Everyone has a band of tissue, called a frenum, which attaches the tongue to the floor of the mouth.  Another frenum attaches the top lip to the gums.  A tongue-tie is a condition that restricts the normal mobility and function of the tongue. Similarly, a lip tie, is caused by a frenum which restricts the lip movement.

What is a frenectomy?

Your pediatrician may recommend a frenectomy, or surgery to release a tongue and/or lip tie, if your baby is symptomatic.  One example may be if your baby is struggling to nurse and not gaining weight, after consultation with a lactation consultant.  There are several reasons for why a frenectomy may be recommended, and it is done on a case by case basis, taking into account the age of your child, the degree of the tie, the severity of your child's symptoms, and the desires of mom and baby.  A gap between the two front teeth is developmentally appropriate and is not a reason to complete a frenectomy.

Symptoms of Tongue & Lip Ties

The La Leche League cites the following as possible symptoms of a tongue or lip tie:

A baby may:

  • Be unable to latch on to the breast at all.
  • Be unable to latch on deeply, causing nipple pain and damage.
  • Have difficulties staying on the breast, making a clicking sound as he loses suction.
  • Splutter and choke when coping with fast flowing milk.
  • Breastfeed constantly to get enough milk.
  • Have poor weight gain or need supplementation to maintain adequate weight gain.
  • Develop jaundice that needs treating.
  • Be fussy at the breast when the milk flow slows.
  • Develop colic.

A mother may experience:

  • Pain during feeds, with damaged nipples. Her nipple may be compressed or distorted into a wedge shape similar to a new lipstick immediately after feeding, often with a stripe at its tip.
  • Engorgement, blocked ducts and mastitis because of ineffective milk removal.
  • Low milk production because of ineffective milk removal.
  • Oversupply if her baby compensates for not being able to breastfeed well by nursing very frequently.
  • Tiredness, frustration and discouragement.
  • A premature end to breastfeeding.

If you have questions about tongue & lip ties, please contact our office so we can address your particular concerns. Visit these pages for additional information about cleaning your baby’s teeth & gums, preventative care for your child, or schedule an appointment.

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