Is it a tongue-tie?

Ah, the questions of tongue-ties! Where do we begin? With so much information — and misinformation — many families struggle with knowing and understanding the signs and symptoms of ties and where to go for diagnosis and treatment.

Let’s start with the common symptoms.

Moms can experience painful nursing, shallow latch, creased / cracked / flattened / lipstick shaped nipples, bleeding nipples, engorgement that is not relieved by feeding, chronic plugged ducts and/or mastitis, nipple thrush, nipple vasospasms, feedings that seem to go on forever and/or need to use of the nipple shield to get baby to latch for feeds.

Babies may have difficulty latching and maintaining a latch to the breast (or bottle), fall asleep early on in a feed, slide to a shallow latch on the nipple, colic/fussiness, spitting up after most feeds, clicking noises while feeding on breast or bottle, gassiness (burps and/or "toots"), slow weight gain, milk dribbling during the feed, biting or chewing on the nipple, frequent feedings, and/or reflux symptoms.

Tongue-ties are often accompanied by lip-ties and sometimes buccal ties. And all can contribute to issues with feeding, both on the breast and on the bottle.

Because no two families are alike, symptoms may vary. Does this mean that anyone that has these symptoms has ties? Certainly not. It is important to work with a skilled provider who specializes in the diagnosis and treatment of ties because some medical conditions that can mimic tie symptoms.

A tie should NOT be assessed and treated by looks alone. The function of a tongue is far more important than visual appearance. A skilled provider will assess not only appearance, but the movement of the tongue in multiple directions: extension, elevation, lateralization, and suck ability. Without a proper examination, it is impossible to know if it is a true tie or something entirely different.

It should also be noted that symptoms of tongue tie do not automatically go away with a procedure otherwise known as a frenectomy. Because tongue ties can have effects on the entire body, it is imperative to seek additional support and help post tongue-tie release from body workers such as chiropractors, cranial sacral therapists, occupational therapists, International Board Certified Lactation Consultant (IBCLC), and speech language pathologists. Treating tongue-tie is truly a team effort.

So where do you go?

If you are experiencing feeding issues, first seek help and support from your birth team. You should also seek the support of an International Board Certified Lactation Consultant (IBCLC) who specializes in ties. If you’re located in the Phoenix area, there are many knowledgeable and caring providers who can help guide you.

My best advice to you is to always follow your mama (or daddy) gut. If the advice you are receiving does not feel right or the issues you are experiencing are not resolving — seek other opinions and help. There can be multiple solutions to a problem. Find the approach that works best for your family.

Written by:

Dr. Cara J. Riek
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