Intro

All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

Top Ten Tongue Tie Myths...

1.  A tongue tied infant has a frenulum on the tip of their tongue - it's obvious to see if they have one!  FALSE
All tongue tie is, is a frenulum that is too short or tight.  A frenulum can be anywhere down the tongue and may not be at all easily visible.

2.  A tongue tied infant cannot extend their tongue past their lower gum/lip - FALSE
Whilst some tongue tied infants are not able to protrude well, others can - particularly when the mouth is "small" ie just open wide enough for the tongue, rather than the large gape required to latch at the breast effectively.  My son on the left has quite a restrictive tie yet he can protrude!  It all depends where the tie is and what aspect of tongue movement it is hindering.

3.  If an infant is tongue tied but can protrude the tongue, the tie wont impact on feeding - FALSE
We see lots of infants who can protrude experiencing feeding problems.  The tongue doesn't just need to protrude to feed as this article discusses, it needs to do a whole host of things.

4.  As long as mum can breastfeed without pain, there is no reason to divide a tongue tie - FALSE
We see infants feeding who are uncoordinated or disorganised and as a result splutter, cough, gasp, arch and scream.  Nipples can be hugely compressed but mums appear sometimes to become almost numb to the pain.  Baby may be windy/unsettled and sleeping poorly.  Whilst some infants gain weight really well with a tongue tie (ie often a lot more than expected) some infants really struggle to grow at all.

5.  A tongue tie cannot impact on speech - FALSE
Whilst certainly not all tongue tied children have speech issues, others struggle with sounds that require certain tongue actions - particularly when the gape is wide ie "L" or when the tongue needs to do something more complicated ie "R", or when speech is rapid.

6.  A person with tongue tie can't roll their "R's" - FALSE
Again it depends on where the tie is and how it's hindering tongue movement.  Some tongue tied people can roll their R's just fine, others can't.

7.  Frenulotomy is an invasive aggressive procedure - FALSE
Unless you also consider a heel prick test as such.  It takes seconds and the difference is often apparent immediately (some infants, particularly older babies may need a little time to learn how to use their new found free moving tongue!)  The NHS states crying time as approximately 15 seconds, however it is often significantly less if the baby is breastfed and  mum is next to baby, enabling fast transfer to the breast post division.  Often the babies have been crying significantly longer than that whilst we discuss the procedure!

8. GPs, International Board Certified Lactation Consultants (IBCLCs), Health Visitors, Midwives, Osteopaths and Speech and Language therapists are all able to identify a tongue tie - FALSE
Whilst some can, others may not have had the specific training to orally examine properly under baby's tongue.  However this information is not always provided and parents are frequently told there isn't a tongue tie when there is!   Some breastfeeding counsellors and IBCLCs are often the most clued up, although some have little tongue tie experience - ensuring you seek out an "oral specialist" IBCLC is essential.  If you are having trouble getting a diagnosis when your child exhibits several signs (please click here if you are unsure what these are), this may help.

9.  A tongue tied tongue makes the tongue deformed when the infant does attempt to protrude, resulting in a heart shape - FALSE
Whilst some infants have a tongue that hearts, others do not!  To the untrained eye the tongue may appear perfectly normal.

10.  Tongue tie doesn't impact on any other area of health -FALSE
Dr Bryan Palmer has studied extensively the impact of tongue ties.  As this article discusses, they are significantly linked with a high palate, resulting in high dental arches and potential dental issues, plus narrower airways.  Releasing the frenulum early gives the tongue time to impact on the still forming oral cavity  Dr Palmer has also linked high palates, arches and reduced airways to other areas of health.

12 comments:

  1. very interesting. How is the research on lip-tie? My DS has his top lip pretty tied to his gums, but it has never impacted his nursing as far as discomfort, weight gain, etc. I only notice it bc his upper lip looks like an upside down V, almost like a shark when he is sleeping

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    1. My youngest daughter (now 11) has a lip tie but fed well for 2 years! The only problem we were warned about by our dentist when she was young was that it could impact on the changing of her teeth and leaving a gap between her two front teeth...she recommended to have it cut only if it seemed that her speech became impaired after she got her adult front teeth. My English dentist never mentioned the lip tie...

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  2. My daughter had both a lip-tie and a tongue-tie, and neither seemed to negatively impact her nursing. However, her dentist, pediatrician, and ENT were all concerned about potential speech and dental issues down the road, so she had an upper and lower frenectomy at 19 months. Importantly, our ENT told us that if we had come in before she was 3 months old, he could have done the procedure without general anesthesia.

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  3. Great article! I am an IBCLC and I get so frustrated when I suspect TT and suggest to mom she return to her baby's Dr. to have it evaluated. More often than not, they are put off with a wait and see approach, or a total denial that this might be the issue the mom's nipples are cracked and bleeding -- or the baby's nursing constantly and not gaining well. I can help mom learn ways to overcome many of these issues, but not without a lot of extra effort on her part. Dr.'s don't have a problem circ-ing a baby boy at a moment's notice, but they're not wanting to clip frenulums. So frustrating! I think I'm going to put together a package of TT info from Dr. Palmer, Catherine W-G, and add this to it and drop it off at area peds offices. Thanks!

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  4. Ah, so glad to see this article. My third child was tongue tied and nursing was so painful. The specialist we saw asked if I was "sure" I wanted her tongue clipped because it wouldn't necessarily effect her speech and they could recheck when she was around 2. She was 3 months old at the time and we went ahead with it. Like I said, nursing was downright tear-jerking. The difference was almost immediate! Nursing times were shorter and way more comfortable!

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  5. My cousin's daughter has a new baby that I suspect might have a tongue tie that is either posterior or just not that obvious. I encouraged her to consult with an ENT near her that I know will clip, but she started pumping and bottle feeding instead. I'm not an expert at spotting ties, but am I right to think if the tongue doesn't lift when the baby cries, there is a problem with tongue mobility?

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  6. My DS had a pretty severe tongue tie. (Tongue wouldn't go past gums, heart shaped, and didn't latch on correctly.) His was clipped at a couple weeks old. Glad I did! Our latch is just fine now. And his tongue does go past his gums now. No heart shape either. :)

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  7. Its also false that a tongue tie release will fix all latch issues. Many tongue tied infants also have an maxillary labia frenulum (upper lip tie). Here is a link to my blog post talking about our experience:
    http://becomingdaizee.blogspot.com/2011/09/trouble-with-frenulums.html
    and another blog about it:
    http://thefunnyshapedwoman.blogspot.com/2011/03/introducing-maxillary-labial-frenulum.html
    and a LLL leader's experience:
    http://www.llli.org/nb/nbsepoct00p161.html

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  8. My son's pediatrician noted a tie at his first appt but said it could not be clipped (too short, I think? or too tight or too/not enough something). Nursing was really rough the first few months but was no problem at all from 3 months to weaning at 2. His weight was very slow for the first 6 weeks, but that was likely due to major blockages in one breast--when those finally cleared he gained--big time! He was above 85% for both weight and height from 3 months to, well, he still is at 4, but he did nurse a lot so I don't know how much he was getting at a time. His speech started very early and very clearly and strangers were always very impressed--thought he was much older. He had every sound but R down by 3.5, including th and other blends. He still (4.5) doesn't have a good R especially in words like "bird" and "word" but I know 7 years olds still working on that. His health is great. I thought he'd outgrown the tie but a mom friend of mine recently saw him stick out his tongue and asked if he had a tongue tie, so I guess he still does. I am guessing I should not be concerned. Thoughts?

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  9. @Anonymous: Great idea!!!! Getting together a packet of info for our peds at the hospital where I work sounds like a great way to educate and make progress w/ getting them on our side! (fixing tt issues vs "let's just wait and see" or "I don't think this (tt) is a problem", etc!

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  10. Nicely done! I have an article on my blog that some of your readers might enjoy on this topic. Here's the link http://www.second9months.com/?p=589

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  11. @Renee Beebe, the answer to every one of those questions is yes for me, yet I just saw an ENT who told me her tongue frenum is not tied to the front of her mouth so it can't be cut, and also that her upper labial frenum is tight but cutting it won't help our breastfeeding problems. I am beyond frustrated. We are doing everything the IBCLC has suggested to help our latching and positioning and I'm still getting sore and damaged nipples. I had to stop nursing the right side to let the scab on it heal. Why is it so hard to get help with this?

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