Many newborn infants that have trouble breast- and bottle- feeding have tongue or lip ties. These ties are caused by a structural abnormality of the frenum, the tissue that secures or restricts the motion of a mobile organ (in this case the tongue and the lip). A normal frenum is elastic and, in the case of the tongue, does not interfere with its movements in sucking, eating and, later, speech. Abnormal tongue frenums can be too short, too thick, too tight or too broad. They can sometimes extend from the margin of the tongue, across the floor of the mouth to the base of the teeth, severely restricting movement of the tongue and the infant’s ability to properly feed. In the case of the lips, abnormal frenums tether the lip to the gum. This prevents the infant from being able to flare out or curl up their lips, which is necessary for the baby to create a seal around the nipple to facilitate successful breast/bottle feeding.
Lactation consultants, like Sarah Lester of Fayetteville, report such frenum abnormalities are surprisingly common and it is estimated that between 4% and 10% of babies are born with some form of tongue or lip restriction. These abnormalities often go undiagnosed and, while some children may adapt as they grow, the ties often remain, causing problems with speech, oral hygiene and continuing difficulties eating.
The symptoms of a lip or tongue tie in infants include: Weight loss or slow weight gain Demands for extremely long and/or frequent feedings (less than two hours apart) Shallow latch on breast or bottle Clicking or popping sounds during nursing Significant reflux or gassy tummy Sucking callous on lip Rapid onset of fatigue during feedings Nursing Moms may also be affected by her baby’s lip or tongue tie.
Symptoms include: Painful breast feeding Breast full of milk after feedings Recurrent plugged ducts or mastitis Nipple vasospasms, commonly misdiagnosed as thrush Nipple trauma including cracking, bleeding, bruising, creasing and flattening Tongue or lip ties can usually be easily treated by a procedure called a Frenectomy, whereby the tethered frenum is removed or modified to restore normal range of motion of the restricted organ.
The frenectomy procedure itself takes less than five minutes and recovery time is usually very quick with infants experiencing minimal discomfort during the next 24 to 72 hours.
The specialists at Village Family Dental recommend a three pronged approach in dealing with tongue and lip ties comprising of lactation consultation, surgical repair and pre- and post- surgical bodywork therapy. Parents that contact Village Family Dental due to concerns about their baby’s ability to feed will initially consult with an International Board Certified Lactation Consultant (IBCLC) and one of our surgeons.
Lactation consultants are allied health professionals who specialize in the clinical management of breast (and bottle) feeding. They are instrumental in helping to recognize the problem and provide post-operative guidance to both mother and child to effectuate better feeding through improved breast attachment. Prior to the procedure, the bodywork specialist massages the child to calm baby’s nervous system and release tension in the affected area(s) to relax the muscles and fully expose the frenulum.
Village Family Dental’s surgical team, led by Dr. Faith McGibbon and Dr. Molly Guy, utilizes a hand-held, soft tissue laser for frenectomy procedures. The laser is quicker and more efficient than traditional methods (scalpel or surgical scissors), and is usually painless. Other advantages of the laser include the fact that there is virtually no bleeding; the laser kills bacteria all but eliminating the possibility of infections; the laser tip is smaller and more easily guided than a scalpel providing more accuracy and precision and the laser’s compact nature allows the surgeon to work deeper into the mouth than with a scalpel or scissors when necessary to remove the restriction.
Lasers also cauterize the tissue as they work making it less likely for the frenum to reattach, unlike scalpels and surgical scissors which cut through the tissue leaving a wound, which is more likely to reattach. Parents, pediatricians and lactation consultants of infants who are having difficulties feeding should call Village Family Dental’s pediatric department at 910-485-8884 to schedule an appointment for a consultation for the child.
By: Dr. Faith McGibbon