If you are already out of the hospital you may, from what you have been reading/seeing, suspect your baby or another member of your family has a tongue and/or an upper lip tie.
You will want to find a practitioner with expertise working with tongue and upper lip ties to do a thorough assessment and advise you on treatment options. An IBCLC (lactation consultant) with experience and knowledge of tongue ties and upper lip ties may be able to assess your breastfed baby/toddler and refer you on for a confirmation assessment and treatment. Release of TT and ULTs is not covered by the Scope of Practice of IBCLCs however. If you are an adult you will need to find a dentist, oral surgeon or an ENT to assess and treat yours. There is quite a lot of knowledge and experience (expertise) in the Western Australian parenting community and I think this is one of those times where itβs important to ask others about their experiences and for recommendations. In Western Australia we have paediatric dentists, paediatric surgeons, general dentists, GPs, Ear Nose and Throat specialists, and adult oral surgeons who all may agree to assess and treat tongue and upper lip ties. However expertise with tongue and upper lip tie restrictions is hugely varied amongst these professionals. I encourage you to call their practice and ask what their experience is with TT/ULTs. How many they treat in a week? Do they use LASER (light amplification by stimulated emission of radiation) or surgical scissors to release? Do they use anaesthesia? Do they treat both tongue and upper lip ties? Do they do assessments and the release procedure in the one appointment? What do they charge? You may choose a practitioner based on recommendation, distance you need to travel, how soon you can book an appointment, the cost, whether they treat both TT and ULT, or if they use laser over scissorsβ¦β¦or a combination of all of these.
Some of the misinformation you may hear:
- tongue and upper lip tie (restrictions) do not affect breastfeeding (or anything else)
- tongue and upper lip ties (restrictions) will βnaturallyβ be torn when a toddler falls and bangs their mouth
- if baby can breastfeed, then itβs not a problem
- if baby can bottle feed, then itβs not a problem
- tongue and upper lip ties (restrictions) will stretch as the baby/child gets older
- it doesnβt matter if you leave it til they are a lot older and then decide
- tongue ties (restrictions) do matter, lip ties (restrictions) do not
- if they bottle feed it doesnβt matter
- if a baby/child/adult can extend the tongue beyond the lower gum there wonβt be a problem
- if speech develops normally, there is no problem
Before and after a baby has had a tongue tie and/or upper lip tie release there are therapies that may support optimal recovery and function. Different practitioners give differing advice on these so itβs important to do your own thorough research.
Bodywork or body therapies such as Chiropractic, Osteopathy, Cranio Sacral Therapy, Myofunctional therapy, Bowen Therapy and/or remedial massage are encouraged before the procedures and to assist with recovery after the procedures. You may be advised to massage and stretch the area that has been released to reduce the risk of reattachment. Skin to skin cuddling your baby is a normal part of nurturing your baby, please do it often. You may be advised to seek assistance of an IBCLC if the baby is breastfed or breastmilk fed. Some babies and children will benefit from suck, swallow and speech therapy, working with an experienced Speech Pathologist. And you may consider other therapies to aid yours and your babyβs physical (including gut health) and emotional health recovery.
The Australian Breastfeeding Association will be able to support you with ongoing breastfeeding information and strategies.
If your baby is still in hospital you may have limited access to these therapies. However, I encourage you to make enquiries inside and outside of the hospital as the more we ask the more we educate. And the more we educate, the more likely these therapies will become part of our regular treatment plans.
For me, linking all of this knowledge with breastfeeding began 18 years ago with the birth of our first son. He had a significant tongue tie and was born with βrazor blades in his mouth!!β I was a member of NMAA (Nursing Mothers, now ABA) and had quite a lot of help with positioning and attachment. Eventually everything clicked at around 10 weeks and the razor blades disappeared. He continued to breastfeed until around 3 years of age when I was pregnant with #2. Our second was born late 1999 and sure enough there was a tongue tie againβ¦.he began breastfeeding easily and caused me no damage or pain. By then I was a breastfeeding counsellor with NMAA/ABA and thought I was proving that some babies could breastfeed with a tongue tie and not cause their mothers nipple damage and painβ¦..and he continued to breastfeed for the next 5 years. I previously told people that both boys had a tongue tie but they breastfed with βno problemsββ¦.I have since learnt that all of the breastfeeding challenges we had may have been caused by those ties that were not released β damaged nipples, over supply with one and undersupply with the other, over active milk ejection, fussing at the breast and refusal, reflux, colic, gagging, frequent feeding, minimal sleep, blocked ducts, blebs, engorgement, clamping/biting, wind. Obviously we canβt turn the clock back and do an experiment with their ties released soon after birth, but I had learnt enough about the possible long term health effects to make the decision to have their ties released during primary school. If I could turn back time, Iβd be having them done as soon after birth as they were discovered.
There are many blogs and Facebook groups that parents and individuals can read/join to learn more about tongue ties and upper lip ties (and the other less known ones). I am very encouraged to see that some parents have become the experts and education advocates in this field. There is a thriving international community learning together, parents and individuals all the way through to the most highly respected professionals. Itβs wonderful!
My aim in writing this article is to encourage parents to be informed and empowered to check for tongue and upper lip ties and have them assessed and treated early.
Dr Larry Kotlow http://www.kiddsteeth.com/articles.html
Dr Brian Palmer http://www.brianpalmerdds.com/
Dr Bobby Ghaheri http://drghaheri.squarespace.com/downloads/
FB: Tongue & Lip tie Support Australia https://www.facebook.com/groups/388958457911643/
FB: Tongue Tie Babies Support Group (international) https://www.facebook.com/groups/tonguetiebabies/
https://www.breastfeeding.asn.au/bf-info/tongue-tie
http://www.tonguetie.net/
Please donβt hesitate to contact me if you have any questions. You are welcome to e-mail delsmithlact@bigpond.com
Images used with permission from individuals and http://www.tongue-tie-education.com/tie-gallery.html