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The Tea on Tongue Ties

 You have probably heard of tethered oral tissues (TOTS) or some other iteration of the name. And, like many mamas, you may have questions about how these oral restrictions can effect or perhaps are already effecting your little one. So let’s chat about TOTS today…


First of all, ties can effect not just the tongue, but the lips and cheeks as well. It is very common for tongue-tie babies to also have restrictions in the lips and/or cheeks, but it can also occur in just one of those spots. TOTS are commonly hereditary.


The frenulum is a mucous membrane that goes from the floor of your mouth to the middle on the bottom of your tongue. Ankyloglossia (tongue tie) means that the frenulum is tight or short, so that movement of the tongue is restricted.


Are ties a “fad”? Lots of parents ask this because of the frequency at which TOTS are diagnosed these days. But the answer is no, it’s not a fad. We just know so much more about this issue now! Additionally, mothers are initiating breastfeeding at much higher rates than in recent decades, meaning that the breastfeeding challenges that occur with tongue-tie babies are being spotted more often than before.


Can ties effect breastfeeding? Yes. Depending on how severely restricted their mobility is, these babies can have issues with weight gain or may drop off their growth curve around 3-4 months. They may not be able to latch deeply enough, or at all. This can result in significant feeding challenges for mom and baby. Your baby might fall asleep at the breast constantly without getting a good feed, or they might breastfeed for ages and never seem satiated. If they are not draining the breast well enough, mom could have reoccurring blocked ducts and breast infections, and painful, cracked nipples or vasospasm. These babies might be very fussy at the breast and make clicking sounds when feeding, they may leak milk when feeding, have reflux or colic-type symptoms, and may breathe with their mouths open.


Can ties effect a child later in life? Yes. These little ones may develop a high palate which can impede on their ability to breathe through their nose. Mouth-breathing leads to higher chances of food allergies, enlarged tonsils/adenoids, chronic colds/coughs, snoring, and sleep apnea. Jaw and dental development and facial structure may also be effected, as well as chewing and swallowing foods and in some cases, difficulties with speech.


Who can diagnose a tongue tie? For starters, probably not your pediatrician. You will need a pediatric dentist who is trained in identifying and treating oral ties. You will also need a skilled lactation consultant, one who can identify the tie and help refer you to the right dentist, and then work with you during the after-care process if a revision is needed. This will help your baby learn how to use their new mouth, and help you with any supply issues or other feeding challenges that may have come up. Body work such as chiropractic care, cranio-sacral therapy, and occupational therapy are also super important and helpful leading up to a revision and afterwards.

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