I recently received the following question from a reader concerning her infant’s lip and tongue tie. Today, I’m going to share a good bit of information with you on lip and tongue ties in children in case you or anyone you know may need it. I’ll also be sharing how I would approach this situation if it were my child with a tie, and how I’d go about managing their treatment as naturally as possible.
I have a question, which I would like to know what you would do as an RN, herbalist, and most importantly, a mama.
Our baby was born 4 weeks ago, at 35 weeks gestation. He is a healthy baby boy, and we’re so thankful! We’ve had breastfeeding issues, and I’ve been pumping and supplementing. I believe the main reason for our issues is due to his upper lip tie and posterior tongue tie.
While I would prefer to have the procedure done with a laser, it’s just not possible for us due to distance/finances/insurance. A local ENT can do the procedure with scissors.
What options do I have for a newborn to help with pain and inflammation? I’m looking for something that would be used for the procedure, as well as the 2 weeks afterwards for exercises to keep the wound from re-attaching. I’ve heard clove oil is used for teething. Are there herbs/essential oils/something else that you would recommend? I don’t know what is typically used to kill pain in this kind of procedure, but would prefer something natural for him.
If you have any advice or recommendations, it would mean so much. 🙂
Thank you!
All About Lip & Tongue Ties In Children
What Are Lip & Tongue Ties
Lip and tongue ties are when the thin piece of skin under the tongue or between the lip and the gum (the frenulum) are longer than they are supposed to be, limiting the movement of the lip or tongue.
There are several places where frenula are common on the body (brain, digestive tract, mouth, genitalia), but when it comes to the mouth, they’re located beneath the tongue, on the upper and lower lip, and at the back of each cheek. Frenulum means “little bridle,” and their purpose is to attach the tongue, lips and cheeks to the other tissues in the mouth.
If the frenulum is longer than normal, it’s considered a midline defect, and they tend to run in families. Other similar midline defects include cleft lip and palate, cleft chin, extra or missing teeth, and deviated septum.
How Are Ties Found
The most common way lip and tongue ties are identified is when a baby has ongoing trouble nursing and mama experiences continued pain because baby isn’t latching on correctly. Tongue ties are usually the cause, but lip ties can also contribute to nursing problems as well since they cause issues with how the lips are shaped during latch on.
The extent of lip and tongue ties are different for every child, and although it may seem that they are becoming more and more common, it’s actually that they’re being identified better these days because ties have been around for a long time.
Speaking of identifying them, you can get a step-by-step guide to checking for lip and tongue ties, with the help of the foremost expert on lip and tongue ties in the US, Dr. Kotlow, if you suspect one in your child. After checking your child yourself, if you think your child has a either kind of tie, and you’re concerned that it could cause problems down the road, it’s best to consult with a professional (child’s doctor, dentist, midwife, lactation consultant, or an ear, nose, and throat specialist) to come up with the best plan of action for your child and situation.
What Causes Lip & Tongue Ties
It’s hard to say for certain what causes lip and tongue ties as it’s not really known. They are known to run in families so it’s thought that they can be genetic.
How Are Lip & Tongue Ties Treated
A simple surgery called a frenotomy or frenectomy ( where the skin beneath the tongue is snipped with sharp scissors or cut with a laser) is the common treatment for lip and tongue ties. This procedure has been around a LONG time, and is a basic, minimal, same-day surgery that is common practice among several medical professionals such as general practitioners, ear, nose, and throat specialists, and even some midwives! In fact, back in the day, many midwives did this on every baby by taking a sharp fingernail and cutting the membranes under the tongue of all babies they delivered. Yowzers!
Okay, back to the modern day surgery. Basically, this type of tongue tie surgery is a simple procedure without a lot of risks, and most times there are no problems, minimal pain and minimal bleeding. In fact, it only takes about 5-10 minutes to do.
My 5 year old niece recently had this same procedure done on her tongue as she had a significant tie there. Thankfully it wasn’t a big deal for her, and I don’t think the pain was bad. I’m not sure if the age of a child makes much of a difference or not, but usually babies do better with these types of procedures as they’re less active at their age.
This kind of surgery is supposed to immediately correct tie issues, however, it’s debated as to whether it’s really needed or not. This debate usually centers around putting a child through surgery for cosmetic purposes only (as ties can lead to gaps in teeth) or because many kids outgrow them (some professionals think they stretch or shorten with age), however, as more ties are being identified, so are the health problems that are associated with them. This association of ties and health problems is what leads many parents to have this minor surgery done on their children.
Health Problems Associated With Ties
The most common problem experienced with ties are in babies that have trouble latching on and nursing from mama. This can mean that mama ends up having lots of pain, many times engorgement, and sometimes mastitis. Most often it leads to early weaning of baby and onto bottle-feeding of baby formula or pumped breastmilk.
Lip and tongue ties can also lead to decreased sleep, increased risk for thrush/yeast, colic, reflux, and gaps in teeth as well as other issues that can develop later in life such as dental decay (from food and milk being trapped in the pockets beside the ties) and speech problems (since the lip and tongue can sometimes be limited in movement).
Is Surgery The Best Option?
Unfortunately, I can’t answer that for you. Like I said before, if you suspect a lip or tongue tie on your baby, it’s best to seek out a professionals opinion to see how bad the tie is and what their thoughts on whether it needs corrective surgery or not. Not all ties need surgery.
If you do opt for surgery, you can see below what I’d do if it were one of my baby’s needing this type of treatment and I wanted to go about managing their post-surgery care naturally.
How I Would Personally Approach Lip & Tongue Ties
I’ve never dealt with tongue tie in any of my kids, but if I had, I think I would have opted for the surgery.
Now I’m a natural mama that, most times, likes to let the body do its own thing as I believe God knew what He was doing when He designed us, but when it comes to something like a lip or tongue tie that is extreme and can cause more problems later on down the road, I’m okay with and grateful for a little bit of intervention… especially since it’s not very risky.
If I were to have the surgery on one of my children, below are the steps I’d follow.
Step 1: Research
The first thing I’d do in this situation would be to research and find out all I could about this type of procedure. What is the surgery like, what risks are involved, what medications are given, what’s the follow-up treatment like, etc.
Once I had answers to these things I’d do what I could to substitute natural things in place of less natural… where possible of course.
From what I found online, a doctor numbs the area, snips the skin under the tongue or lip (or uses a laser if you opt for that version of the surgery), and then lets baby nurse. That’s it. What I didn’t find was whether they used anything such as creams or antibiotic gels afterwards… only Tylenol for pain.
Exercises are also encouraged after the procedure because they can heal back together and then you’d have to have the procedure repeated. Here is an article from Dr. Kotlow that explains lip and tongue ties as well as the exercises you need to do.
Step 2: Trading “Less Natural” For “More Natural”
When it comes to numbing… I would have baby numbed during the procedure. There isn’t a natural replacement for that as natural things like herbs and oils are not that strong, and if they are, they aren’t to be used on babies. For example, clove essential oil does numb, but only on the surface. And, it’s not to be use on children under 2 years of age because it’s STRONG. In fact, no essential oils are recommended for infants. It really only starts at 6 months and then it’s in very diluted amounts.
So, as far as natural things go, from what I know, I’d make an herbal ointment. This can be used on the wound sites after the procedure. Not only can it help with preventing infection, but also with pain and bleeding depending upon the herbs used. Plus, I think it will help the wounds from re-attaching as it keeps the tissues slippery. I’d probably slack up on using this as the wound begins to heal on its own (6-10 days).
I’d also use some things to help baby relax better before and after the procedure. For this, I’d use some Rescue Remedy and an calming herbal tea. I’d do both as one is flower essences and one is whole herbs. They’re both herbal, but they work in synergy with each other.
And of course, I’d nurse baby as often as they wanted during this time. I usually let my babies set their own feeding schedule and then try to stick close to those times, not just let them eat every time they cry, but after something like this, I’d definitely slack up in that area and let them nurse freely to comfort themselves.
Below you’ll find the recipes for these remedies if you decide you want to use them.
Natural Remedies For Tongue Tie Surgery
Relaxing Tea
I mentioned that I’d use Rescue Remedy before and after the procedure to help baby relax, dosing via the inserts recommendations. I also said that I’d use a calming herbal infusion as well. For this, I’d give baby 1 tsp. using a dropper every 30 minutes for the first 2 hours after the procedure followed by 1 tsp. hourly for the rest of the day. The following recipe is for 1 pint of infusion which should last 1 day.
Ingredients:
- 2 parts chamomile
- 1 part catnip
- 1 part passionflower
Directions:
Put herbs in pint jar. Herbs should fill the jar half full. Boil water in a tea kettle and pour over dried herbs in jar. Put lid on. Let sit for 4 hours minimum. Strain herbs and compost them. Sweeten infusion with maple syrup if needed. Store in refrigerator and use as needed.
Tongue Tie Salve
Next, I’d use the following herbal salve on the wound as often as the doctor recommends. If they don’t suggest anything, I’d use it after each time baby nurses.
Ingredients:
- 1 ounce of coconut oil
- 2 ounces of olive oil (*Add more olive oil if you need more to cover the herbs.)
- beeswax
- 1 tsp. whole cloves
- 1 tbsp. calendula flowers
- 2 tbsp. yarrow
Directions:
Combine your herbs and oils in a jar and put the lid on. Place the jar on a dishcloth in a crock pot. Add water until it comes to 1 inch of the top of the jar. Let it heat on low heat for 3 days. Add more water as it evaporates out. After 3 days, strain your herbs and put your oil in a saucepan over low heat. Add in a small amount of beeswax and mix until it melts. Test a bit of your oil on a cool surface to see how hard it gets. You want it to be the consistency of soft Vasaline. Add more beeswax if you need it to firm up more or more olive oil if you need it to be softer. As soon as the consistency is right, pour your liquid in a jar or a 2 oz. tin and let it sit to firm up. Be sure to label it!
So there you go. A bit about lip and tongue ties, plus, what I’d do naturally if it were me.
I hope this helped answer this reader’s question, and if it applies to you, then I hope it helps you too. As always, I’m human, and I make mistakes. Do your own research and come up with your own answers. I’ve provided some great research links below in the reference section for you to use if you wanna look into things more.
Now it’s your turn…
Have you ever dealt with a lip or tongue tie in your baby? If so, what did you do? Leave it or have surgery? How did it go for you, and if you chose surgery, how did your kiddo do? do you or dad have one? has it affected you, if at all? Share your stories and advice in the comment section below.
REFERENCES:
- http://en.wikipedia.org/wiki/Frenulum
- http://www.entcolumbia.org/frenul.html
- http://www.kiddsteeth.com/
- http://www.mommypotamus.com/a-step-by-step-guide-to-diagnosing-tonguelip-ties/
- https://breastfeedingusa.org/content/article/tell-me-about-tongue-ties
- http://www.tonguetie.net/
- http://www.llli.org/llleaderweb/lv/lvaprmay02p27.html
- http://theleakyboob.com/2012/11/the-basics-of-tongue-and-lip-tie-related-issues-assessment-and-treatment/
- http://nurturedchild.ca/index.php/breastfeeding/challenges/what-to-expect-after-tongue-tie-and-lip-tie-release/
Meagan: Great article – I’m an RN too and have worked maternity nursing for years. I remember a number of babies’ having their tongue ties clipped and not having any problems after. I think that their increased nursing after that suffices for exercise. Their moms were so much more comfortable and even though they worried about the pain to their babies during the procedure they were happy after because the results were so dramatic.
I don’t know about anesthetizing them prior to the procedure. It sounds barbaric not to, I know. But any kind of local anesthesia that has to be injected is actually going to hurt worse than that quick clip. Maybe some topical – but that isn’t usually so effective.
I never heard of lip ties – wow! You can teach an old dog new tricks…..hehehehehehe……
The herbal ointments and teas sound so very nice. And also, the breast milk itself will be the biggest aid in healing the area.
Like you, if it were me and I was having problems with breastfeeding (not to mention a baby that could be losing weight because the milk might not be transferring properly), I would go for it.
I don’t know of any baby that has had problems relating to frenectomy but it’s possible that has happened so do your research about that.
Yes Nancy, I totally agree that nursing would be a great exercise in keeping things from reattaching. I think the lip ties are the ones that tend to attach more, but maybe with frequent nursing that too wouldn’t be much of an issues. And yes, breast milk is so good for everything it seems!
As far as anesthetizing them, I’m sure that all depends on where you’re at. You’re right though, it does hurt just as bad to numb something as it does to just get it over with it seems.
Thanks for your comment!
My first had a tongue tie and the doctor clipped it at 2 weeks old because the lactation consultant figured out that the tie was causing problems with nursing and he wasn’t gaining weight. We just had it done in the doctors office. They had a tool to hold the tongue out of the way and a quick snip and it was over. My son cried briefly, but was asleep on daddy’s shoulder by the time we walked out the door. I am so thankful we did it and with my next 2, I had the doctor check at birth, but neither of them did. If they had been, I would have requested them to clip it.
Thanks for sharing Renee! I’m so glad it went well for you.
One of my four children had tongue tie. Due to some other quirky health issues, we had some genetic testing done. We found that we have quite a number of genetic problems including MTHFR and others. MTHFR defects show up in many ways (if it shows up at all), but one of these ways is in midline defects such at tongue tie. I certainly do not intend to suggest that everyone with tongue tie has serious genetic defects but I wound suggest that if tongue tie “runs in your family” (particularly if other health quirks do, too) it might be a good idea to consult with a medical practitioner who is open to genetic testing such as DNA testing. We had ours done through 23 and Me and then went further to have other biodynamic health testing done to learn more about ways to improve our health and to prevent future problems. I went from feeling fatigue, irritability, anxiety, depression, and inability to focus to feeling pleasant, more energetic, sleeping better, etc. after having tests run on myself and the kids and taking simple nutrients that my body wasn’t converting on it’s own from my food. My kids health has improved remarkably as well! Our lives are changed for the better in an incredible way because of this testing and treatment. Anyway, I’d just recommend that if midline and other disorders run in your family, you might consider testing.
Thanks for sharing Melissa. That’s definitely something to keep in mind.
Great article! One of my five has a tongue tie and a lip tie, I’m just here to say, I have done nothing about it yet. We’ve not had an issue, she is 4 now. She nursed until close to 3 years and speaks clearly. So far so good! If the time come I feel the need to intervene, I know where to get help. Thank you.
That’s great that she has been totally fine and not needed any procedures up to this point. When I was researching for this post, it seemed that if kids did fine with nursing and speaking then other problems weren’t much of an issue later on either. Hopefully that will be the case for your little one. Best of luck, and thanks for your comment!
Hey! My little one is 6 months old and is tongue tied like his father was. We live close to Meagan and she knows both of us. I am also an RN. My husband had his clipped when he was 8 years old and can remember it very clearly. His doctor didn’t numb it at all and he recalls that it stung but did not hurt. He reports that it was scary though. His was clipped to help his speech. He couldn’t even raise his tongue to touch the roof of his mouth. The only side effect left over from his tongue being tied is he has a slight problem with prounouncing Ss. I had some problems early on with my son and his tongue being tied. For the first 2 months I really had to work on how to get him to latch correctly and had very sore nipples for the first month. I spoke with our pediatrician and she advised us to watch and wait. She said they tend to stretch over time and may not have to be clipped at all. So that was our decision at the moment. I’m still breast feeding and hope to continue for his first year. Good Luck and hope everything works out ok!!
Thanks for sharing Jessica! I heard that many of them do stretch too. I suppose it’s one of those things you just have to keep an eye on and only get fixed if it causes other issues.
Thank you for sharing this! I recently found out our 1,5 year old daughter has a lip tie. After 8 months of nursing she suddenly didn’t want anymore, at all! No matter what I tried. I knew about lip ties but because I nursed for 8 months without any problems I didn’t think about it.
She seems to speak clearly now, the only struggle is brushing her teeth because it hurts. We’re visiting my family in Holland in December (we live in Thailand) and then we’ll have it checked out. I’m afraid that hers is quite bad because it starts all the between her teeth. Let’s she what happens in December because I don’t want her to go through surgery if it’s not necessary…
Thanks for sharing Patricia. I hope you get some good news when you have her checked out, and it seems like surgery is an easy one if that is something she ends up needing.
Hello!!! My daughter is the same age and sounds like your daughters is like mine.
I just found out today she has it. ? What did you do about it? I would love to know!
Thank you! -Kelly
My oldest daughter had a lip tie, which broke on its own one day when we were brushing her teeth. It has since healed, and never reattached. Our chiropractor noted that she seems to have a tongue tie as well, but she speaks beautifully, and nursed until 2 1/2, with no pain or problems. Neither my husband or I have either tie, but I do remember my mom mentioning having had one clipped in the dentist office when she was a kid.
Interesting Savannah. I did read that many tongue ties aren’t problematic and that they stretch as a child ages so no intervention is necessary. That’s for sharing with us!
My second son was tongue tied. I noticed something funny with this tongue when I first held him after he was delivered via caesarean. But I didn’t think of it again till a day or so later when he’s wasn’t nursing as easily as my first child. When I asked the midwives what was wrong. They told me his tongue was tied, that it was not really any problem and it would sort it’s self out in time.
I continued to have trouble getting him latched on good. Then when we finally saw the paediatrician for his discharge examination. I asked her opinion and she said it was an easy fix that is better to be done as soon as possible. That just the week before she had a sixteen year old patient that wanted his cut so he could French kiss (Poor thing)
and with his older age it became more difficult. needles to numb it, stitches, swelling, pain and cost. Where as with my little boy she just opened up his little mouth, held up his tongue and clipped it with a tinny set of scissors. It only took her a minute or two. Then she handed him to me and I put him strait on the breast. He latched on with a good strong suck and we didn’t have anymore problems feeding after that. He hardly even cried. And best thing of all is that he was only five days old and won’t remember a thing.
I’m glad I had it done. It was such an easy thing when he was that young. And it saved me worrying that it might not sort it’s self out and he might have a lisp or not be able to pash a girl some day.
Thanks for sharing your story Amy! I too read that it can be much harder to have it corrected for an older child, teenager, or adult. Glad it all worked out well for you!
Thanks for your article. I’m just wondering if Bach rescue remedy is safe for babies? All the packages that I looked at said they were not recommended for children under two. Do you just decrease the dosage then? And what form of the rescue remedy would you use? The drops or spray? For the balm, the cloves, calendula and yarrow are safe to be ingested for a baby? Thanks!
From my understanding, Bach rescue remedy can be used on children under 2. I believe I addressed that question in this post (perhaps in the comments) somewhere. It’s flower essences which is basically a really diluted tea. My guess is that the packaging has to say it can’t be used on children under 2 for legal measures. I personally use the drops for my kids, and as far as the balm goes, it would be safe for babies.
Thank you. I wasn’t aware that there was also a kids version of the Bach rescue remedy. The store I’d looked at just carried the regular version. I will definitely look into getting the kids one! 🙂
Hi Meagan. Don’t know if you remember me, but we attended our BSN program together. I hate that I’m seeing this a year late, but hopefully my experience will help someone… I apologize in advance for the length!
My daughter was born spring 2014 and I immediately recognized that she had a tongue tie which we had clipped while in the hospital. For months I had every breastfeeding problem in the book- vasoconstriction, blisters, mastitis, low milk production, etc. which forced me to supplement with formula which broke my mommy heart. I was exhausted in every capacity and at the point where I had reserved to pump & bottle feed, if there was no difference in BFing when my IBCLC said baby’s saliva tells mom’s body what antibodies to make- which forced me to press on. So after 3 Speech Therapists and 5 IBCLCs, the fifth one read my daughter like a book- from labor to delivery to reflux (associated w/ LTs & TTs) & able to tell me over the phone what was wrong with my dtr. She recommended I join “Tongue-Tied Babies Support Group” on facebook (which I highly recommend as there are medical pros and lots of information available through it) and told me the name of a local craniosacral therapist (CST) and dentist that lasered TTs.
We had her ties lasered without medications (the dentist convinced us it shouldn’t be very painful as the laser cauterizes the nerves). My husband said it looked like her tongue grew 2inches when they lasered it. She never acted as if she was in pain afterward. YouTube showed me exercises as the dentist provided none.
From there, the CST was our blessing as she helped our LO relearn how to nurse because she’d never been able to do so properly as she was nearly 4months old when we finally discovered the root of her problems.
Our daughter was able to come off reflux meds & for the first time I was able to nurse pain-free and stopped taking fenugreek.
All this occurred before I knew much about living naturally, but I would still do the same thing today.
Neither my husband nor I have obvious ties, but my mom had trouble BFing so I assume it’s something from my side of the family.
I hope this helps someone persevere and find help for their LO! There’s so much more to this story, but I feel I’ve said more than my fair share. I’m happy to answer any questions that arise from my comments. Blessings!!
Yes I definitely remember you Jacqueline! How are you??! Thanks for sharing your story here, and I’m so sorry for all the trouble you had. I’m grateful you decided to share your story here because your story could help other mamas that are struggling with the same thing.
So when you first had your daughters TT clipped in the hospital, do you think it wasn’t clipped enough or that it healed back the way it was which led to all the symptoms you experienced? I’m just curious if it’s common for those sorts of procedures to not work as expected. I also wonder if not doing exercises had anything to do with it not being as effective at that time. I’m sure it’s hard to do that sort of thing with a newborn though so maybe nursing is intended to be enough at that time… as far as exercise goes.
I’m also interested in the “baby’s saliva tells mom’s body what antibodies to make” comment. I’ve never heard that and that’s so interesting. I’m definitely going to have to look into that more.
Props to you, BTW, for sticking with breastfeeding even though you were struggling too. I’m so inspired by moms who will do whatever it takes to make that happen for their babies.
Are you still in JC or did you move away? I have some extended family members that see a craniocsacral therapist there, and they LOVE her. She’s amazing, but it is so difficult to get an appointment with her. She’s booked solid and only accepts new patients twice a year.
Anyway, I’m so glad that you found something that would help and that you were able to nurse your daughter and get her off meds… as well as be introduced to more natural living info. I definitely believe this is such a rewarding way to raise our children. Thanks again from your comments!
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My daughter saw Dr. Kotlow for this surgery at 2 months old. He gave us drops to use under her tongue on the day of surgery.
1 drop of essential oil of clove with
10cc coconut oil.
Said to sparingly put a little on your finger and dab it on the area. I’ve not used it because I’m honestly a little scared after reading about essential oil of clove in such a young baby.
I would email a clinical aromatherapist and ask their opinion. It may be fine at that dilution for an acute situation as opposed to using it often with teething, but again, I’d check with an aromatherapist to be sure. Thanks for your comment, Melody!