Lip-Tied

We first noticed there was a problem when breastfeeding just wouldn’t stop being painful. We worked our way through every possible (and real) problem, only to have the pain persist. Poor latch. Poor positioning. Thrush. Sunburn. Vasospasms. Blocked ducts. Over supply. Fast let down. Sea monkeys.  OK, everything but that last one. And still, nursing remained painful. I continued to nurse because of the many, many reasons that nursing is best, but it was challenging. Running out of other possibilities, we considered tongue and lip ties.

I never knew that it is not normal to have a flap of tissue connecting your tongue to the bottom of your mouth, or your lips to your gums. I’ve always had them, and fortunately, I have no significant problems. But apparently, this is abnormal, and can cause all sorts of problems, one of which can be painful breastfeeding. A lip tie can prevent a baby from getting a proper latch or remaining latched. A tongue tie can do the same.

When Alexis was born, I noticed a small ridge running vertically down the middle of her upper gum. Not knowing a lot of new babies, I assumed this was normal. In fact, it was part of a rather thick and extensive frenulum– fibrous tissue that connected her lip tightly to her gum. In Alexis’ case, the lip was connected to the gum, and then the tissue continued down and around behind the gum into her hard palate. I didn’t take a picture, although I found a few old pictures where you can see a little bump of the tissue on her gum. Hers looked a lot like the class IV lip tie on the first page of this PDF document.

Unaddressed, it could result in a gap between her front teeth, cavities, and dental problems into adulthood. Lip ties can also cause painful gas, as a lip-tied baby tends to swallow a lot of air while nursing. Alexis certainly did. We spent many an early night bouncing and burping, struggling to get out the gas that clearly had her so uncomfortable. Tongue and lip-ties can cause gagging, sleep apnea, speech problems, and developmental problems with the jaw. More immediately, an unaddressed tongue or lip tie can result in early weaning, either due to the persistent pain or because the failure to latch well can lead to a decrease in milk supply, which is a slippery slope.

So we made one of the hardest parental decisions we’ve had to make in Alexis’ short life and took her to a dentist for evaluation and treatment. Alexis had the lip tie, as well as a minor tongue tie. We agreed to have both revised, which the dentist did with a laser. Often, tongue and lip ties are revised or clipped using scissors and/or scalpel in a procedure that involves general anesthesia. I would prefer to avoid using general anesthesia on my little girl if at all possible, and with a laser, the only anesthetic necessary is a little topical gel. I’m not sure anything but a laser could have been so precise, or removed as much of the tissue that was on the gum itself.

The entire process took only a few minutes. Alexis remained conscious, and was none too happy about being swaddled and having the dentist’s fingers in her mouth. Even as a new baby, she didn’t like to be swaddled with her arms tucked in. It was hard to watch my poor baby struggle and cry through the procedure, knowing that I had decided it should be done. But I also knew that this is a condition that would probably result in other uncomfortable problems and procedures if left untreated. Fixing it now was the lesser evil. As I was the one to hold Alexis still during the procedure, I got an excellent view of what was done. There was absolutely no bleeding. Her cries were angry, but they weren’t cries of pain. Once it was over and she was out of that awful swaddle, she calmed down quickly.

Within an hour, she had taken a short nap, nursed, was smiling, and seemed just like her normal sweet self. A little later, she got fussy and after a couple of aborted attempts, refused to nurse. It was clear her mouth was sore and she was hungry. We gave her Tylenol, focused on distraction, and did skin-to-skin snuggling. After taking another short nap, Alexis was back to nursing. Painlessly! We have a little recovery time to go through, which includes stretching her lip to prevent it from healing together, but this will be quick and bearable.

For mamas struggling with painful breastfeeding, I encourage you to explore the possibility of tongue and lip ties. Find a lactation consultant who knows about them and can help. I felt the difference as soon as the procedure was done. Nursing has been painless ever since! And while Alexis didn’t enjoy it, I’m positive the whole thing was much more traumatic for me.

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11 Responses to Lip-Tied

  1. Jolene says:

    You absolutely did the right thing… Your bravery will last a lifetime… But you already know that.
    Love to you all. G’ma Jolene

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  3. Lea says:

    Whoever told you that this procedure would prevent future dental problems (ie gap between the front teeth) was incorrect. The same issue that causes lip tie also causes a tooth gap, but this is not something that can be prevented from snipping a little tissue. The only way to truly prevent that gap is to remove the tissue between the two bones in the front of the mouth that form the palate. This requires general anesthesia and oral surgery.
    My daughters all have lip tie. One I chose not to BF and the dr told me we needed the tissue clipped to help bottle feeding. We refused. The second I BF for 18 months with no issue. I’m currently nursing the third who is newborn and has the typical latch troubles but we hope to be past that soon.
    I do hope that this procedure solved your nursing troubles!

    • Shannon says:

      Lea,
      Thank you for your thoughtful comment. I waited awhile to respond to see how things progressed with my daughter. The revision did result in an immediate and total improvement in our nursing situation, which has been very beneficial for both of us.

      Perhaps I wasn’t clear enough in my post about the specific procedure we had done– we didn’t just get a little tissue snipped. Instead, the dentist used a laser to very carefully and completely remove all of the tissue connecting my daughter’s lip to her hard palate. It wasn’t just cut, it was burned away. 8 months later, Alexis had her first pediatric dentist appointment, and I was very happy to hear that the dentist did not see any scarring or additional tissue (which can sometimes appear after a revision.) Nursing remains painless. And the big gap between her two front teeth closed completely as her next two teeth came in. I originally wrote that this sort of revision can help with teeth gaps because that is what I found in my research. I can now add to that that my experience with my daughter supports my research. In our case, there is no gap, and there definitely would have been one if we had not had the lip tie revised.

      I hope your third little one managed to overcome their latching troubles, and I’m happy that all your children sound like they are doing well despite lip ties. 🙂

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  5. Deziree says:

    Thank you for sharing your story. My little one had his lip and tongue lasered 8 days ago. What was your stretching regimen? My worst fear is of reattachment and needing it done again. He is 10 weeks and has developed an aversion related to stretching. How long did you stretch? How did you train your little one to flange his top lip up? He continues to carry on his old habits. Thank you.

    • Shannon says:

      Our stretching regimen was pretty simple. If I’m remembering correctly, we stretched her upper lip three times once a day for a week. It was a relatively quick process. Only took a minute. She hated it! We did what we had to, knowing that a little upset (ok, horrible crying) now was better than reattachment and starting all over later. We did not stretch her tongue, as that tie was pretty minor and the dentist did not think any stretching would be necessary. I was afraid of reattachment, too, and I know it does happen.But for us, that amount of stretching was sufficient. When Alexis had her first dental check up at 12 months, the dentist noted that she didn’t see any re-attachment or other issues. And, functionally speaking, nursing has remained painless. As for training your little one to flange his lip properly while nursing, I’m afraid I can’t be a whole lot of help there. Alexis generally flanged her lip like she should after the procedure, although occasionally (even now, a year later) her lip will still curl under. Because it doesn’t cause any pain and doesn’t seem to interfere with her ability to transfer milk, I have generally let it be. If I were trying to improve it, though, I’d probably keep a finger close as little one is latching, so that I could flip out his lip as he latches. If it’s problematic, I’d un-latch and try again. If you’re still having trouble, I’d also check with an IBCLC. They are amazing, and would definitely have the best advice for how to improve baby’s latch. Best of luck to you and your little one!

  6. Nicole says:

    I am glad you are sharing this with people. My son would never breastfeed, no matter what we tried. Finally, after failing to gain weight for weeks, we started pumping and feeding him a bottle. He start thriving after that. Now he is 6 and the dentist pointed out that he is lip tied and will need to get this taken care of in order to prevent problem with the spacing of his adult teeth. As I researched this, I learned that it can be a problem for infants when trying to breastfeed. I never even noticed the lip-tie before, and definitely never heard of it. I wish I could do it over again and know the info I know now.

    • Shannon says:

      Thank you for sharing your story, Nicole. I think we all probably have have something that we wish we could go back and do differently now that we know more. From what I understand, tongue and lip ties are something everyone used to know about and then, somehow, they were forgotten. Our pediatrician didn’t really take them seriously, and I gather that’s not unusual for doctors these days. She told me that my daughter would have a “cute little Lauren Bacall gap” and that orthodontists actually like a gap, because it gives them more room to work. What a presumption, already sending my toothless baby to an orthodontist! And, more importantly, completely disregarding to real issues caused by ties. I’m glad your dentist caught the problem and hope it will be resolved easily for your son. 🙂

  7. Jessica says:

    Thanks for your story and positive outcome…I have a 6 week old baby girl. She is having the worst gas/reflux issues and is just pretty cantankerous. Every so often we get a glimpse of happy baby, but it’s not typical. At birth, I noticed her tongue tie and pointed it out to the pediatrician. He said it wouldn’t be a problem and so I breastfed through the pain thinking it would get better. But after 5 days, we had it clipped by another doctor because it got too bad. Turns out, he didn’t cut deep enough, so now we’re headed to the pediatric dentist. I researched more and more about the link between colic symptoms and tongue/lip tie and then checked her lip. I am not pretty certain she has lip tie as well which explains so much – her shallow latch, the breaking of suction, milk dribbling out during feeds – as well as the gas/reflux issues. The IBCLC I saw also said that the acid coming up to her mouth might be causing the burning of my nipples (they are super pink). I so so can empathize with your story and am happy to see that breastfeeding became painless for you! It gives me hope!

    • Shannon says:

      Thank you for commenting, Jessica! I’m glad I could give you some hope. When we’re struggling with breastfeeding, it can be so hard to hang on sometimes. In my experience and from what I’ve heard from others, pediatricians seem to be poorly informed about tongue and lip ties and not take them particularly seriously. I’m sure there are a few great pediatricians out there who know their stuff, but in general, I’d trust a trained IBCLC on this matter over my pediatrician any day. The symptoms you described certainly sound like classic tongue and lip tie symptoms. And if breastfeeding is still painful, then more definitely needs to be done. I hope the pediatric dentist was able to fix everything for you two, and that by now you know how painless breastfeeding really can be. (It blew my mind the first time I nursed after my daughter’s revision.)

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