All Tied Up: Lip Tied & Tongue Tied
Never doubt that “mommy sense”. Fight for what you feel is “wrong” or “off”. Do not let other’s belittle your concerns. You know your baby better than anyone else. I should have fought before, but I’m fighting now. And we’re going to win this curve ball after Liam has “surgery” next week in California..
From the day Liam was born I thought something was off about his oral anatomy (and I know a bit about that, being an SLP and all). I asked the lactation consultant in the hospital and was told “it just looks different because he doesn’t have teeth and is so small…” How I wish I had been wrong, or that I’d fought more back then. Recently a few things were really itching that thought in the back of my mind:
- People kept saying “oh those are the cutest two little teeth! You’ll get more soon” and similar phrases. Except… he has six teeth. Four on top that no one ever seemed to notice.
- He doesn’t “pucker” his lips very well. I’ll post again this week with a video showing how he “kisses”.
- When he drinks water, it is through a straw. But he more “pinches” it between his lips than puckers. Also, it ALL falls out of his mouth if he takes the straw out.
- When we try to feed him by bottle he always collapses the nipple between his lips.
- [warning: may be TMI] When he nurses he doesn’t take the whole nipple into his mouth. He stays near the tip – I was constantly told this was just because he had a small mouth
- He nurses for VERY short stints. A few minutes and then takes a break.
What sealed the deal was his top two front teeth growing in significantly recently. They came in with a big gap. When I was looking closer at the gap I realized it – his lip is attached through his top two teeth and onto his palate! I called Oliver from the airport (I was flying home) and told him “Liam is lip tied…. bad.”
What followed was extensive research on my part. The biggest impact for me was realizing the following:
- Lip ties are very common and mostly genetic
(go ahead, run to the mirror. We all did…)
- Most lip ties come with a tongue tie
- There are two types of lip ties …
- Frenulum Labii Superioris (inside the upper lip) – this is Liam’s
- Frenulum Labii Inferioris (inside the lower lip).
- It causes significant problems in breastfeeding – doesn’t stimulate milk production, damages nipples, bad latch, poor weight gain/failure to thrive, etc.
- It is EXTREMELY common, but hardly diagnosed!
“Ties” are rated on a scale of “classes”. For lips ties, a class 1 is “normal” and a class “4” is the most severe. For tongues the scale goes the opposite direction. I know Liam has at least a class 3, but possible class 4, lip tie. You can see some great images here:
There are so many myths and “old school” mindsets out there that impact intervention on lip ties:
- Many doctors/lactation consultants believe medical intervention isn’t needed, thinking children will “grow out of it”.
- Many professionals will not treat infants/toddlers/etc.
- Some suggest “waiting to see if it impacts speech, then intervening”
Ug! As an SLP I can say with assurance – NEVER wait to see if something “impacts speech”. By that time you are looking at extensive intervention to correct something rather than being “ahead of the game”. And the more research I did, the more I realized intervention was not only important, but necessary. And fast.
When battling a “lip tie”, the individual needs a “frenectomy”. In layman terms, you need to cut the frenulum that attached the lip to the gums or the tongue to the floor of the mouth. This is primarily done one of two ways:
- Cut with a scalpel then stitched (Z-plasty surgery)
- Cut and simultaneously cauterized via laser
Stitches and a toddler sounded like a nightmare. And the healing for that was extensive and much slower than a laser. Research into the laser procedure gave us a general “picture” of how the appointment would go:
- They would put local anesthesia into the frenulum being cut
- After giving it a few minutes to kick in, they cut the frenulum
- The procedure lasts approximately 6 minutes start to finish
This seemed like the best decision to us. The hardest part will be having to restrain Liam while they cut. So, now that we had decided we were going to allow someone with a laser into our child’s mouth, we needed to find out who does this procedure…
I first assumed it would be a medical doctor or ENT who would specialize in this. But it is actually cosmetic dentistry! We searched and found the names of the leading specialists. If someone was going to be in my child’s mouth (an SPL’s kid!) with a LASER, they had better know what they are doing! We found one of the leading specialists (and researchers!) in the nation is Dr. Kotlow in Albany, New York. And his very first suggestion, if you can’t go to him, is Dr. James Jesse in Loma Linda, California. We did find some dentists who do the laser in our area, but we prayed about it and only really felt peace about going to California. So I called his office, stated immediately that I was an SLP with a child with a class 3/suspected class 4 lip tie and probable tongue tie. They had an opening the following week.
What Can I Do?
Honestly, go check your little one. Talk to your friends about checking their little ones! Do you know someone struggling to latch/breastfeed? Or someone who is ready to give up due to pain/cracked nipples/etc? Share this post! Get them help – help that friend rid themselves of “mommy guilt” and raise awareness that this is common and FIXABLE! Be the answer someone else needs to much and keep more kids off the SLPs caseload by giving them a great start to their breastfeeding AND speech development!
We fly out Wednesday night to LA where we will meet up with my mom (she is flying in from San Jose). We then pick up our rental car and drive to our hotel in Loma Linda. Thursday as 2pm PST we have our appointment with Dr. James Jesse to correct Liam’s “ties”. We are cleared to fly home the very next day, but instead chose to stay until Saturday afternoon and give Liam some “chill time”.
Over the next week or so I will post what we packed for our trip, what helped with the surgery/recovery process and a less “informative” and much more “personal” peek into what we are all thinking and feeling through this process. Keeping it real!
Some great blogs and websites:
- Dr. Kotlow
- Dr. Jesse
- Frenectomy Today
- Discovering And Correcting Lip Tie On A Toddler And An Infant
- A Warrior Mom: The Discovery of the Upper Lip Tie
- How To Spot Tongue/Lip Ties & Get FREE Expert Advice