When many pregnant women picture their future babies, they imagine being able to breastfeed their infants to provide them nourishment and to keep them healthy and growing. Unfortunately, breastfeeding issues can arise for many reasons, such as food allergies in the baby, milk supply issues in the mother, and health issues in the baby or mother. One roadblock to breastfeeding that is increasingly being recognized is that of tongue tie and lip tie.

These issues get added attention in particular in February, for Kids ENT Health Month.

Tongue tie, known as ankyloglossia, and lip tie, known as a tethered labial frenulum, are not well understood by many healthcare professionals.  While everyone has some tissue attaching the tongue to the floor of the mouth or the lip to the upper jaw, problems can arise when that tissue is too tight, preventing the tongue from lifting up or sticking out enough, or the lip from turning outwards. 

 A proper latch for breastfeeding requires the baby’s tongue and lip to be untethered. In the setting of a tie, the latch is not effective and this can cause a host of problems.  The mother can experience significant pain with feeding, cracked or bleeding nipples, incomplete emptying of the breast, mastitis, and diminished milk supply with the need to pump or supplement with formula.  The baby can require excessively long or frequent feeds, can have significant spit-ups or reflux or colic and can have poor weight gain.  

 When breastfeeding issues are present, mothers should seek the advice of a lactation consultant, a health specialist trained to assess the latch of the baby and to address many of the factors causing the problems with feeding. 

 Ultimately, if ankyloglossia or a tethered labial frenulum is suspected, a physician or dentist trained to manage these problems can evaluate the baby. Typically these providers can perform a brief procedure the same day.  In young infants, this can be done in the clinic with only local anesthesia, and sterile scissors or a laser is used to clip the small amount of tissue that is preventing the proper latch.   There can be some mild pain in the baby after the procedure for which the doctor or dentist will give options to manage. Also, there will be exercises discussed to help prevent the tissue from scarring back down and to optimize the motions of the mouth. Seeing the lactation consultant or other health providers after the procedure can help to ensure the very best latch is attained.

 Tethered tongues or lips can cause other issues beyond breastfeeding such as problems taking a pacifier or bottle, speech problems, and issues with large gaps between the front teeth or dental decay.  Older children can also undergo clipping procedures, though they may require a brief anesthetic depending on their age.

In most cases, feeding issues stemming from tongue or lip tie are curable, with the help of an experienced team.  As a fellowship-trained Pediatric Otolaryngologist-Head and Neck Surgeon with a special interest in ankyloglossia and tethered labial frenulum, I am happy to offer the families of Lompoc and surrounding areas the most current management of these problems.   

About the Author

Author: Dr. Dale Amanda Tylor, MD, MPH, Otolaryngologist (ENT)

Dr. Dale Amanda Tylor, MD, MPH is also associated with ENT Associates of Santa Barbara. Dr. specializes in treating pediatric ear and hearing issues. An otolaryngologist, or ENT physician, is trained in the medical and surgical treatment of patients with diseases and disorders of the ear, nose, throat and related structures of the head and neck. Originally from Montreal, Canada, Dr. Tylor attended medical school at McGill University in 2002 before transferring to the University of Florida in Gainesville, where she completed a General Surgery internship and Otolaryngology-Head and Neck Surgery residency in 2007. She completed specialized fellowship training in Pediatric Otolaryngology-Head and Neck Surgery at Rady Children’s Hospital in San Diego.