Tongue and lip tie – more than just the latch

As Chiropractors who work on the pediatric population, we have to be aware of certain things that specifically pertain to them. Having extensive training in peds really allows us to understand the unique challenges that arise, and train our staff on how to give the best experience for our peds patients.

We are constantly learning, and one that came up time and time again was issues surrounding lip and tongue ties. Honestly, we were not trained in this area and somehow be it from a divine source, we were given a baby (Etta) who had a severe lip tie (also tongue) and it compelled us to up our game.

Prior to our experience, the standard for when we saw these issues was to refer back to their GP. Most often, the response was that if they were gaining weight and latching ok, there was nothing further they would recommend. We did not judge, we did not pursue because well, we just didn’t know. (insert vulnerability here…)

We honestly did not know how to help these babies beyond what we would do with our hands. We posted about Etta out of curiosity on a parent level, and wow! Did we ever see a huge response from our friends who are parents!

Mom’s messaging and informing us to pursue it further because of things that arose for their children when the ties were not released, such as decreased milk supply at around 4-6 months, leaving them to supplement or stop breast feeding all together. Conditions like thrush that persisted throughout their breast feeding experience requiring them to try a multitude of different creams to try to kill it. The list goes on.

Our eyes were wide open and don’t you find that when you are in this situation, you start noticing things in your environment and life that lead you to keep looking and learning? Information about ties began to pop up on our FB page, people reached out, and we were ultimately put in touch with an incredible dentist in Saint John who specialized in frenectomies (tie releases) with the most up to date technology (a CO2 laser).

This dentist was recommended by a colleague of ours who we had been seeing post about ties…who had tremendous experience with working with babies and children with ties Dr. Jenna Davis Oakville, ON, as well as another chiropractor who’s kids had just had the procedure done in her area of Elmira ON.

We were on our way to learn from experience (our favourite form of learning).

Of course when we went to Dr. Lamont’s office in Saint John NB, we asked as many questions as we could. We learned a TON! Our knowledge began to grow. It has grown exponentially after attending a course specific to this, this past weekend.

We wanted to share the common complications or issues that may arise with a lip or tongue tie that go beyond the latch, but talk about that a little bit too because this is a huge concern for new mom’s in that early breastfeeding journey and if detected and resolved could change the whole course of the mom and baby!

So here they are:

  1. Failure to nurse, or nursing challenges:
    Of course, yes! The quality of the latch makes a huge difference. Things to be aware of are obviously sore nipples, flattened nipples, blisters, baby popping off the breast, milk seeping out of the corners of baby’s mouth, clicking noises, frequent feedings, fussy baby/irritable, side preference when nursing.

    Things to notice beyond nursing……
  2. Increased risk of decay and gum disease:
    If your toddler or child has an increased amount of cavities that may or may not relate to the typical sugary diet and poor oral health habits, this could be playing a role. How? After you eat, you naturally move your tongue around your mouth to essentially wipe away food debris from your teeth. With a tongue tie, this becomes nearly impossible due to lack of range. This can increase that risk. Oral hygiene becomes even more important in kids with ties.
  3. Speech issues:
    This can be incredibly tough for parents and kids. Therapy is so effective! But if you are finding this an issue, it is definitely worth an assessment to see what is going on in the child’s mouth. The implications around speech issues include a decreased self-confidence in the child, learning delay’s, stuttering…..these can be devastating for the kids and their parents.
  4. Swallowing:
    This pertains to the messy eaters, when you pop your baby off of your breast and there is milk everywhere, if they cough frequently during feeds – these are all potential signs of oral tissues that are tight.
    The more obvious issues with swallowing would be choking and vomiting/reflux.
  5. Sub-optimal formation of the jaw and mouth:
    This one blew our minds! But it makes complete sense. Any adaptation your baby is required to make, affects the development of the palate (the roof of the mouth) and the jaw. Don’t stop there though, it also impacts the development of the curve of the neck, spine, and can impact the information that is relayed to the brain.

    That large space between your child’s 2 front teeth, that can be a sign of a lip tie. Crowding and a narrow upper jaw – all potential signs of tension from the ties. It can pull up on gum lines and impact gum health. It can cause a receded lower jaw, it can impact the movement of the mandible (you know, that crooked yawn that is super cute!).
    Body work is incredibly important for this aspect! This is where we come in and can influence the success and outcomes by our techniques as well as take home exercises to reach maximum results.

    This post will blow your mind, too! Check it out!

    Other things that are so relevant would be tongue thrusting, clicking or pain/migraines as the child gets older into adulthood, even sleep apnea because of the position of the tongue and jaw during sleep. Mouth breathing becomes more common here as well. All which have further impacts on health!
  6. Gas/colic
    As a result of the poorly adapted latch, baby tends to suck in air. Gas, colic affect sleep, bonding, emotional health. Frequent spitting up is not fun for anyone. Also inefficiency to draw out the hind milk because of the lack of full suck, and abnormal or adapted tongue movements – which can relate to gas and colic.
  7. Other issues related to quality of life:
    You know, those fun things like the ability to lick an ice cream cone, playing musical instruments, french kissing! Fast forward into senior years and maybe it’s difficult to keep dentures in place! Facial asymmetries may also be noted, such as the receded jaw line, uneven eyes, etc that can respond with cranial work before and after the release. Etta had a left torticollis which may or may not have been connected to the ties, but certainly had the habit to extend her neck while resting – indicating tension in her neck that relaxed significantly post revision.

    These things seem little, but can actually be huge when you think of quality of life and implications.

So how do you know whether or not your child has a lip tie, and whether it is functional or not? This is where there is lack of congruence. It seems as if the main issue is weight gain in the circles we are in. As you can see, it relates to so many aspects of a baby’s current and future well-being.

We advise to also see your lactation consultant, as they have knowledge that extends beyond ours. You may or may not have received this diagnosis, but perhaps if it wasn’t released you are noticing some of these challenges. We are also a great source to check the function!

What did we do with Etta? We consulted Dr. Jenna Davis who took us through a multitude of functional testing and analyzing (which we now know!) to determine if the issues we were experiencing were related to the tie, and finally, to a trained dentist who had the proper laser to finally assess and together we decided to go forward with the releases.

Most importantly, trust your gut! You are built with incredible intuition.

We are forever grateful for the advice and guidance we received from everyone! We were so fortunate to have Dr. Jenna come to Halifax to offer her course so we could be immersed in the knowledge she has so we can further help those babies and kids in need! Now we know what to look for, how to assess, and how to prep pre and post release! We have furthered our relationship with Dr. Lamont in Saint John, and look forward to building this network through collaboration of knowledge in Fredericton so we can all help these kids and families to the fullest ability!