Pediatrician Discusses: Tongue & Lip Ties 

I have to say I don’t know that I agree with the idea of not revising/waiting to see if it’s really a problem. I definitely understand not messing with it if it isn’t necessary, but that thought process can really do a disservice to some families if their doctor doesn’t recognize there truly is a problem. My son had tongue and lip ties and was failure to thrive by 5 days old. His doctor was aware of the ties, but he seemingly latched really well and I researched so much that I handled breastfeeding so well that my postpartum nurses told me they never thought I was a first time mom till they read my chart, so his doctor decided I had low supply. He’s a DO and clearly practices as one which is why I chose and truly appreciate him for the fact that he does assess and truly consider benefit vs risk, but with this situation we didn’t have time for wait and see. The LC was too busy for me at the time and I mentally couldn’t handle the idea of her telling me I had low supply the older my son got. It took me 3 months to finally convince my son’s doctor to give a referral for a pediatric dentist based on concerns for speech (he had a tie all the way to the tip of his tongue). I dealt with constant clogs and having to hand pump (got the clogs better) frequently, so much so I got tenosynovitis in both wrists. It was excruciating. My son nursed all the time and he was still wanting 20-24 ounces of formula a day. His suck got SO much stronger after the frenectomies that it hurt because I wasn’t used to it. Within two weeks after, the most formula he would take was 8-10 ounces. I went from having multiple clogs a week to one, maybe 2, a month. Only if we went out and I gave formula and waited a little too long to nurse because I didn’t like to in public. Even though he looked like he was latching well, he couldn’t remove milk effectively before the ties were revised. My supply never fully recovered. The LC said I 100% could have exclusively breastfed if his ties had been revised early. His doctor being in this camp of not messing with it because he didn’t think it was a problem, and deciding he didn’t want to do anything from a breastfeeding standpoint, ruined my chances to EBF. 😩 My husband and I also both clearly have tongue ties and find it frustrating/annoying. I’m very confident it effects my posture, makes my neck feel tighter, and forces my tongue to sit more forward in my mouth (which makes my front teeth push out and has basically ruined the money my parents spent on braces) I have a lisp because I don’t have full range of motion of my tongue. Its not bad enough to have been noticed for speech therapy as a child, and I think it’s gotten worse in adulthood as well. It’s honestly really aggravating to know if I could just move the center of my tongue higher I wouldn’t have the lisp. I literally chose my child’s name based off names I could say without the lisp being heard. It also gets stuck between or rubs on my teeth which is annoying/painful at times. I have a lip tie as well and I hate how it pulls my lip up. I have to intentionally hold my lips shut. I was born when ties weren’t a common thing noticed or discussed and I often consider getting them revised now as an adult, but my insurance wouldn’t cover it. The way ties are handled in newborns overall needs to change. I personally feel newborns with ties should be automatically referred to the providers who actually handle revisions to be assessed by them, but in that same thought, the doctors who handle them should be well educated in breastfeeding and the motions required for it to do more full and extensive assessments. Fully checking motion and sucking capabilities, to know if it is truly needed, would help families like mine. It would saved me a lot of figurative and literal pain and heartache. I also feel your thoughts about therapies to improve functionality with the ties is good in theory and would do a lot for how many actually need revisions, but so many parents won’t know to push for this and so many doctors don’t think to educate or refer for these things. It’ll take the medical community cycling in the newer doctors who learned this information in school, or took it upon themselves to learn, forcing “old school” doctors to change and or lose patients before it becomes commonplace and that’s so unfortunate. So many things need to change in the ways you’ve discussed on this subject 😩

You want to release any oral restrictions when it often impacts breastfeeding, aerophagia, colic, difficulty drinking the bottle, reflux, eating solids, airway issues/ snoring, form follows function, so the jaws stay narrow with a low tongue position. Palate high which gives to little space in the nose to breathe through. The pushing motion of tied tongue pushes the teeth out of line. You can go on and on....

Thank you for this valuable information. My child has a lip and tongue tie but we faced no issues with breast feeding or solids but with all the talk around importance of clipping I was looking for more information. You helped clear my mind from doubt and worry.

In the old days (1970's) my brother had a tongue tie and my mom noticed he couldn't eat well when he started solid foods. My mom took him to his pediatrician and showed him. The pediatrician said, "oh yeah!" Then the doctor reached for a pair of surgical looking scissors and clipped it! My mom was shocked and so was my brother who was now screaming. My mom took my brother home, the tongue bled a little and healed quickly. He never had any further issue. Now I see all this tongue massaging, laser surgery, etc., and I always think of my brother and wonder how his tie would have been handled today.

My now 17yo was born with a tongue tie. He nursed well. We decided to wait. His speech came along fine. He NOW wants it snipped. He is the only student who can not till his "Rs" in AP Spanish. We're leaving it up to him and his dentist at this point.

Can’t tell you how helpful this was to watch!! Thank you!

Thank you for this video! I find that t’s hard to find unbiased specialists because it seems like all of the “savvy” professionals (at least in my area) are so adamant and pushy about how horrible it is to leave it unrevised, despite the lack of data as you shared! I feel constant guilt for not revising my daughter’s even though she has appropriate function at this time. This makes me feel better.

Thank you for clarifying on this topic. My baby have lip tie but there wasn't problem with breastfeeding. And she does speak kaka, baba. Be safe and take care.

My daughter had very significant oral restriction from both a lip and tongue tie. Her lip tie inserted all the way to the papilla and her tongue tie was all the way to the tip of her tongue. She was never really able to latch and whe she did it was very painful and she wasn't able to transfer milk. On the bottle she could never form a good seal or suction. Milk would pour out of he sides of her mouth and she would be chewing on the end of the nipple instead of sucking. Her lower jaw would start to quiver during feeding which ai later learned was muscle fatigue from working so hard to transfer milk. She was not gaining weight appropriately and it would take over an hour to finish a 3 oz bottle. We had a revision at 5 weeks (a week ago now) and things have improved so much. She gained 6 oz basically just over the weekend. She will finish a bottle in a reasonable time and the best part of it all is that she is finally able to latch. It's still a work in progress but so so much better. I have lip and tongue ties that never obviously affected me like my daughter. I did have orthodontic issues and had a space between my front teeth. I had braces twice. It made me extremely self conscious growing up. I would def do it again if needed.

I was added to what I describe as a "black market tie revision fb group" in which a LC was claiming that only her "preferred providers" were recommended rather than a pediatrician, ENT etc. This "preferred provider" concept had some people travelling hundreds of miles away and in the mean time these babies' caloric needs were possibly not being supplemented. The assumption was that pediatricians aren't "breastfeeding experts." (I know you're working on LC credentials also so which is pretty cool!)

Have you talked to any IBCLCs about what they see? You are really minimizing the effects.

My baby ended up in hospital due to dehydration as he wasn't extracting enough milk. After telling everyone I actually had plenty of milk supply and he's just not getting enough so I had to start bottle feeding him so he won't die, they told me to just keep bottle feeding him. Apparently they don't believe in tongue ties. 🙄 And they put his drop from 50th to 2nd percentile, as well as prolonged jaundice and dehydration down to his reflux. 🙄 In the end the dentist found her couldn't move his tongue to the side, he had a very weak and poor suction which is why I didn't have any nipple pain because he couldn't keep a seal!! He was literally on death's door until I started bottle feeding but apparently the medical community thinks tongue ties are not a thing, to the point they don't include it in their differential diagnosis. To hell with such biased medical doctors. So they say there's no evidence treating tongue tie helps, but equally there is no evidence that not treating tongue tie doesn't harm. Parents aren't mental to want to treat a tongue tie, we are the last people who want to see our babies cry or in pain. We'll do everything to avoid it first and only seek a tongue tie revision if we tried everything else first.

My grandson is two and not talking properly yet .He saw a speech therapist today .He has a severe lip tie and a tongue tie. We are gratefull its something easily repairable

Mobility, suck training and myofascial release should be done BEFORE and AFTER a release. As an OT/CLC and infant feeding therapist I totally agree that a functional feeding evaluation needs to be done and therapy BEFORE going for a consult for a diagnosis. Pediatricians should refer for feeding problems for breastfeeding, bottle feeding babies the same when leaking is noticed and clicking sounds are made - especially when there is body tension. Often times with good therapy we can make an impact but there are times a baby may need a release. I see the problem as the baby not getting proper intervention BEFORE a release. Informative video- parents should always be in the driver's seat but also should know what happens with the tongue and how to guide feeding safely if they do not get a release.

Release the tongue. The tongue has more of a connection to the body than just breast feeding, speech issues, etc. The tongue is referred to the hip, digestive system, sinuses, teeth, etc. It causes many issues in the future. Prevention is better than the cure.

I had no idea I had a tongue tie until I was 25 years old. I just got it released and I no longer have neck and shoulder tension and jaw pain that was causing debilitating migraines. I can already tell that I swallow better (I used to choke on liquids and food all the time). My dentist was very dismissive but gave me an oral surgeon referral anyway. I'm glad I self advocated and can't wait to live with less pain

This is awesome! The amount of parents I’ve seen say “I got my baby’s tongue tie clipped at 4 weeks and 6 weeks later he started breastfeeding better!” Is it really that inconceivable that your 10 week old would breastfeed better than your 4 week old that has had 6 weeks less practice and development? I definitely think that of course there would be ties that impact function but the number of infants receiving this surgical procedure is very alarming, not just because of the potential unnecessary pain but because of the risks you mentioned. It could be that after the tongue tie revision maybe parents are approaching feeding more positively and maybe focussing on latch etc after the tongue tie clipping because having the procedure done has piqued their awareness of this. As you said, without good data we can’t really know

My 15 month old had a traumatic birth so we thought that was why he had such a hard time sleeping, he spit up a lot and always choked when being bottle fed. He has a hard time biting down on something hard and he does have a speech delay. We didn’t find out he had tongue tie until his first dentist appointment, after that we scheduled an appointment with his pediatrician and she did nothing. He we are months later and my son has not had a good nights sleep since birth and I know it’s because of his tongue tie!! We have a appointment tomorrow and I’m not leaving until she sends a referral out!

@pedsdoctalktv9960 thank you for taking the time to provide us with such a sound discussion on Tongue & Lip Ties. My greatest disappointments are parents rushing into the procedure without exploring alternatives as well as health professionals such as Paediatricians in general not being involved in respectful conversations with the allied health professionals about these issues that affect families. This is what affects families the most here - we as clinicians need to work together with respect, to support the families that we care for. There is so much divisiveness around this issue within the medical profession, that families are mistrustful & seeking out their own information via sources such as social media which causes issues in itself. Thanks again for highlighting this important topic!

Thank you! Both of my kids have lip ties, and have a gap in their teeth. Luckily breastfeeding went great, hurt in the first few weeks, but went on over a year. The dentist for my first said we'd keep an eye on it, as it may fix itself by ~5 years.(before adult teeth come in) That is when we'll decide if we'll do something. My 2nd has her first dentist apt next month, so we'll see. :)

My IBCLC did diagnose my baby with a tongue tie. It is not causing an issue for me and my baby is able to transfer milk. My IBCLC did notice he is having some restrictions, but she did not recommend a release since he is growing fine and he was able to transfer 4.4 oz of milk from me in around 15 minutes.

This is the best video!! Thank you for creating it

My first born had a tongue tie, we fixed it when he was a newborn, he is 5years old and has a speech delay. My youngest son has a tongue tie we didn't fix, he is 3 years old and also has a speech delay

Having a baby’s (or child’s, adult’s, or as soon as it is identified) tongue-tie fixed can help them to thrive and improve on things like nutrition, speech, sleep quality, and behavior. Having that tongue-tie treated properly by a knowledgeable provider for an average cost of $1,000 is an investment in your child’s future. In many instances, not treating can lead to financial, emotional, and health consequences.

You are a God sent! These were my feelings exactly!

Currently happening with my 12wk granddaughter. Getting evaluated now

Thank you for tackling this truly touchy subject. I am so grateful for the evidence based information.

What I want to know is how did people feed their babies before all this tongue tie revision?

Thank you so much for this video! I think my daughter has a tongue tie and I’ve been stressed about it for the last 6 months, but this video helped ease my mind a little. Breastfeeding was really painful for me for the first 8 weeks but then it got better so we chose not to pursue it and I’ve worried I made the wrong decision ever since. Recently I heard that sleeping with the mouth open can be related to ties - is that true, and if so is that something to be concerned about?

My baby is 9 months we waited to see if she would be okay but it's starting to affect her. She's having trouble eating solids and only eating purees..after eating purees she gets very congested and most of the food ends up outside her mouth..they did a barium test and she does not have gerd and food is going down properly .. we have tried everything and only thing left to assume is that it's the tongue tie...does she sound like a candidate for it??

How do you know that the thousand of children with tongue ties have no problem later on in life? In the birth clinic I was told it shouldn't be a problem, after 2 weeks of pain I'm considering to give up breastfeeding, got a lot of breastfeeding advice but baby is still not able to latch well. And the staff at the hospital will never know that.

Hello I was about of a programmer at the u of Winnipeg from 2 to 7 I trying to figure out who I can’t spell or read well this has cause me better jobs though out the years but I would not say my tongue tie is the problem my situation Ground up .. my experience has moved me up to management and leadership positions my specialty is going into a toxic environment and able to make it beneficial for the owner to the community in a positive light.. yet I can’t go get my ceo management or psychology degree that I wanted to work with others . Wasn’t able to go for my bus lessons because I could not read the government words but yet after chatting to the teacher and I know …. I did teach my daughter to read and write and her at 12 writes better than I .. Atm I’m I not working due to disability .. so my veiw point is in a healthy family situation I am sure I would not had this much problem.. but I did start society and help others and thank you for this video cause now I can understand why how a well I can look at right professionals and with the work overcome these two things

I was wondering also if these are getting diagnosed more because of an increase in breastfeeding? I feel like more people are trying to breastfeed now compared to when I was a baby. And so more people are hyper aware. No idea. Just a thought. Thanks for the video. Currently have a 3 month old and thought she had a tie and my pediatrician checked her out and said it was all good. Went to a LC who gave me some ideas on positioning and boom, problem solved :)

Hi , my son had toungue tie by he wasn’t treated , he drank breast milk till he was 4 years we did very well and now he is going to be 7 years . But now he has adenioids problem but he has a little problem with r problem . I am wondering of his continuous nose block and adenoids can be cos of the tongue tie ? I did read a research saying those kids having toungue ties might end up getting adenoids or poor sleep or mouth breathing . Please help a mom here . Please

Great content, thanks for all you do! We would love to connect , we are all about community education and would love to work together on sharing more information so that folks can make more informed decisions. For every missed diagnosis, there is a misdiagnosis and so it is with information that we will tip the scales in the favor of our patients getting the care they actually need, and not a bunch of procedures that may or may not be necessary. Knowing when NOT to operate is critical, and so thank you for sharing your fair perspective on the matter! Thanks again for all the great work, Cheers, TBI.

I have both tongue and lip tie

I'm a 2nd time mom and unsure if my 3 month old has a tongue tie or not. I'm having problems with him properly latching.

Does it mean there is tongue tie if there is lip tie?

It's just another way toget money from patients in America . I have that, my son, husband, my grandkids. My son couldn't pronounce R and G when a young child, we trained him how to do it, my grandson also, both never had any problems, before and now. It's just as I said, way to get money like it is in "transitioning" for young kids. Awful what's going on here with children, trafficking, "transitioning" sexual abuse . Just has to stop.

Thank you for this worse than useless information. This is actually MIS-information. This message pretends to be helpful, but completely ignores the reality that YES, many kids are seeing affected function in their breastfeeding quality, mouth breathing, sleep quality, teeth alignment, jaw development, speech, and supporting head and neck muscles. However, not every kid shows up with these things affected 100%. It's a spectrum. This message seems to consider it irrelevant that not every kid shows every symptom, during their entire developmental journey. STOP acting like the medical community makes decisions with full knowledge of their blind spots. I am a medical professional. I know we don't know much of what goes into the big picture. So instead we make decisions to safeguard the status quo.

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Don’t we all have tongue ties? I mean I don’t understand. Our tongues are all tied to our mouth.

My first had a moderate tongue tie and we didn’t fix it. They said he would outgrow it or we could hurt him just for the sake of it. We opted to wait until it was a problem. Plenty of kids speak funny. He spoke on time and had problems with certain pronunciations like every kid, but none associated with his tongue tie. Our second didn’t have a tongue tie. We laugh at how loose his tongue is, it’s definitely getting vitamin D putting on a show. 😂 Think of it this way, are you going to circumcise your son because someone says they MIGHT get an infection, which COULD happen either way??? Just do something because it’s THE THING people do? That wouldn’t be health care.

The data is NOT lacking - you are not informed. There are major RCT’s proving effective’s. Also- ,clipping is NOT a an effective procedure to release effectively. As on OT/‘Slp and IBCLC you have e no idea what you are talking about, You need to understand that clipping is an INCOMPLETE HALF PROCEDURE. But there are indeed studies that show very clearly a clip is INEFFECTIVE procedure ! You are talking about a red herring. A full rekeaease allows proper orzo facial development by allowing. Normal function of the tongue. The lip tie has very little data to support Everything you are saying is your opinion- not fact or based in research data!!! You are sett8ng families up to fail with your lack of understanding for how milk supply is made, what AIR induced reflux ibis, what the normal Scar neutral is d Your own uneducated, uniformed views are not neutral.

Don't release it at any cost. Let your baby get adjust to it