There seems to be a tendency in social media, with practitioners and with concerned parents, to have a greater focus on lip ties than tongue ties. But is this a justified focus on the most important of the two, or is that focus in fact misplaced? We believe that it is indeed misplaced, and that in many cases a tongue tie is the real root cause of many tie related symptoms, especially those related to breastfeeding.

Why is there such a focus on lip ties?

But if the tongue tie is often the real sinner, why all the focus on lip ties then? Dr. Ghaheri has three main points.

  1. It is easy (way easier than tongue ties) to evaluate
  2. Many parents and practitioners have a hard time differentiating between lip ties and the normal labial frenulum
  3. The procedure and subsequent recovery, is relatively easy

It is important to stress, that lip ties do cause issues. The causes and symptoms of a lip tie include:

Symptoms in the baby:

  • Difficulty latching
  • Make a clicking sound while latching
  • Choke or splutter on milk
  • Cluster feed
  • Have a hard time gaining weight
  • Be colicky

Symptoms in the mom:

  • Pain during latching
  • Damaged or distorted nipples
  • Mastitis or engorgement
  • Issues with low supply of milk

According to Dr. Ghaheri, even though lip ties can cause issues, around 99% of the cases where breastfeeding is the issue, the baby has a tongue tie. In about 50-60% of those cases, the baby also has a lip tie, and in about 1% the lip tie is the cause of the breastfeeding issues.

For our in-depth introduction to lip ties, click here.

Why is the tongue tie to blame?

First and foremost, the tongue is the active muscle in breastfeeding. It is the muscle that creates the negative pressure required for nursing. Also, almost all scientific research demonstrating the benefit on frenotomy on breastfeeding was done on patients that underwent tongue tie releases. This shows that the tongue tie release alone was beneficial.

Another point is that a restricted tongue can also affect the function of the lip. If the tongue does not make the wave motions required for vacuum generation, the baby might try compensating by sucking the breast in. This can cause the lip to be sucked in, which might generate the same symptoms as a lip tie, albeit be due to inefficient nursing.

The wave motions required for vacuum generation referred to earlier, are performed when the tongue moves up and down. If the tongue is restricted to the point that it cannot move sufficiently upwards, this will be the number one cause for tongue tie symptoms.

For more information on tongue tie symptoms, click here.

If a practitioner focuses on lip ties without investigating the possibility of a tongue tie, it may be an indication of inadequate education or experience in diagnosing and treating tongue ties. The tongue should be the first place to look, if you and your baby experiences issues with breastfeeding.

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