Tongue & Lip Tie Release
•10% of people have a tongue tie.
• There is a 50/50 chance of
your baby having a tie if either
parent has or had a tethered
• Boys are more likely to have
tie issues than girls, indicating
a gender link.
Answer yes to any of the following:
Examples of Tongue Lip and Bucal Ties
• Creased, Cracked or blanching nipples
• Painful latching of infant onto breast
• Poor or incomplete breast drainage
• Gumming or chewing of the nipples
• Infant unable to achieve a successful, tight latch
• Falls to sleep while attempting to nurse
• Unable to keep a pacifier in mouth
• Slides off the breast when attempting to latch
• Short sleep episodes (feeding every 1- 2 hours)
• Waking up congested in the morning
• Only sleeping when held upright position, in car
• Apnea- snoring, heavy noisy breathing
• Gagging when attempting to introduce solid foods
• Poor weight gain
Tongue Ties - Tongue, or Tethered Oral Tissues is a short, thick lingual frenulum that restricts the mobility of the tongue and is nearly always associated with a lip tie.
Often it restricts the tongue from extending beyond the lower gum line during suckling. This can significantly impact feeding and may cause the baby to compensate by making abnormal or strained tongue and jaw movements during breast or bottle feeding.
Lip Ties - It is necessary for the lips to form an adequate seal on the breast to aid in thorough milk extraction. The lip(s) with restriction may not be able to latch well enough to generate the negative pressure needed for breastfeeding. Providers can release both (or all) tethered oral tissues to reduce or resolve compensatory muscle use.
Cheek Ties: A buccal tie or a cheek tie, as they are often to, are abnormal mucosal tethers extending from the cheeks to the gingiva. These tethers occasionally interfere with breast or bottle feeding and may eventually contribute to gum recession. Fortunately, buccal ties are easily released the same way as tongue and lip ties.
What to Expect During an Assessment
• Infant is placed in moms lap or on table with mom helping
• A head lamp is used for clear vision
• A sweep made around upper and lower jaw and under tongue
• Baby’s weight is compared to birth weight
• A short questionnaire is filled out
• Recommendation of practitioner and permission to move forward for any ties released that may be suggested
What to Expect During the Release
• Sterile technique is used
• A numbing agent may be used
• A hemostat solution is used to retard bleeding
• Instructions for post care given
Common myths that interfere with parents getting proper care and treatment of infants presenting with tethered oral tissues.(TOTS) None of these comments have any scientific basis for being stated.
1. Tongue-ties do not exist.
2. Tongue-ties will correct themselves.
3. Tethered oral tissues do not affect breastfeeding.
4. A tight lingual frenum will stretch or tear without treatment.
5. Tongue-ties and other tethered oral tissues do not cause maternal discomfort.
6. Tongue-ties do not effect developing speech.
7. Surgical revisions for TOTS require the operating room under a general anesthetic.
8. Children under the age of three months are too young to have surgery to correct TOTS.
9. Colic and air induced reflux are not related to TOTS.
10. If you have the upper lip revised, it will have a detrimental affect on roots of developing
11. Surgical revisions are dangerous due to bleeding, cutting nerves, and blood vessels.
12. The upper lip and cheek ties are not important for successful breastfeeding.
13. If you release the upper lip, it will cause scaring ,therefore you need to wait until the baby
is older and braces are completed.
14. Your baby will fall and release the upper lip.
15. Revising TOTS is just a placebo effect.
16. Lasers are dangerous, cause burns and are not safe to use on children.
Dr. Lawrence Kotlow
Tongue & Lip Tie Resources