Tongue and Lip Tie FAQ

[MaryJaneLouise]

There seems to be a lot of tongue and lip tie problems (ankyloglossia) going on lately, so I thought I would try to make an FAQ about it. I will ask it to be stickied, or bump it occasionally. I don’t know much about this topic, so everyone who does please add to this. Thanks .

Kellymom’s always a good place to start:

http://www.kellymom.com/babyconcerns...tonguetie.html


MarcyC found a good resource describing various types of tongue and lip (labial) tie here. It's written by Elizabeth Coryllos, the guru of tongue tie:

http://www.aap.org/breastfeeding/8-27%20Newsletter.pdf

Here’s a thread with names of doctors around the country who can help diagnose and/or treat this condition:

http://www.mothering.com/discussions...ghlight=tongue

[PatioGardener]

Dr. Brian Palmer is a dentist who speaks about the importance of breastfeeding. He has two interesting presentations about tongue-ties:
This one is about ankyloglossia http://www.brianpalmerdds.com/frenum.htm
and this one is about ankyloglossia and breastfeeding http://www.brianpalmerdds.com/bfeed_frenulums.htm

[MaryJaneLouise]

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

These folks did an experiment where they did a fake tongue tie clip operation ("sham") and compared with a real tongue tie clip, in babies who had a diagnosed tongue tie. Moms had significant nipple pain relief with the real tongue tie clip as compared with the fake operation. (They followed up the fake operation with a real one later too).

This would be a good abstract to print out & give to your doctor, if you suspect a tongue or labial tie.

J Pediatr Surg. 2006 Sep;41(9):1598-600.

Immediate nipple pain relief after frenotomy in breast-fed infants with ankyloglossia: a randomized, prospective study.

Dollberg S, Botzer E, Grunis E, Mimouni FB.

Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel. [e-mail]

PURPOSE: Ankyloglossia ("tongue-tie") occurs in nearly 5% of neonates, but its clinical significance relating to breast-feeding difficulties is controversial. We tested the hypothesis that in infants with ankyloglossia referred because of breast-feeding difficulties, frenotomy alleviates the symptoms. METHODS: Twenty-five mothers of healthy infants with ankyloglossia were recruited because of sore nipples. Infants were randomized to either of 2 sequences: (1) frenotomy, breast-feeding, sham, breast-feeding (n = 14) or (2) sham, breast-feeding, frenotomy, breast-feeding (n = 11). The mothers as well as all personnel taking care of the child after each sham or frenotomy procedure were masked as to the study sequence. In every sequence, and after each sham or frenotomy procedure, a standardized latch score and pain score were obtained from the mother. RESULTS: There was a significant decrease in pain score after frenotomy than after sham (P = .001). There was also a nearly significant improvement in latch after the frenotomy in these mothers (P = .06). CONCLUSION: Frenotomy appears to alleviate nipple pain immediately after frenotomy. We speculate that ankyloglossia plays a significant role in early breast-feeding difficulties, and that frenotomy is an effective therapy for these difficulties.

[MarcyC]

Thanks for doing this! A wealth of info right here in one thread!

[superfastreader]

I have our tongue tie story linked in my sig--it's a great "been there, done that" post for parents who are unsure about clipping a type 4 TT.

[MaryJaneLouise]

Anybody else with more info or stories?

[MaryJaneLouise]

another good thread with testimonials

http://www.mothering.com/discussions...6#post10384396

[Rockies5]

yes. I've successfully nurse two babies with severe ties, no clipping. Both nurse through a part of the next pregnancy, one with severe GERD and over supply issues and both past the first birthday (one past the second).

Too many LCs are taught that clipping is the only option and don't know practical ways to get around it.

[MaryJaneLouise]

Originally Posted by Rockies5

yes. I've successfully nurse two babies with severe ties, no clipping. Both nurse through a part of the next pregnancy, one with severe GERD and over supply issues and both past the first birthday (one past the second).

Too many LCs are taught that clipping is the only option and don't know practical ways to get around it.

Can you tell us more about the practical ways to get around it? I, for one, don't know much on this topic

[pamama]

My newborn has a tongue tie. Looks to be type 3 or 4 to me. I'm a bfing counselor who has successfully nursed 2 babes (ds self weaned at age 4 and dd1 will be 4 in April and we're tandem nursing for the second time) and this is the most trouble I've had. She's been a slow gainer but her latch has gotten a bit better so I hesitate to clip if it isn't necessary. I'm going to wait and see how she does over the next couple weeks and then make a decision.
I've been helping her work on her latch and she's doing much better. It is something that can get better with time in some cases. The frenulum can stretch as the baby gets older. Luckily I have a very bfing friendly ped who will support whatever we decide to do about her tongue tie. i am glad to see, though, that not everybody clips the frenulum and can still bf successfully. A friend of mine 9another bfing counselor) has a child with tongue tie and she nursed him with only some early latch issues for 15 months before she even noticed his tongue tie.

[Nan'sMom]

Originally Posted by Rockies5

yes. I've successfully nurse two babies with severe ties, no clipping. Both nurse through a part of the next pregnancy, one with severe GERD and over supply issues and both past the first birthday (one past the second).

Too many LCs are taught that clipping is the only option and don't know practical ways to get around it.

I'm very interested in hearing about this. We had dd1 clipped and I do believe it was necessary. However, dd2 has a posterior tongue tie too and lip tie and we didn't have her clipped because she was getting plenty of milk (maybe because I was tandeming?). I've always wondered about my decisions, both of them, and ways to get around all of this.

[2boyzmama]

:

my ds2 is about to have lip surgery because of a severe tie...

lurking...

[Nan'sMom]

Originally Posted by 2boyzmama

:

my ds2 is about to have lip surgery because of a severe tie...

lurking...

Hi, quickly checked your story. If you are sending photos to Dr. Palmer you might want to try Dr. Coryllos as well. She is semi-retired and now does all tongue tie operations I believe. She's passionate about it and very smart. Worth a try. PM me if you want to--I can give you contact info. And good luck!

[Shirada]

I came on to post about Brian Palmer but see that PatioGardener has already mentioned him . I second his website. I actually wrote to him and he was most helpful. My dd had her frenulum taken care of with laser when she was 5 and it was an in-office procedure and not a big deal at all, (not like the horror stories I heard of with the regular surgical procedure). Our dentist is very informed with the larger issues of tongue-tie, (not just early breastfeeding issues). He is Dr. Weiner in San Diego area: http://ranchosandiegodental.com/?page=aboutdoctor.

If your baby is under 1 year, I definately recommend getting it clipped NOW. I also successfully nursed my daughter, (till age 4 in fact), but a tight frenulum casues many problems with oral development, teeth alignment, jaw, social issues, (not sticking out tongue, french kissing, licking an ice-cream, getting food around mouth and not being able to lick it clean etc.)

[MaryJaneLouise]

Another good article:

http://www.lowmilksupply.org/tonguetie.shtml#10

Here's part of it:

Tongue-tie can lead to low milk production problems, since the baby cannot effectively remove milk from the breast. But there will be earlier indications that a baby is tongue-tied: latch problems, chronic sore nipples, “clicking” or “popping” sounds while baby is breastfeeding, shortened feedings (baby quits early), or prolonged feedings because baby is not satisfied.

Tongue-tie is not a rare condition. In one study, 4.8 percent of newborns were identified as having some degree of tongue-tie, most on the mild side.(11) Of the babies who had tongue-tie, 24 percent had significant problems with breastfeeding that lasted six weeks or longer. In another study, approximately 3.2 percent of babies were found to have “significant” (problematic) impairment of the frenulum. Thirteen percent of the mothers in that study who sought help for breastfeeding had problems related to tongue-tie.(12) Males are more likely to have tongue-tie than females, and this condition often runs in families.

[MaryJaneLouise]

One other word of warning to those with lip (labial) tie. My sone has a fairly mild case of this, but I think that, combined with pretty severe GERD and night nursing, caused bad upper tooth decay. He needed caps/crowns on all 4 top teeth.

If I had to do it all over again, I would have the lip tie cut from birth. Or, I would definitely keep an eagle eye on those front teeth, and brush brush brush several times a day.

[MarcyC]

Originally Posted by Rockies5

yes. I've successfully nurse two babies with severe ties, no clipping. Both nurse through a part of the next pregnancy, one with severe GERD and over supply issues and both past the first birthday (one past the second).

Too many LCs are taught that clipping is the only option and don't know practical ways to get around it.

I'm really anxious to hear how you nursed with tongue-tie. What are other options besides clipping. Please share your story. My DS has a type III tongue tie, which has led to my low-supply. He also had a high "bubble" palate which isn't helping things at all. But we keep trying...

[MaryJaneLouise]

[guestmama9904]

how common is this problem or set of problems? i too have seen a lot of mdc users discussing this issue and had never really hear much about it before coming here. why the seemingly sudden prevalence i wonder. i guess what i am asking is why would our children be born with a disability in their mouth structure that prevents them from nursing (and evolutionarily speaking therefore surviving) normally? i wonder if this is a modern problem or if it was dealt with differntly in times past. just curious.

[Erinz]

I've always figured that there are more moms here willing to work through anything and everything to continue breastfeeding.

I was willing to fight through blood sweat and tears to breastfeed, and good thing for that sheer determination!

I had my son's severe tongue tie clipped at 5 weeks old. It took but a second, one drop of blood, and that first nursing session immediately following the clip was like a dream. My wounds healed within 2 days. I had tried everything before the clip, and we had other issues such as thrush, over-abundent supply, constant engorgement, forceful letdown.... I was to the point of wanting to pull out the formula which is VERY VERY unlike me.

So, if it isn't severe I definately think it is worth working around without a clip. However, if you are risking discontinuing breastfeeding alltogether because the pain is unbearable and you are amazed the bleeding fissures in your breasts haven't become infected -- then this is a good example of an appropriate clip IMO.