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What are tongue and lip ties and how do we assess for them?

We have all heard the terms tongue and lip tie, but what really are they??


Frenulum: a small fold of tissue that supports a mobile structure (lip, tongue and cheeks).


This structure allows for proper sucking, swallowing and mouth movement.


Fun fact: There are actually seven frena (that's plural for frenulum!) that can be present in the mouth. So in addition to the one under the tongue, there can be one under both the upper and lower lip as well as one inside each of the cheeks, upper and lower called buccal frena.


All of us are born with frena and it is normal for this tissue to be present. What we run into and where problems lie is when this tissue is restrictive and the moving parts are unable to function properly.


Part of the confusion around oral ties is that there really isn't one standard way to assess them and no standard definition for what is "normal" or not. To make it even more controversial, there is little research evidence to support this area and many medical providers want evidence to support their practice. Sigh..... what are we to do?


As IBCLCs this is how we look at it:


When we are working with a mom and baby who are struggling with feeding, we look at the big picture and how each of you is impacting your feeding experience. In fact, we are usually the only professional you see who is doing this!


We have been trained to thoroughly assess mom, baby and the dyad (that's a fancy word for both mom and baby together) as a whole, looking for signs and symptoms of oral restrictions. There are many symptoms that can be related to oral ties and some of them are not so obvious!


When we do a thorough oral assessment we are looking at the structures of the mouth and also eliciting certain movements and motions that allow us to see how they are moving and functioning.


By understanding what the tongue and mouth are supposed to do while feeding, we are able to identify when that is not happening.


If your baby was assessed by a provider that solely looked in your baby’s mouth without assessing for the function of how the tongue and lips are functioning, then this was not a proper and thorough evaluation.


If you feel that you are dealing with tongue and lip ties, reach out and schedule a consult with us! We will listen to you and look at the whole picture. We will do a thorough and complete oral assessment and explain our findings and how they are impacting your baby's ability to feed. And then, we will present you with options for what you can do to address the issues. Look for more blog posts on the release process and what we need to do to support a baby through a tongue and lip tie release!


We would love to help you on your feeding journey.



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