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Lip and Tongue Ties

Please note that this is a controversial topic and the information below is based on the latest, evidence-based practice.

A lip tie is a thick piece of tissue that connects the upper lip to the upper gums that can restrict movement of the lip. Contrary to some opinions, there is NO connection between lip ties and a child’s ability to nurse or speak effectively. Lip ties should never be addressed in infancy. Most lip ties are harmless, and won’t need to be addressed. In the event that they interfere with orthodontics, they can and should be addressed during early adolescence.

A tongue tie is a condition that is present at birth that restricts the tongue’s range of motion. A tongue tie is identified by the presence of an unusually short, thick, tight band of tissue that tethers the bottom of the tongue's tip to the floor of the mouth. Usually this thick band separates before birth. When it fails to do so, the motion of the tongue can be so restricted that a child’s ability to speak, eat and swallow can be compromised.

A tongue tie might be diagnosed in the following instances:

• Your infant has trouble breastfeeding – an infant with a tongue tie cannot move the tongue or put it in the right position for breastfeeding. This can cause severe nipple pain and affect their ability to get the right amount of breast milk. • A speech pathologist thinks your child's speech is affected by tongue tie. Typically, a tongue tie will affect the “t," "d," "z," "s," "th," "r" and "l” sounds. • Your older child complains of tongue problems that make it challenging to eat, speak or reach their back teeth with their tongue. This can affect oral hygiene (the child’s tongue cannot sweep food from the teeth).

While a tongue tie does need to be addressed, HOW it is addressed is EXTREMELY important, so PLEASE take careful note:

There are pediatric dentists who claim they can diagnose and treat a tongue tie. You should NEVER rely on a dentist to diagnose or treat a tongue tie. This procedure can damage important muscle tissue.

If you suspect that your child has a tongue tie, mention it to your primary care pediatrician or lactation consultant. A tongue tie cannot be diagnosed by visual inspection alone, and usually, cannot be diagnosed before around two weeks of age. A lactation consultant and / or pediatrician will assess the infant’s feeding and growth, and whether mom is experiencing abnormal discomfort. If they suspect a tongue tie, they will refer you to a pediatric ENT who is trained and experienced in treating the condition. When performed by a pediatric ENT, the procedure is VERY quick and straightforward, with minimal recovery time.

Remember that all medical procedures pose some risk, and should only ever be performed if found to be medically necessary.

If you are concerned about your infant’s feeding, we are now offering a breast feeding clinic to help support our families with early feeding challenges. All you have to do is call our front desk and schedule a lactation / breast feeding medicine visit with Dr. James or Dr. Mulhausen. Both pediatricians are trained to assess and support the nursing couplets (moms and infants). Breast Feeding Clinic hours are limited to Monday and Friday mornings.

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