If your infant is struggling to breastfeed or bottle-feed, you may wonder if they have a tongue tie or lip tie. There is much information available online, some good and some not-so-good, that can make the whole process overwhelming. We are all born with a lingual (tongue) and labial (lip) frenulum, which is connective tissue under the tongue or lip. Just because you can see your baby’s frenulum does not mean they have a tie. Sometimes there is a variation in the frenulum, making it shorter or thicker than normal, or it may tether the tongue too close to the tip. We are noticing more “ties” because more babies are breastfed, and more mothers are reaching out for help.
If you think your baby might have a tie, the first step is to see an IBCLC that is well-versed in oral habilitation. IBCLC’s have different skill sets and training, so it is important to ask questions and know who you are seeing. You may think that you should see your baby’s pediatrician, an ENT or pediatric dentist if you suspect a tie, but an IBCLC should actually be your first stop. The IBCLC will consider ties as one possible reason for breastfeeding difficulty, but will also address many other possible causes of breastfeeding challenges. An IBCLC will :
Evaluate your baby’s function at the breast or with a bottle and share information/education about what may be causing challenges with feeding.
Assess your baby, looking for good reflexes, tension or tightness in the body, or torticollis.
Do an oral exam—an IBCLC cannot diagnose a tie, but will make observations about what is happening in a baby’s mouth and offer exercises to help with tension, tongue movement, and strengthening.
Work with you for optimal positioning and latch, and assist with any other challenges you may be facing.
At the end of your visit, the IBCLC will share recommendations for what should happen next. Many times, a chiropractic or craniosacral therapy appointment may be recommended. If the IBCLC is concerned about your baby’s tongue or lip frenulum, she may recommend seeking further evaluation by a pediatric dentist or ENT.
Releasing a tie is just one part of the process in helping your baby feed more easily. Addressing other contributing issues before a release helps the release to be more successful. Following up with an IBCLC after a release for exercises helps your baby to regain the function and strength they need to breast or bottle feed well. Having an IBCLC who can support you and your baby throughout this process is key to your success.
~Becky Franzen is an IBCLC with a MA in Lactation and many continuing education courses about tongue and lip ties, including the master-level course Oral Habilitation for the Breastfeeding Dyad.