Ties or tissue tethering in general are not properly assessed at birth. Late recognition can impact baby and breastfeeding significantly. Nursing difficulties, feeding, lack of latch for effective suck-swallow-breath coordination.
Lack of suction or suckling with ineffective seal flange of upper lip.
Future diastema when baby teeth erupt into the mouth depending on tissue position. Diastema is a significant space between the central incisors teeth when they erupt.
Baby compensates for nourishment and struggles to get breast milk.
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Diagnosing - The symptoms listed assist in the diagnosing process. Some pediatricians have not be made aware of this complication and the procedure that is required. Don't be surprised that your doctor states, oh it is fine treatment is not required. That is not always the case.
If you are having the symptoms above then something needs to be done. The babies health is at risk and your milk supply is not going to be efficient to supply the baby with nutrients. Your breasts will feel like raw meat.
Something must be done.
Seek help with your lactation consultant or myself. We can certainly assist with the baby's frenum diagnosis.
Tongue and lip releases are non-invasive procedures. Yes, the baby will be uncomfortable for a few days. Please ask the provider what is recommended for discomfort.
Skype / FaceTime Tele-practice is available
What is a Tongue Tie?
Can affect infants to adults.
Ankyloglossia or tethering are other terms used.
This is a restriction of the movement or range of motion of the tongue that is typically present at birth. The restriction or tethering is a piece of tissue called the frenum under the tongue (lingual frenum) this tissue is to hold the tongue in place to the floor of the mouth. Lingual tongue frenum can be short, thick and tight or extends to far forward to the tip of the tongue. This restriction does not allow the tongue to do it's job, such as: chewing, swallowing, sucking, speaking or expanding the upper arch as nature requires. Tongue-Tie is not uncommon.
Some children experience body tension in their entire body. This needs to be examined by a Bodyworker or Cranial Sacral Therapist. These professionals assist the body in releasing the tension throughout the body. Orofacial Myologists re-educate or retrain the tongue muscle to do it's job. Infants need to learn how to suck, children need to learn how to use their tongue to speak, eat, chew and swallow correctly. It's a process. Tethered tissues need to be stretched with a Myofunctional Therapist for 4 weeks prior to revision, and 6-8 weeks following revision for total success. Many patients have oral issues that they are not obvious, but can be corrected with Orofacial Myofunctional Therapy. Full assessment is recommended.
I believe that parents should play with their tongues with their babies prior to revisions. Stick your tongue in and out - the baby will try to imitate you - that's great!
With "tongue play" routinely the baby feels this is natural. Placing your clean fingers in your babies mouth should be natural and often. Again the baby will feel this is normal, start stretching with an Orofacial Myologist 4 weeks prior to the revision. This will make life for all easier post revision.
Stretch 4-6x a day with an Orofacial Myologist
Stretch 6x's a day for at least 4 weeks.
Positioning yourself behind the baby stretch upper lip upward and back toward the nose.
Stretch 4-6x's a day with an Orofacial Myologist
Place clean fingers under tongue pulling upward and back.
Place clean fingers under tongue pulling upward and backward. Taking fingers and spread finger on each side of the lesion outward. Take finger and roll it upward in the middle of the tongue. baby will not like this post revision - in time all will be fine.
Your provider will recommend what type of pain medication to be used.
Cold foods, drinks will assist in making the area feel better.
Tongue & Lip Ties
Who to see for treatment?
Pediatrician, Oral surgeon, some dentists that are experienced with baby frenum releases.
Ear, nose throat doctors that are experienced in this type of treatment on a baby.
Call and ask the appointment secretary how often the doctor does this type of procedure. With what type of equipment. Laser, cauterization, or clipping?
No need for sedation or operating room.
Make an appointment for a consultation, is there a cost for a consultation?
In order to prevent the tissue from reattaching it is important to exercise the tissue daily, before and after the revision. Muscles have memory, the tongue is a muscle it needs to be trained. Don't be afraid of touching the lips or tongue. It is your baby and this can be a great bonding moment.
Clip nails so they are short, no sharp nails. Wash hands thoroughly.
Stretches are very important. You don't want the baby to go through this procedure again. Best time to do the stretches are when it is not related to nursing or diaper changes.
Post nursing - 30-40 minutes.
Take clean hands and fingers from behind the baby place forefingers under the tongue and lift the tongue upward and toward you. Sitting on the floor with baby's head toward your knees or your legs in a V-shape is usually a safe comfortable position for both of you.
Rub a little coconut oil on your finger and rub gently the released area.
Stretch the upper lip, upward and back toward you. Laugh, giggle, click your tongue make noises - make it fun.
DO at least 6-8 stretches. Repeat 6-7x's a day, more if possible.
Rub gently coconut oil on the lip release area.
Evaluate each time for reattachment. You are the eyes for any concerns.
Tongue & Lip Ties
Tethered Oral Tissues
What you will see:
The revision should appear like a diamond shape. If you don't see a diamond shape it is not a complete revision per Dr. Ghagheri.
Healing can be quick, the head is a very vascular area. White blood cells jobs is to heal quickly. Keep stretching.