What Causes Lip, Cheek and Tongue Ties in Infants?

This blog was written by Hasini Namburi, who spent the summer with Milk Matters PT, gaining experience in infant care and development. Hasini explored the impact of oral anatomy on infant health, focusing on potential causes of lip, cheek, and tongue ties. All rights to the content remain with the author.

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As I heard the noises of babies’ laughter, occasionally accompanied with some inevitable crying, I was in awe of the beauty of life. I’ve always loved working with kids- be it in showing my interest in babysitting my little cousins or face painting at the high school football games- working with the infants of MILK MATTERS made me feel immensely grateful and charmed by the sight of new life.

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This past summer, along with getting days worth of sleep and ruining my sleep cycle, I also learnt a lot about physical and occupational therapy for toddlers at the MILK MATTERS clinic. During my interactions with these kids, not only did I become more at peace, but also, I started to feel more patient. Several of the tasks I was assigned to do were tasks that required patience and calmness; whether it may be organizational tasks assigned by Dr. Gigi, or merely watching and observing the patients at therapy. It was my solemn duty to keep them in a pleasant mode and I enjoyed all of the little tricks I learnt along the way, the baby rattles being my super power in my quest to prevent tears! I started to grow a strong affinity towards several of the toys that were stored at the clinic, my favorite being – the rainstick, all in my attempt to stop the babies from crying.

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I learnt about the conditions that babies are born with including – lip ties, cheek ties, and tongue ties. These ties are oral anomalies which are formed when the tissues of the gums, cheeks, or lips are attached together. The ties of each of these particular tissues range from 1 to 4 based on their position.

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The reason for these ties is not definite. I looked into more of this effect and evaluated the several causes that it could have been. After evaluating several patients’ diagnosis, with Dr. Diana’s help, I hypothesized that tension in a baby’s body is the main reason why they are born with such conditions. This tension can be caused through many reasons, some of which include:

• Breech babies:  in such pregnancy birth conditions, the baby’s butt is popped out first out of the vagina before any of the other party parts; which in turns causes the baby to be born with a lot of tension in their body
• C-section babies: sometimes these babies are not as loose as other babies because of the tension that they accumulate over the time of the surgery while they are being birthed.

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A good way of finding tension within the body would be to observe the red spots on the baby’s body. ‘Baby V’’s body  (I will be using a different model of referencing the names of the patients for confidentiality purposes), had several of these red spots, which were later massaged with coconut oil in order to release the tension.I also learned other tricks to see whether the baby is feeling tensed:

• If the thumb is wrapped under all of the other fingers while the baby’s hand is fisted
• If the retained Babinski reflex of the baby is less responsive, then it would determine that the reflexive muscles of the baby are weak; most likely a result of tension in the body.
  • This reflex is observed when the big toe is lifted and all other toes spread out.

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Little did I know that this tension in the baby’s body can have a drastic impact on the baby not only when they are adolescent, but also when they grow up. In several cases that we studied and helped with, babies with a lip tie faced difficulty in sucking on the nipple. This poor sucking ability could in turn lead to poor diet and nutrition levels in the baby, inevitably leading to a slow growth pattern. In other cases, the tension in the bodies of the babies may accumulate over time and lead to speech disability and problems while walking.

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A lot of the babies like ‘Baby T’, ‘ Baby J’ and ‘Baby V’ were referenced to torticollis – a head turn preference as a result of the accumulation of tension within their bodies. The methods used by the doctors to indicate such a condition in the bodies of the babies were in a couple ways, some of which as follows:

• observing white spots on the scalp of the babies
• Flatness on the head (this could be treated by exercises which would help evenly distribute the weight in the scalp). This condition of flatness is referred to as plagiocephaly; observed when the skull is extremely soft and the weight is unevenly distributed. Due to continuous pressure on a particular side of the scalp, this phenomenon is observed.

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According to Speech Pathologist & Myofunctional Therapist, Danielle Klee, lip ties, tongue ties, and cheek ties, may have various developmental issues for the baby. Some of these issues include:

• growth: result of slow or inconsistent feeding
• speech disabilities: as the ties in the oral tissues may constrict movement
• distinctions in the craniofacial structure which may potentially lead to plagiocephaly

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Along with these physical anomalies in babies, several babies are also given treatment for occupational therapy- which would consist of skills with responding to stimuli and introducing new food. I worked with Alex, an occupational therapist at MILK MATTERS who was working with the occupational therapy department at the clinic. Most of the babies at the occupational therapy (like ‘Baby N’ and ‘Baby J’), were those who had already been trained with physical therapy. I observed that both of these therapies were very intertwined as patients typically tend to attend both.

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It wasn’t just all book learning, it was a beautiful 4 week experience where I interacted with doctors of high skill and knowledge, babies- less than 6 months, and the cheerful siblings of the patients who were so enthusiastic about anything and everything they did! These kids and I played kitchen set, sold cupcakes and possibly became the world’s richest bakery!

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Although I did learn a lot about bodily dysfunctions in babies, I am happy to say that this experience was extremely fruitful as it helped me increase my levels of patience, understanding and empathy as I interacted with babies much younger than me.

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Lip, cheek, and tongue ties can impact various aspects of a child’s development. If you suspect your child may be affected, consult a pediatric specialist. For guidance and support, visit Milk Matters PT or contact us to learn more.

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