How to Identify Tongue-Tie and Lip-Tie in Babies

Tongue-tie (ankyloglossia) and lip-tie are often diagnosed early on, but some cases can go unnoticed, especially if the signs are mild. Recognizing these conditions early can help prevent feeding problems, developmental delays, and long-term oral issues. Here’s how you can identify them and take action early to improve your baby’s comfort and health.

Signs of Tongue-Tie (Ankyloglossia)

Tongue-tie occurs when the frenulum under the tongue is too tight or short, restricting the tongue’s movement. Here are some common signs to look for:

In Newborns:
• Breastfeeding Issues: The baby may struggle to latch properly or may need to feed more often because they’re not effectively transferring milk. This can lead to frustration for both the baby and the mother.
• Nipple Pain for Mother: If the baby can’t latch properly, mothers may experience nipple pain, cracking, or damage. This often happens because the baby is not able to create an effective seal with the breast.
• Clicking Sounds During Feeding: Babies with tongue-tie often make a clicking sound while breastfeeding due to the improper suction caused by the restricted tongue movement.
• Poor Weight Gain: Because of ineffective milk transfer, babies with tongue-tie may not gain weight as expected.
• Difficulty Latching or Keeping the Latch: The baby may not be able to maintain a latch and may become frustrated during feeds.

In Older Children and Adults:
• Speech Difficulties: If the tongue cannot move freely, the child may have trouble pronouncing certain words or sounds, such as “t,” “d,” “l,” “r,” and “s.”
• Difficulty Eating Solid Foods: As the child grows, they may have trouble eating solid foods, particularly those that require more chewing or tongue movement, such as meats or textured foods.
• Dental Issues: Tongue-tie can affect oral hygiene. A restricted tongue may make it difficult to clean the teeth properly or could cause teeth to shift inappropriately.

Signs of Lip-Tie

Lip-tie happens when the frenulum (the tissue connecting the upper lip to the gums) is too tight. This can affect breastfeeding and cause other oral and developmental issues later on.

In Newborns:
• Shallow Latch: Babies with lip-tie often struggle to latch properly because their upper lip cannot fully flange out to create a good seal on the breast. This may result in a shallow latch and nipple pain for the mother.
• Gum Issues: The baby may not be able to properly bring the upper lip over the gums, which can result in poor sucking and milk transfer.
• Frequent Feedings: Because the baby is not getting enough milk during each feed, they may need to nurse more often, which can cause frustration for both the baby and the mother.
• Nipple Damage: A shallow latch or improper sucking can lead to sore, cracked, or bleeding nipples for the mother.

In Older Children and Adults:
• Difficulty with Oral Hygiene: As the child grows, the lip-tie can cause issues with oral hygiene. It may be difficult for the child to move the upper lip enough to properly clean their teeth, potentially leading to tooth decay.
• Gaps Between Teeth: In some cases, a lip-tie can contribute to spacing or gaps between the upper front teeth, which may become more noticeable as the child grows.
• Speech Problems: Just like tongue-tie, lip-tie can also affect speech, particularly the pronunciation of certain words or sounds.

What to Do If You Suspect a Tongue-Tie or Lip-Tie

If you notice any of the signs of tongue-tie or lip-tie in your baby, it’s important to consult with a healthcare provider, such as a pediatrician, pediatric dentist, or lactation consultant. Here’s how you can take action:
1. Consult a Professional: A pediatrician, lactation consultant, or pediatric dentist can assess whether your baby has a tongue-tie or lip-tie. They may also perform a physical examination to determine the severity of the condition.
2. Get a Referral for a Frenectomy if Needed: If the diagnosis confirms that the tie is causing feeding issues or other concerns, a frenectomy may be recommended. It’s best to address these issues early to avoid further complications.
3. Ask About Post-Procedure Care: If a frenectomy is performed, your healthcare provider will likely recommend certain exercises to help improve the range of motion in your baby’s tongue or lip. For tongue-tie, this may include gentle stretches to prevent the tissue from reattaching too tightly during the healing process.
4. Follow-Up Appointments: After a frenectomy, follow-up appointments may be necessary to monitor healing, ensure the tie doesn’t reattach, and evaluate whether the feeding, speech, or oral issues are improving.

Tips for Supporting Your Baby After a Frenectomy

The recovery process after a frenectomy is usually quick, but there are a few things you can do to ensure your baby’s healing goes smoothly and feeding becomes more comfortable.
1. Practice Feeding Immediately: After the frenectomy, your baby may feel some discomfort, but it’s usually temporary. Try breastfeeding or bottle feeding soon after the procedure to promote healing and reinforce proper latch techniques.
2. Perform Stretching Exercises (If Recommended): If your baby’s tongue or lip tie was released, your pediatrician or lactation consultant might recommend gentle stretches to ensure proper healing and prevent reattachment of the tissue. Be sure to follow their instructions carefully.
3. Use a Soothing Gel or Pain Relief: If your baby seems uncomfortable, a healthcare provider may recommend a soothing gel or mild pain relief to make the process easier. Consult your doctor before using any medication.
4. Monitor for Changes: Keep track of improvements in your baby’s feeding. If breastfeeding was painful or inefficient before, you should notice a marked improvement after the frenectomy.
5. Be Patient: While some babies experience immediate relief after a frenectomy, it may take some time for them to adjust. They may need extra time to practice their new tongue and lip movements.

Conclusion: Early Detection and Intervention Matter

Recognizing the signs of tongue-tie and lip-tie early can make a big difference in your baby’s feeding success and long-term oral health. If you suspect that your baby has either condition, seek professional help as soon as possible. A simple frenectomy may be the solution you need to improve breastfeeding, speech, and oral development.

If you’ve already undergone a frenectomy, follow the post-procedure instructions closely and be patient during your baby’s recovery. The results are often life-changing, and many parents report seeing vast improvements in their baby’s feeding and comfort within days.

-Dr.SA