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Babies are born to breastfeed, and when they are unable to do their job it might be due to difficulties with their suck. Babies need to be able to move their tongue freely in their mouth. They need good elevation to where the tongue tip can touch the top of their mouth and extend past the lips when their mouth is wide open. They need to be able to cup the breast with their tongue to make a vacuum to extract the milk and keep a good seal on the breast. Good function and mobility of the baby’s tongue make breastfeeding painless for mom and transfer of milk easy for the baby.

Tongue ties can affect the mobility of the tongue. There are 4 types of tongue ties. Type I and type II are easily seen because the attachment of the frenulum is at the tip of the tongue or just beyond the tip of the tongue. Type III and IV tongue ties are known as the posterior “hidden tongue ties”. This is where the frenulum is attached distal to the midline and may not be obvious and only found with palpation of the frenulum. The frenulum may feel very tight and taut.

Another part of the baby’s mouth that can contribute to breastfeeding difficulties is the frenulum that attaches the upper lip to the upper jaw. This is called a maxillary lip-tie and there are also 4 classifications. The classifications range from minimally visible attachment to the attachment extending into the hard palate or anterior area. Maxillary lip ties can prevent the baby from making a good seal on the breast because they are not able to flange their lip appropriately.

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Both tongue ties and lip ties can not only cause pain and nipple trauma for mom, but they can cause the baby to be inefficient at nursing, potentially causing infant weight loss and low milk supply. Remember the nursing baby runs the show. Other potential problems that could occur if the tongue and lip ties are not corrected are speech issues, dental and orthodontic issues, social issues like smiling and kissing, sleep apnea, spaces between the front teeth and reflux due to the baby swallowing air due to the poor latch.

The recommended treatment for a lip or tongue tie is water laser to cut the tissue. Infants do not need anesthesia for the treatment, as they have little blood supply and nerve tissue to the area. Research studies have shown that after treatment moms report better latching and milk transfer. A lactation consultant can help to identify if this is the problem that is making nursing difficult and help with teaching mom the follow-up tongue exercises that are needed to ensure your baby relearns how to use their tongue effectively.

To find out more about Motherhood Center’s lactation consultants, breast pump rentals, and breastfeeding support, click here: Breastfeeding Support

Photo by: Janelle Aby, MD

Post by: Renee Bowling RN, Certified Breastfeeding Educator

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