What is a Tongue-Tie?
Tongue ties occur when the frenulum (the string of tissue attaching your tongue to the floor of your mouth) is too short, thick, or tight, therefore impacting the overall function of the tongue. Impaired tongue function can contribute to difficulties in breastfeeding and bottle feeding in babies. If left untreated, impaired tongue function could also contribute to difficulties with swallowing, speech, and breathing.
What are Lip-Ties and Buccal-Ties?
A lip-tie or buccal (cheek) tie occurs when the labial or buccal frenula are too short, thick, or tight, or insert low into the gumline, impacting function of the mouth. Impaired lip-tie and buccal-ties can also contribute to difficulties with feeding. If a tongue-tie tie is present, it is increases the likelihood there will be a lip-tie or buccal-tie.
Tongue-Ties in Babies
Ties are often undiagnosed so it is important to be aware of the signs so you can seek professional advice on how to proceed. Most commonly, ties show signs of dysfunction when the baby is young and having difficulty with breast or bottle feeding. Both mom and baby could show signs of ties, which are outlined below.
Baby Signs:
- Shallow latch
- Clamping or chomping on bottle or breast
- Clicking sounds at bottle or breast
- Decreased milk transfer, or poor weight gain
- Coughing/gulping during feeds
- Frequent feedings or long feedings (> 40 min.)
- Reflux, frequent spit-ups, or GI discomfort
- Sliding or popping off breast
- Fussiness or arching away from breast/nipple
- Gagging
- Baby lip blisters
- Loss of liquid during feeds from baby
- Milk tongue (white coating)
Mom Signs:
- Maternal nipple pain
- Misshapen nipples after nursing
- Recurrent breast engorgement or mastitis
- Decreased milk supply
Tongue Ties in Infants
A baby may not show signs of ties until they become an infant and start eating solids. This could manifest in what looks like picky eating, physiological problems or oral motor skill deficiencies. A baby may have also gone undiagnosed with ties and may have a history of breast or bottle feeding difficulties. Below is an outline of signs of ties to look for in infants.
Physiological Signs:
- Poor weight gain
- Constipation
- Gi discomfort
Picky Eating Signs:
- Food refusal of certain textures
- Disinterest in trying new foods
- Preference for only dry and crunchy foods
Oral Motor Signs:
- Frequent coughing or choking
- Drooling
- Poor lip closure/anterior food loss
- Mashing foods anteriorly with a munching pattern vs chewing on molar surface
- Difficulty transitioning to age appropriate food textures
- Food pocketing
Tongue-Ties in Older Children
Furthermore, if ties continue to go undiagnosed into toddlerhood, there may be signs of breathing difficulty, swallowing , or dental complications. In addition they could contribute to speech difficulties, which is outlined below.
Speech Signs:
- Poor articulation
- Interferes with speech sounds
- Sibilants and lingual sounds
- Pronouncing certain letters
It’s important to get ties looked at by a specialist so they can help with treatments and referrals. Seek advice on how to move forward before struggling with feeding for too long and the problems get worse for baby and Mom. It is important to keep feeding experiences positive from the very beginning of life to build a good foundation.