Tongue and Lip Ties

Tongue and Lip Ties

By Desiree Frigenti – Senior Paediatric Physiotherapist & Director of Ocean Kids Health.

Hello again!

In my very privileged position as a Baby Physiotherapist assessing and treating babies every day I am often asked the question: Does my Baby have a Tongue /Lip Tie?

Tongue tie (Ankyloglossia) and Lip Tie are conditions that can affect infants and may interfere with breastfeeding/bottle feeding and, in some cases, lead to other issues such as speech difficulties.

Here are some signs of tongue and lip ties in an infant:

Tongue Tie:

  1. Difficulty Latching: Infants with tongue tie may have difficulty latching onto the breast/bottle. They may slip off frequently or have a shallow latch.
  2. Swallows a lot of air leading to symptoms of reflux
  3. Dribbles and leaks milk from around their mouth.
  4. Tiny lip ‘suck’ blisters. This is usually caused by friction from sucking during feedings.
  5. Difficulty lifting the tongue to the upper teeth or moving the tongue from side to side.
  6. Trouble sticking out the tongue past the lower front teeth.
  7. Milk residue on your baby’s tongue may be more likely to occur.
  8. Poor Weight Gain: Difficulty extracting milk efficiently can lead to inadequate weight gain in the infant. Gets tired quickly during feeds.
  9. Nipple Pain: Mothers may experience significant nipple pain and damage, including cracks and bleeding, due to the improper latch. The nipple looks pinched or creased when your baby comes off the breast.
  10. Fussiness at the Breast/ Bottle: The baby may become frustrated or fussy while breastfeeding because they’re not getting enough milk.
  11. Short Lingual Frenulum: A clear sign of tongue tie is a short, tight band of tissue (the lingual frenulum) that tethers the underside of the tongue to the floor of the mouth, restricting its movement.
  12. Heart-Shaped or ‘V’ shaped Tongue: When the baby cries or lifts their tongue, it may appear heart-shaped or v shape due to the restriction.
  13. Clicking Sounds: A clicking sound while breastfeeding/ bottle feeding can be indicative of an ineffective latch.

Lip Tie:

  1. Difficulty Flanging the Upper Lip: A lip tie occurs when the tissue connecting the upper lip to the gum is too tight. This can make it difficult for the infant to flange or evert the upper lip while breastfeeding/ bottle feeding.
  2. Shallow Latch: Similar to tongue tie, a lip tie can lead to a shallow latch and difficulty staying latched onto the breast/bottle.
  3. Nipple Pain: Mothers may also experience nipple pain and damage when the baby has a lip tie because the baby cannot achieve a deep latch.
  4. Poor Milk Transfer: Due to the shallow latch and restricted upper lip movement, milk transfer may be inadequate, leading to slow weight gain.
  5. Gum Groove or Notch: A visible groove or notch in the upper gum area where the lip attaches is a common sign of a lip tie.

If you suspect your infant has a tongue or lip tie or is experiencing breastfeeding/bottle feeding difficulties, it’s essential to consult a healthcare provider, such as your GP, Paediatrician or a Lactation Consultant, for a proper evaluation and guidance on potential treatment options, which may include a simple surgical procedure to release the tie (frenotomy).

Early intervention can help improve breastfeeding/bottle feeding and prevent long-term issues.

Des Frigenti
Senior Physiotherapist
Ocean Kids Health

Our Ocean Kids Health team are here to help you and your child thrive!