What should I know about tongue ties in newborns?

Question

What should I know about tongue ties in newborns?

Answer

In 2020 a panel of 16 leading ear, nose and throat specialists published guidelines warning that tongue-ties were over-diagnosed and that cheek-tie releases simply should not be performed. Studies have also shown that with or without correction of tongue ties, breastfeeding often improves with time making it difficult to sort out cause and effect.

Tongue tie, lip tie, and buccal tie are conditions that occur when the tissues connecting the tongue, lip, or cheek to the mouth (respectively) are too tight or thickened, which can restrict movement. Here’s a breakdown of each:

1. Tongue Tie (Ankyloglossia):

• Tongue tie is a condition where the strip of skin connecting the underside of the tongue to the floor of the mouth (called the lingual frenulum) is shorter than usual or attached too close to the tip of the tongue.
• This can restrict the tongue’s range of motion, potentially affecting breastfeeding, eating, speech, and oral hygiene.
• Symptoms may include difficulty latching onto the breast, poor milk transfer during breastfeeding, clicking sounds while feeding, and nipple pain for the breastfeeding parent.
• Treatment options include a simple surgical procedure called a frenotomy, where the frenulum is snipped to release the restriction.

2. Lip Tie:

• Lip tie is similar to tongue tie but involves the piece of tissue that connects the upper lip to the gum (called the labial frenulum).
• Like tongue tie, a tight or thickened labial frenulum can hinder breastfeeding by making it difficult for the baby to maintain a good latch.
• Symptoms may include difficulty flanging the upper lip outward during breastfeeding, poor seal around the breast, and sometimes, a visible “tie” extending from the gum to the lip.
• Treatment options also include frenotomy or, in some cases, a more involved procedure called frenuloplasty.

3. Buccal Tie:

• Buccal tie is less commonly discussed but involves a thickened or tight band of tissue on the inside of the cheek, which can restrict the movement of the cheek.
• This condition can affect breastfeeding and bottle feeding, as well as speech development.
• Symptoms may include difficulty maintaining suction during feeding, inefficient feeding, and potential speech issues as the child grows.
• Treatment options typically involve releasing the tight tissue through a minor surgical procedure.

It is essential for parents to consult with healthcare professionals if they suspect their newborn has any of these ties, as proper diagnosis and treatment can significantly improve feeding and overall oral function. Lactation consultants, pediatricians, and pediatric dentists are often involved in the assessment and management of these conditions.