Oral restrictions or “tongue-ties” may be a popular topic in baby feeding, but that doesn’t mean they’re always connected. An oral restriction can affect a baby’s latch or ability to drain the breast, but not always. Correcting a tongue-tie doesn’t mean breastfeeding will come easily. It’s important to understand what type of care each patient and family needs.
What are oral restrictions or tethered oral tissues?
Oral ties are bands of tissues that can occur under the tongue at the lingual frenulum (ankyloglossia), lip (labial frenulum), and buccal pads (frenum attachment at cheek and gum line). These connections may vary in length and elasticity–which in turn can affect severity and symptoms.
How do oral restrictions affect baby feeding
Oral ties may affect the lactating parent and/or baby. For lactating parents, they may experience pain while feeding or after feeding, nipple damage, clogged ducts, and/or mastitis. For babies, symptoms may be clicking while feeding, inefficient seal on breast or bottle (allowing milk to dribble out) or tiring while feeding. All of this can affect the amount of milk transferred. Later in life oral restrictions may affect speech, oral health/hygiene, sleep and digestion. However, ties can be present with no symptoms or symptoms may be present with a moderate tie. They can also be present for the lactating parent, baby or both. Each situation is unique but when oral restrictions are discussed, the dyad as a whole should be addressed.
Can an IBCLC diagnose an oral restriction
Oral restrictions are not the expertise of SimpliFed IBCLCs, and they will not diagnose one. However, our providers are able to support parents if an oral restriction affects baby feeding while referring back to the appropriate care team.
When to see an IBCLC for support
While baby feeding, seeking care from a professional early and often is important. However, the diagnosis of an oral tie is not always the answer to why breastfeeding isn’t going as planned.
Certified lactation consultant Abrie McCoy says “Poor latch or nipple pain are signs that a parent needs support, but there is no evidence that says having an oral restriction will cause feeding issues 100% of the time.” IBCLCs can help when discussing the presence of oral restrictions but support is best when it comes in the form of a team. This team can include a lactation professional, pediatrician, pediatric ENT, pediatric Dentist, Speech Language Pathologist, Myofunctional therapist, and even a Body Work/Massage Therapist.
What care is needed if an oral restriction is corrected
When families move forward with revision a continued support plan is necessary. Care teams can help families with active wound care, stretches and exercise to ensure that the revision heals properly and remains effective. Post correction, lactation consultants will work on latch, positioning and creating a plan to ensure comfort. As well, work closely with a family's pediatrician to ensure milk transfer is good.
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