Transcript: Tongue Ties and Lip Ties: Symptoms, Treatments and Aftercare
The Boob Group
Food and Cooking Tips for the Breastfeeding Mom
Episode 108, June 6TH, 2014
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
SUNNY GAULT: Hey Boob Group. We have a special announcement before we start the show. New Mommy Media – the parent company of The Boob Group is looking for moms and dads to join the new sales team and sell advertising on our shows.
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ROBIN KAPLAN: Nipple pain, slow weight gain and fuzzy baby can all be a sign that baby’s having a difficult time latching on and effectively breastfeeding. These are also some of the classic symptoms of a tongue and/or lip tie.
Today, I’m thrilled to welcome back our expert Catherine Watson Genna – an International Board Certified Lactation consultant and private practice in New York City. She’s also the author of multiple lactation books and a popular speaker on Infant Sucking Skills.
Today, we’re chatting about: “Tongue ties and lip ties and their symptoms, treatment and aftercare. This is: “The Boob Group.”
ROBIN KAPLAN: Welcome to The Boob Group broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.
Have you signed up for our weekly newsletter yet? Best thing about it have each new Boob Group Episode delivered straight to your e-mail inbox every week. That way you’ll never miss your next favourite episode. Sign up today on our website. Today, I’m joined by two lovely panellists in the studio. Ladies, will you please introduce yourselves?
JULIE SANDERS: I’m Julie. I’m 31. I’m an engineer and I have one daughter and she is seven months old.
LINDSAY WHITTAKER: I am Lindsay. I am 31. I’m an operations manager and I have two little ones. I have a 3 year old boy and an 8 month old little girl.
COLINA COROTHERS: Hi. I’m Colina Corothers. That was my son Adam. He is my only son and I work at a call center overnight which is always fun.
ROBIN KAPLAN: Both babies are in the studio. They’re currently making goo-goo eyes at each other and talking as well. I’d like to give a shot out to Mj, our producer. Mj, do you want to tell everyone about The Virtual Panellists Program please.
MJ FISHER: Yes, I do. So, not all of you are listeners are local to San Diego. Not all of you are actually in the country. So, it’s a way for you to join our conversation and be a part of the show even if you can’t be in the studio with us. We’re posting the same questions that we’re asking our in-studio panellists – so you can share your experience; give your tips, your opinions.
What I’m seeing actually is: “Lots of moms are helping each other.” So, like kind of a cool extension of our show because we’re here to help you and you’re helping each other. We may even read your comment while we record. Then for participating, you are entered to win a one-month subscription to The Boob Group Club.
If you want to get more info about the program, just check out our website theboobgroup.com under the Community Tab for more info.
ROBIN KAPLAN: All right, thanks Mj.
MJ FISHER: Thank you.
LARA AUDELO: Hi Boob Group listeners. I’m Lara Audelo, a certified lactation educator; volunteer at Best for Babes and author of The Virtual Breastfeeding Culture. I’m here to answer some of your most common questions about: “How you can achieve your personal breastfeeding goals without being undermined by cultural and institutional booby traps.”
Such as: “What to do when your child care provider is not supported of breastfeeding?” Child care support for breastfeeding isn’t talked about as much as the other breastfeeding issues. But a recent incident in Toronto, brought to life about: “How much of a faster it is in mom’s ability to sustain breastfeeding.”
A recent study from the CDC examined a relationship between child care provider support for breastfeeding and mother’s breastfeeding duration. It found that: “Breastfeeding as six months was significantly associated with child care provider support to feed expressed breast milk and allow mothers to breastfeed at the child care place before or after work.”
Compared to mothers who reported fewer than 3 total supports; mothers who reported 5 supports were 3 times is likely to be breastfeeding at 6 months. Our findings suggest: “The child care providers breastfeeding support in the early months may help mothers maintain breastfeeding for longer durations.”
It’s compelling enough that the surgeon general in her call to action to support breastfeeding makes the recommendation quote: “Ensure that all child care providers accommodate the needs of breastfeeding mothers and infants.” End quote.
The CDC also found that: “Only 6 of the 50 states have child care regulations requiring the centers quote – encourage for breastfeeding and feeding of breast milk by making arrangements for mothers to feed their children comfortably on sites. End quote.” Just six – now, it’s almost certainly a case that: “Many child care providers support nursing moms on their own without being required too by the state. But doesn’t the absence of regulation say something about the lack of recognition of this is an issue?”
We think that is a booby trap; a special thank you to Tanya Lieberman, IBCLC for writing The Booby Trap Series for Best for Babes.
Visit bestforbabes.org for more great information about: “How to meet your personal breastfeeding goals and check out my book The Virtual Breastfeeding Culture for collection of breastfeeding stories.” Be sure to listen to The Boob Group for fantastic conversations about breastfeeding and breastfeeding support.
ROBIN KAPLAN: Today on The Boob Group, we’re talking about: “Symptoms, treatment and aftercare of tongue ties and lip ties.”
Our expert Catherine Watson Genna is an International Board Certified Lactation Consultant in private practice in New York City – the author of the book Supporting Sucking Skills and Breastfeeding Infants and Selecting and Using Breastfeeding Tools; as well as a wildly popular presenter of lactation conferences around the world.
She is also one of my most favourite experts in the field of lactation. So, thanks for joining us Catherine and welcome back to the show.
CATHERINE WATSON GENNA: Thanks for having me and hi Robin. Hi Julie, Lindsay and little ones.
ROBIN KAPLAN: Well so Catherine, can you explain to us: “What is a lip tie or an upper lip tie and a tongue tie?”
CATHERINE WATSON GENNA: A tongue tie is when the little membrane under the tongue is tighter than usual where it’s placed more forward than usual. The same thing can happen to the little fold of skin that holds your lip stand. The upper lip or the lower lip can be tight. There can even be some on the sides of the lip.
Sometimes they’re problematic; sometimes they’re not at all. It all depends on how tight it is and what else is going on with the baby’s anatomy and the mom’s anatomy.
ROBIN KAPLAN: Okay. So ladies in the studio, did your child have a tongue tie, lip tie or both? Julie?
JULIE SANDERS: My daughter had both that were actually diagnosed separately.
ROBIN KAPLAN: Okay and how about you Lindsay?
LINDSAY WHITTAKER: My daughter actually has a lip tie, an upper lip tie.
ROBIN KAPLAN: Okay, not a tongue tie then.
LINDSAY WHITTAKER: Not a tongue tie.
ROBIN KAPLAN: Okay, all right. Catherine, is this something new that we are noticing about breastfeeding babies? Are tongue ties and lip ties now more common than they used to be? We’re just hearing about them more frequently.
CATHERINE WATSON GENNA: We’re really not sure about that. [Inaudible] is the first person to publish that: “Tongue tie and lip tie can go together by the way in the early 1990’s.” Many of us noticed that: “A baby who has one is more than likely to have the other but not always of course.”
The human race has been treating tongue ties in many different cultures for thousands of years. So, it’s possible that we’ve just been treating it for so long and then we dropped it in the 1930’s and 40’s when birth moved into the hospital and breastfeeding fell apart under the every four hours in just one breathe for two minutes the first day.
Sort of things – bad advice became the norm and more people started to bottle feed because they just couldn’t make a milk supply with that poor, early market research.
ROBIN KAPLAN: Okay.
CATHERINE WATSON GENNA: So, we’re not sure if we’ve just seen more because we’ve been treating it for so long that babies have survived with tongue tie are passing it on; or if there’s something in the environment that’s problematic.
ROBIN KAPLAN: Okay. I do want to welcome one more panellist to the show. Colina, welcome to the show; it’s nice to have you back.
COLINA COROTHERS: Thank you Robin.
ROBIN KAPLAN: Great. So, Catherine one more question for you before we ask our panellists a few questions. So, what are some signs that a baby has a tongue tie and do these signs are they different when a baby has an upper lip tie?
CATHERINE WATSON GENNA: Okay.
Some signs of a tongue tie are:
• Nipple pain
• Baby who can’t stay on the breast or has a lot of difficulty latching on the breast.
-Especially, after day 2 or 3 when the breasts starts to get fuller. Some babies with tongue tie can latch on just fine that first day or two in the hospital. Then they go home, mom’s milk starts to really increase and her breasts get firmer and then the baby has a lot of difficulty.
• Another sign is: “A clicking noise when the baby nurses kind of like and that’s caused by the tongue trying to lift up and then being pulled back by the little fraenulum – the little membrane.”
-That can make allow air in the baby’s mouth and some babies will swallow a lot of air.
• Baby may not be able to turn their upper lip out a little bit.
-You want to see the teeniest bit of red when the baby latches on. If you only see white, the upper lip is tucked in; they may have a bit of a lip tie.
-We’re not sure if lip ties matter more if the baby has a short jaw.
Dr. Linda Dahl one of our local ENT who has a lot of expertise in treating tongue tie feels that: “If a baby has a short lowered jaw, the lip tie is much more of a hindrance to latching and staying latched than if the baby has a more normal jaw.”
ROBIN KAPLAN: That’s super interesting because sometimes those upper lip ties make a huge difference and other times, you wouldn’t even notice.
CATHERINE WATSON GENNA: Yes.
CATHERINE WATSON GENNA: Okay, all right so ladies, what are the signs that your baby had a tongue or a lip tie? Julie, you want to start?
JULIE SANDERS: For the tongue tie, they were a few signs. She latched fine but we noticed that: “She didn’t quite gain at the rate that she should have been.” She was nursing pretty much constantly like 20 times a day, she would be nursing.
Just because she couldn’t get enough milk because of the tongue tie; so it was just kind of a little of the time. She was able to maintain her weight but not really get quite enough. There was a lot of nipple pain. She would gum my nipples quite a bit. So, it was a rather painful experience for me.
I think they’re might have been a little bit of the clicking. But I didn’t really know at that time; it was kind of hard to know. Then, for her lip tie, she was tucking her lip under but I didn’t even know the look for that until when I visited you for a lactation consultation and then you identified it right away.
ROBIN KAPLAN: Okay. Was that causing you pain as well Julie?
JULIE SANDERS: The lip tie?
ROBIN KAPLAN: Yes.
JULIE SANDERS: Yes, on the top.
ROBIN KAPLAN: Okay.
CATHERINE WATSON GENNA: Julie, your experience is really, really common. [Inaudible] research shows that: “Babies got twice as much as milk after their tongue tie was corrected when they were breastfeeding.” So, many babies breastfeed very poorly and they go into that continuous feeding pattern to try to make up for it.
ROBIN KAPLAN: Yes, absolutely. I definitely remember that. How about you Lindsay?
LINDSAY WHITTAKER: Well, I actually had a lot of nipple pain. She latched fine. She nursed fine. She clearly gains weight no problem.
ROBIN KAPLAN: She’s a little Chunker Cathy.
LINDSAY WHITTAKER: But my nipples just fell when she would latch on – it felt like: “Somebody was sticking needles on them.” I actually was at a baby shower with Mj one day and was telling her about this problem. She looked and she said: “Well, she’s probably got a lip tie.”
ROBIN KAPLAN: Yes, a future lactation consultant in the room.
LINDSAY WHITTAKER: Since then, I looked into it and a lot of the things she does when she’s nursing, she doesn’t flips her lip out and she only nurses on the very tip. That showed me that: “Yes, she definitely does have it.” I just kind of dealt with the pain and just let her since she was gaining so much weight, I didn’t feel like it was necessary to do anything about it.
ROBIN KAPLAN: Okay. So, Catherine how is a lip tie and a tongue tie diagnosed?
CATHERINE WATSON GENNA: Many practitioners have different ways of diagnosing but they’re usually by how much the tongue can move around the mouth for the tongue; and how much the lip tie indents the upper gum. If there’s a deep indentation in the gum and the ties gone between the two halves of the gum, it will often cause a gap between the teeth. We think that: “Treating it in infancy may prevent that.”
As for tongue tie, we want to look at all of the tongue movements. We want to look at the baby’s ability to stop the tongue, bring it side-to-side and stick it out. Other practitioners will gently press down on the floor of the mouth or drag a finger across the mouth at the very back of the tongue to see if their finger will pass across.
The fraenulum will just kind of pop up out of the way like a little speed bump or if it’s a big [inaudible] and you have to come around it. Jim Murphy uses that language and his evaluation is very helpful.
ROBIN KAPLAN: Okay, does a tongue tie or a lip tie always negatively affect breastfeeding? Is there such thing as a slight tongue tie?
CATHERINE WATSON GENNA: Yes, sure. They are slight tongue ties. If mama has really elastic breast, a good milk supply and nipples that stick out easily, it’s easier for tongue tied baby. If mama has softer nipples, flatter nipples – so there is the mommy part of the equation too. Some fraenula are more stretchy than others.
The stretchier fraenulum even if it’s closed to the tongues up, it’s going to be a much less of a problem than a really tight one even further back towards the base of the tongue.
ROBIN KAPLAN: Okay, so it’s not a matter of how far it necessarily it comes to the tip that would indicate how much of a challenge it might be with breastfeeding. It’s really assessing how capable the baby is of removing milk and also making sure mom’s not in pain and stuff like that.
CATHERINE WATSON GENNA: Exactly.
ROBIN KAPLAN: Okay and what else can cause trouble moving the tongue or staying on the breast? We know that that’s not always an indication of a tongue tie. It could be some other thing is going on.
CATHERINE WATSON GENNA: Absolutely, pinched nerves can give problems moving the tongue the Hypoglossal Nerve is the nerve that causes a lot of tongue movement. It goes out from the very base of the skull and sometimes during birth; one of them can get pinched on one side or the other.
Having a tight neck from babies get kind of stuck in Utero of the last few weeks of life and they can wind up with one side of the neck a lot tighter than the tighter and that has effects on how the jaw and tongue’s function as well. With those babies, you’ll see that they can move their tongue to the side much more easily on one side than the other.
Also, babies with little bit of neurological issues or babies that are very tiny may have some more difficulty latching and breastfeeding babies with a large tongue. So there are a lots and lots of reasons. So, we want to be really careful to rule out all those other things before we say that: “The breastfeeding problem is from the tongue tie.”
ROBIN KAPLAN: Okay and so for babies who do have tightness in the neck – Torticollis things like that, do you often recommend that they try body work first to see if that resolves it?
CATHERINE WATSON GENNA: Absolutely. If the fraenulum is all the way to the tip of the tongue and the baby who has Torticollis then that baby may really benefit from having the tongue tie treated as well as getting body work.
But, for a baby who is further back and it’s more questionable; having body work first seems to be really helpful. It doesn’t seem to be helpful enough to just treat the tongue tie when the baby seems to have both tongue tie and Torticollis.
ROBIN KAPLAN: Okay and for body work, do you have a particular type of body work that you recommend?
CATHERINE WATSON GENNA: Well, my local person with magic hands happens to be a paediatric chiropractor. But some people really love Physical Therapist, CranioSacral therapist, Occupational Therapist, Massage Therapist – there are many people with expertise that can do an amazing job with babies. So basically, you find your person in your own area who has the best expertise.
ROBIN KAPLAN: Okay, wonderful. Well, when we come back, we will discuss: “How a tongue tie and lip tie how we treat them as well as the aftercare for them if a parent decides to treat them.” So, we’ll be right back.
Welcome back to the show. We are talking with Catherine Watson Genna about: “Tongue ties, their symptoms, their treatments and their aftercare.” Catherine, if a parent decides to have his/her tongue tie or lip tie revise, what is the difference between using laser or scissors for revision? Is one method better than the other? Does it depend on the practitioner?
CATHERINE WATSON GENNA: Yes, I think depends strongly on the practitioner. But each technique will also have its cases where I think it’s superior. Scissors are fast. It’s done in a fraction of a second. Laser takes a little bit more time. So, the baby has to be held still for longer in that maybe a little stressful for some babies.
We really don’t know a lot about pain other than some study show babies like don’t really cry very much; and other studies show that: “Babies do seem to be cranky after.” That depends a lot on the baby. But I do see a little bit more feeding refusal by babies who have lasers done by certain doctors.
Other doctors have very low feeding refusal and we think it has to do with the type of lasers. Hot lasers burn more tissue. I’m really excited about the Carbon Dioxide Laser. It seems to do a very gentle job and hurt very little of the surrounding tissues. So, we’re starting to see some really good results.
Some of the people I know from the IATP or experimenting with that now. Then, laser also seems to be really helpful when we’re revising an old Frenotomy that has a lot of scar tissue because the laser gets through the scar tissue more readily.
ROBIN KAPLAN: Okay. One of the things I’ve noticed with laser for upper lip tie is too is that: “The practitioner often will clear off the gums as well.” So that, I’m curious if it ends up that: “The baby’s teeth end up coming in not with such a gap as they may have if that piece was still there.” But I know we probably don’t have that information yet.
CATHERINE WATSON GENNA: Yes. We really need so much more research but certainly if it’s the fraenulum between the gums that’s preventing the teeth from coming together; if we vaporize that fraenulum with the laser then we can allow that bone to grow together and the teeth to come together in midline.
ROBIN KAPLAN: Okay.
CATHERINE WATSON GENNA: That’s the hope.
ROBIN KAPLAN: Exactly. All right ladies, did you have your babies tongue tie or lip tie revised be kind of talked about that a little bit. Did your practitioner use laser or scissors? Colina, we’ll start with you.
COLINA COROTHERS: All right. We did have ours revised both of them right away. They used scissors as far as I know. I didn’t look. I couldn’t. I think I was more traumatized than my son was because he didn’t cry at all. It was really fast.
They brought him right over. He latched; breastfed fine and he didn’t have any kind of issues as far as not wanting to eat or anything like that. So, it went really well for us.
ROBIN KAPLAN: How old was he?
COLINA COROTHERS: That was the day after he was born.
ROBIN KAPLAN: Okay, super quick. How about you Julie?
JULIE SANDERS: We had both revised. As I’ve said: “They were diagnosed separately.” So, we had them done separately. The first time was with scissors. Our paediatrician actually did it. For my personal experience, actually the scissors was not very quick. He actually ended up having a cut three different times to get in there enough.
It was as she said: “It was very traumatic for me.” I was pretty much sobbing right next to her because they had to hold her down. She nursed right away afterwards and was fine. Then, we went to a paediatric dentist for the upper lip tie and he used a laser. He actually also re-revised her tongue tie as well because there was some scar tissue there.
With a laser, he could just kind of get more of it. That was actually very fast just because he’s kind of an expert on the subject. It was also little gentler just in how he did it. He had dad laid down in a chair and hold her. So, she was a little more comfortable.
She again, nursed right away afterwards. I think there might have been a little crankiness there later that day. But generally, she recovered from both pretty quickly.
ROBIN KAPLAN: Julie, how old was your daughter for each of those procedures?
JULIE SANDERS: I think she was 2 weeks for the tongue tie and 4 weeks for the lip and tongue tie.
ROBIN KAPLAN: Okay. Lindsay, you ended up not doing the revision of the upper lip tie?
LINDSAY WHITTAKER: No. By the time we figured out what it was, I felt like we had established such a good breastfeeding routine. Just a thought of cutting her or doing the laser, I know everyone – it’s the moms who have the harder time. I just couldn’t bring myself to do it.
ROBIN KAPLAN: Yes. You guys are already at a point where things have really resolved.
LINDSAY WHITTAKER: I felt like she’s gaining the weight. She’s nursing fine. My biggest thing is the nipple pain. I still get it but I try and do certain techniques to try and help that.
CATHERINE WATSON GENNA: There’s no guarantee that the nipple pain would go away if you did revise it. Success rates run from about 50 to 90% depending on which study. So, there’s no 100% guarantee. So, your baby is thriving and you can tolerate it and you’re not getting damaged, that certainly is not a bad decision.
ROBIN KAPLAN: Absolutely. With the studies, it would be hard to see because I think it’s also a practitioner-wise too; like we definitely have a lower percentage of success rates from particular practitioners and a much higher one from different ones. I think: “It just kind of depends on that as well.”
CATHERINE WATSON GENNA: Absolutely.
ROBIN KAPLAN: Catherine – actually Mj, did you want something you wanted to share really quickly?
MJ FISHER: I had a VP.
Stephanie Ackley, she said that:
She had her son’s upper lip tie and posterior tongue tie revised at about 7 or 8 weeks old. She said it was misdiagnosed by the midwife the PCP, ENT, the lactation consultant, speech therapist.
She said: “She called around and found the dentist who is familiar with the tongue tie and lip tie. Made an appointment and he was seeing within a week.” They had revised the other laser. No anaesthesia and it took her five minutes. He got to nurse right after.
ROBIN KAPLAN: Okay, very cool. Catherine, speaking of healing time; does it differ between practitioners whether they use a laser or a scissor?
CATHERINE WATSON GENNA: Yes, absolutely. It seems to take between 3 and 7 to 10 days for the frenotomy site to completely heal depending on how deep it is. If they need to snip in to the floor of the mouth and we get that big [inaudible] – that takes longer. That’s more on the 7 to 10 days for that to completely heal over.
If it’s just a little snip of the straight fraenulum, that will heal much more quickly. You’ll just get a little white line that will heal within a few days.
ROBIN KAPLAN: Okay, how would a parent find the best practitioner to do this revision in their community? Is this something the baby’s paediatrician can do? We have a lot of paediatricians in San Diego who are doing this now; or is it more preferred to find – do they look on Yelp? How do they know who the best people are?
CATHERINE WATSON GENNA: I wish we have a Yelp for this. That’s a really good idea Robin. Word of mouth, talk to your local [inaudible] leader, your lactation consultants. Diana West and Lisa Marasco on their low milk supply is it dot com or dot org? I always get confused. Website has a list of practitioners that people have had really good results with who do Frenotomies.
Really, look around because yes, it’s a really simple procedure and pretty much anyone can do it. But then there’s: “Do they do enough? Do they do it gently? How much did they burn the baby?” What I’m saying is: “We just want to have it done as gently and expertly as possible.”
ROBIN KAPLAN: Okay and what happens during a revision procedures? We’ve been talking all about it? What actually goes on during this process?
CATHERINE WATSON GENNA: Well practitioners vary but most practitioners will use some sort of pain really for pain prevention. If it’s a really thin fraenulum then there are no nerves in it and it won’t hurt the baby. So, they don’t need to use anything. But if its thicker, some doctors will rub on an anaesthetic gel or a local anaesthetic gel; some will inject it if it’s going to be a longer procedure.
Then they do either a snip or 2 or 3 with a scissors. Sometimes it does take a couple of snips to get to the entire fraenulum or they will use the laser and kind of heat the light back-and-forth over the area that they want to vaporize. The laser actually explodes the cells that heats the water and explodes the cells.
Laser usually creates its own blood clotting. If it’s done by scissors, they will usually press a piece of gauge over the spot for a few seconds to a few minutes to just stop any bleeding.
ROBIN KAPLAN: Okay. Ladies, was your baby fuzzy after the procedure and if yes, for how long? Colina, do you want to go first?
COLINA COROTHERS: Sure, it was a little hazy because it was so soon. But I don’t really remember very much fuzziness. He was still kind of in that sleepy stage and so, he just kind of nursed and snuggled up and went back to sleep.
ROBIN KAPLAN: Okay. How about you Julie?
JULIE SANDERS: Well, for the second time with the laser, the paediatric dentist was actually about 80 miles away so it was kind of a long car trip back. She actually slept the entire time right after. So, she was not I don’t know fuzzy.
ROBIN KAPLAN: Okay.
JULIE SANDERS: A lot better than I thought it would be
ROBIN KAPLAN: Good and she nursed once you guys got home?
JULIE SANDERS: Well she nursed right after while we’re still in the office then after we got home.
ROBIN KAPLAN: Okay. Catherine, let’s talk a little bit about aftercare. What are some options for aftercare that are recommended after a tongue tie or a lip tie procedure?
CATHERINE WATSON GENNA: Okay. Many people are advocating, lifting the tongue or stretching or actually rubbing in the incision to try to prevent scarring. Scarring is a really issue. I started out as an IBCLC 20 years ago; we pooh-pooh the idea of scarring. But, we actually have really seen that it can happen.
All wounds contract as they heal. So, there’s always going to be some contraction as the baby heals. We want to kind of minimize that by having the baby mobilize the tongue a lot. Breastfeeding is like the very best thing that mom can do because the baby continues using their tongue properly while they breastfeed.
I think that in my own practice, moms who haven’t established breastfeeding yet – they are still bottle feeding the baby as they heal, it don’t get as good a result. Then, many practitioners are recommending lifting the tongue or stretching the area. Some things that seems to help – Leslie Stern who’s another lactation consultant recommends: “Dipping your finger in ice water so it’s really cold and baby’s tend to like that on the wound if you’re stretching the wound.”
Lifting the tongue when the baby is sound asleep kind of rubbing their little lips so that they’ll open their mouth, rubbing their little gum so they’ll let you in and then lifting up the tongue with two fingers for about three seconds is what Jim Murphy was recommending last I talked to him.
So, people that do a lot of frenotomies really think that: “There are better outcomes when there is some sort of lifting or stretching done as it’s healing for at least a week or two.”
ROBIN KAPLAN: You had mentioned that the families that are still working on breastfeeding and are doing a lot of bottles or may not have as quick of a result or as successful as a result after the procedure. Do you find it’s the same thing with mom squeezing nipple shields as well?
CATHERINE WATSON GENNA: You know I haven’t investigated that Robin.
ROBIN KAPLAN: Okay, I was just curious. A lot of moms are really nervous about using that afterwards. I wasn’t sure if the tongue worked much differently when it was just bare breast or nipple shield.
CATHERINE WATSON GENNA: I have to look at our ultrasounds again. I have some of babies nursing with nipple shields. So, we’ll have to take a look at that.
ROBIN KAPLAN: Okay, sounds good. Our last question for you which I guess is the million dollar question that I got all the time from my families when I’m recommending these procedures. Are there lasting implications if the tongue tie or lip tie is not released?
So, if a parent decides: “You know what? Things are going okay. I’m just going to wait it out and see if everything’s okay.” Do we worry about tooth decays, speech issues, eating solid food challenges etcetera that if it’s not done that it might increase risk for this?
CATHERINE WATSON GENNA: Yes. For lip ties, we have very little data. Larry Kudlow published a short case series of babies that swallowed a lot of air that’s improved after their lip tie was treated. But for the tongue ties, there’s a lot of information.
Babies with tongue ties that go close to the tip of the tongue are more at risk for speech difficulties. Babies that have tongue tie may have more swallowing problems. They may have more difficulty gaining weight when they have to start transitioning to eating textured foods, solid food.
Babies with a posterior tongue tie may have a lisp when they learn to speak a little bit extra [inaudible] on their S’s. The dental decay maybe associated with not being able to get your tongue around your mouth to clean your teeth in between brushing. So, really careful dental hygiene if you have a tongue tied child so you haven’t treated.
The things we worry about most are the structure of the mouth. When a baby doesn’t have a tongue tie, their normal sucking helps spread their mouth while they’re breastfeeding. It spreads the palette that spreads the nasal air way. That may reduce the baby’s risk of Sleep Apnea and make room for the teeth.
When the baby has a tongue tie, they use their tongue in unusual ways that don’t produce that same amount of spreading because the tongue can’t press up on the roof of the mouth and it can’t press the breast up in the roof of the mouth the same way. So, Sleep Apnea is a really huge problem in our culture right now.
ROBIN KAPLAN: I remember reading something about: “There was an increase rate of adult males getting their tongue ties released because of Sleep Apnea; as adults like 40, 50 or 60 year old men because it made a difference.”
CATHERINE WATSON GENNA: At that point, the palette is already fused. So, really the time to work on the palette is around puberty, before puberty. So, if you choose not to get the baby’s tongue tie released and the palette does stay narrow, you can always have a maxillary expansion done when the child is 10, 11, 12 years old. That’s a procedure done by the orthodontist. It’s not [inaudible] but it does give you a second chance to widen the dental arch in the airway.
ROBIN KAPLAN: All right. Well, thank you so much Catherine and to our lovely panellists for joining us in this conversation about: “Tongue ties and lip ties.” Plus for our Boob Group Club Members, our conversation will continue after the end of the show.
As we will discuss: “If it’s common for breastfeeding issues to arise later on if a tongue tie or a lip tie is not revised.” For more information about The Boob Group Club, please visit our website at www.theboobgroup.com .
DENISE ALTMAN: My name is Denise Altman and I am a private IBCLC; otherwise known as a registered lactation consultant. Private practice means I have my own business and I specialize in prenatal education and breastfeeding support. This session is about: “Prenatal path to breastfeeding. Something I definitely have an opinion about.”
First off: “It’s all about the birth in the very beginning.” So, this is something that you should be thinking about from early on. Don’t wait till your third trimester to start preparing for birth.
• What your dreams are?
• What your hopes are?
• Have do you imagine your birth occurring?
• What is the scenario?
• How long do you think it will take for your baby to be born?
• How do you know if your imagination and your dreams are going to aid for reality?
• What do you know about birth and where did you learn it?
This is something that most women dream about when they start thinking about becoming a mother. But sometimes it doesn’t go beyond the dreaming phase. It’s your job to educate yourself and your partners so that you’re all prepared when that day comes. I hope this information on this session can get you started on exploring your options.
For additional tips on choosing a breastfeeding class, birth rep, prenatal or breastfeeding prep – please visit my website www.feedyourbaby.com and keep listening to The Boob Group.
ROBIN KAPLAN: That wraps up our show for today. We appreciate you listening to The Boob Group.
Don’t forget to check out our sister shows:
• Preggie Pals for expecting parents
• Parent Savers for moms and dads with newborns, infants and toddlers
• Twin Talks, our show for parents of multiples.
Thanks for listening to The Boob Group: “Your judgement-free breastfeeding resource.”
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
SUNNY GAULT: New Mommy Media is expanding our line-up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or organization interested in joining our network of shows through a co-branded podcasts, visit www.NewMommyMedia.com .
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