weight gain
- Baby feeling frustrated at the breast/bottle
- Increased tension in the body
Some tongue-ties are easy to see with the untrained eye. It looks almost like a string that is holding the tongue to the floor of the mouth. Posterior tongue ties are harder to spot, and only trained clinicians typically can diagnose them.
The reason is because these tongues look “normal”, and the restriction is actually behind the tissue in the mouth, so that string-like appearance of the tie is hidden.
If I suspect a tongue tie in my baby, what should I do?
The first step on your tongue-tie journey is to find a trained and recommended provider, and also begin work with a tie-savvy lactation consultant.
Local mom’s groups are great to get opinions from on experiences within an office as to how they were treated, was it a welcoming atmosphere, etc.
Finding a provider who has a lot of training (and good training!) can be more challenging. Good places to start:
- Check their website to show what courses they have taken
- Who they have studied under
- Other patient testimonials
- Recommendations from local lactation consultants, nurses, doulas, or speech language pathologists
What does a tongue-tie release look like?
For a baby, a revision is best done with a CO2 laser. Not only does this type of laser ensure minimal bleeding and minimal post-op discomfort, but it also helps to ensure a complete release.
The procedure itself takes just a few seconds. The wound will be left open, and stretches will be taught to you in order to help the wound heal by secondary intention and not reattach.
You will likely see your dentist for a follow up appointment to ensure healing is taking place normally, and you will continue seeing supportive care (IBCLC, bodywork, chiropractor, etc) for additional support after the release.
What if I choose not to get my baby’s ties released?
It is always your choice in what medical procedures are done for you and your family.
However, a tie is made up of fascia, NOT muscle, it will never “stretch” or “lengthen”. Meaning, it won’t get better on its own.
The body will learn to compensate with the tethered tissues, but these compensations can vary in how symptoms present.
Some patients can be left with orthodontic issues, airway issues like sleep apnea, and migraines or severe head and neck tension from ties. They can also cause speech and feeding issues later on as well. It is always easier to treat the problem early in life, because later on, many more steps are needed rather than a simple release.
In Conclusion
Tongue-ties can cause serious issues if not addressed, and those issues can continue into adulthood. Once an adult, they become much more difficult to treat, as anatomical abnormalities have occurred and additional surgeries are typically needed prior to a release.
It is best to treat early for those having symptoms. Remember, you are your and your child’s biggest advocate, and if you think there is a problem, continue pushing until you get answers!