Understanding Tongue Ties in Infants: Signs, Symptoms, and Diagnosis

Breastfeeding and bottle feeding your baby can be one of the most enjoyable parts of becoming a mother - but it can also lead to stress, frustration and tears, for both baby and mom. Perhaps you suspect your baby has a tongue tie. Perhaps your baby has already been diagnosed with a tongue tie. There is a lot of information out there regarding nursing and the issues that can come with it. Milk Matters PT is dedicated to helping parents understand what a tongue tie may look like and diagnose it correctly so that the issue can be addressed and mom and baby can find the joy in the feeding bond. Luckily, while surgery known as a frenectomy will be recommended, there is also therapy available that can help your baby before this procedure is even considered. 

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First, however, if you suspect your baby has a tongue tie, there are various signs and symptoms to look for at home to then have followed up by your pediatrician or pediatric physical therapist. Most PTs are able to see you even without a pediatrician recommendation!

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Signs that your baby may have a tongue tie can include the following:

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• Facial asymmetry
• Neck Tightness
• Frontal bossing
• Lip blisters
• Neck creases
• Poor tongue motion
• Retracted jaw
• Uneven mouth opening

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While signs of a tongue tie might be noticeable, what matters most is the function. Function refers to things that affect how your baby eats, drinks, breathes, sleeps and eventually vocalizes. Even if there are signs present, understanding how it impacts these essential functions is key to ensuring your child's need for surgery and how well they will do. For example, things you can look for include:  

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• “Colic” or gassy baby
• Chomping/clamping on nipple/Gumming
• Shallow latch/leaking milk
• Swallowing air/clicking noise while feeding
• Difficulty keeping latch/pops on and off of breast
• Not emptying breasts fully
• Falls asleep within minutes of feeding
• Seems constantly hungry
• Long/sleepy feeds

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If your baby has any one of these signs or symptoms, just a few  therapy sessions can reverse these things and help restore you and your baby’s feeding relationship. Understanding the importance of function is key when addressing tongue and lip ties. It's not just about appearance, but how these ties affect feeding, breathing, sleep, speech and overall oral health. Understanding proper function paves the way for a thriving, happy little one.

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Not all symptoms related to tongue ties affect the baby. Mom can present symptoms for the baby's tongue tie as well. These may show up as the following:

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• Pain while nursing
• Lipstick shaped nipple
• Plugged ducts/mastitis
• Low milk supply
• Cracked/bleeding/damaged nipples

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Why is paying attention to mom’s symptoms so important? This can affect the mood and health of your little one down the line. Did you know the tongue plays a role in growth and development of cranial/facial complexes, keeps airways open at night and is connected to the spine and the toes through the fascial system? Once again, if you and/or baby has one or more of these symptoms, proper diagnosis is important. 

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As with any kind of medical procedure, being as prepared and having as much knowledge as possible beforehand is extremely important. That is why I always stress to parents the importance of pre and post frenectomy therapy. I have seen much better outcomes when babies have at least 1-2 therapy sessions before the release is performed. Functional neuromuscular re-education as well as improving the way a baby moves are very important prior to the release procedure. Therapy helps to decrease tension/tightness and focuses on tongue function and suck training with developmentally appropriate positions and exercises. 

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To ensure a proper diagnosis, please keep the following in mind: 

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• Find a knowledgeable provider well versed in ties is more important than the type of provider.
• Finding a pediatric PT/OT/IBCLC can help you figure out what your baby needs.  
• Don't struggle alone, there are answers. A knowledgeable therapist can identify where your baby is specifically struggling and provide you with tools and techniques that will immediately make a difference.
• Just because a baby is diagnosed with tongue tie, doesn't mean they need immediate surgical correction. Take a breath, and remember, it will all be fine.

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For more on navigating oral restrictions and the simple steps to follow if you suspect a tongue tie for your baby, click HERE for access to my free guide!