Newborns are known for being fussy: In those first weeks after birth, babies often struggle to get the hang of sleeping and feeding properly. But, while every new parent prepares for many sleepless nights, there are some babies who continue to struggle with the basics for months on end with seemingly no cause in sight.
If a baby is struggling to latch while breastfeeding, is constantly hungry or is losing weight, the reason could be a hidden ailment that impacts five percent of of all newborns: tongue-tie. Tongue-tie, also known as ankyloglossia, is a condition that can affect a child's ability to eat or speak, due to the tongue being tethered to the floor of the mouth.
But how are tongue-ties treated? And how can a parent tell if their baby is tongue-tied?
What is a tongue-tie?
"Each of my children has been born with a tongue-tie," shares Marisa Tolsma, a mom of four from Colorado. Tolsma says she suspected a tongue-tie with her firstborn, but after her midwife assured her nothing was wrong, she set her concerns aside. It wasn't until her third child was born that she revisited the potential issue.
"I had switched to a different midwife who knew how to recognize tongue-ties," Tolsma recalls. "She suspected a tie right after my third child was born and recommended I go to a dentist experienced in frenectomies (a procedure to correct tongue-ties in which the soft tissue responsible for the tie is cut) for an evaluation and diagnosis. I took my baby and other two children and he diagnosed tongue and lip-ties in all three of them."
When her fourth child was born, Tolsma took him to the same dentist who diagnosed him right away.
Arizona orthodontist Todd Dickerson says, put simply, a tongue-tie is a condition present from birth that restricts the tongue's range of motion: The tongue is tethered to the bottom of the mouth by tissue.
In addition to tongue-ties, some children suffer from lip-ties, where the skin of the upper or lower lip is attached to the gum in a way that is restrictive to the function of the lips. And, there are cheek-ties, a condition where a child's cheek connects to the bony ridge on the upper or lower jaw, further restricting movement of their mouth.
What causes tongue-ties?
Tongue-ties often run in the family: Deborah Rothschild is a newborn care specialist and mom of two who says after her sons were diagnosed, she and her husband learned they had tongue ties as well.
"It's genetic," Rothschild tells Yahoo Life, explaining her family's experience with the condition. "It's the tongue's job to rest at the roof of the mouth, however when someone is tied and the tongue is tethered to the bottom of the mouth, the tongue can't reach the roof of the mouth or perform its correct functions."
What are the symptoms of a tongue-tie?
Rothschild shares early on her children, who are now teenagers, showcased signs and symptoms of being tongue-tied like reflux, projectile vomiting, sleeping with their mouths open and colic (prolonged fussiness and crying). Still, she and her husband learned the hard way that not all pediatricians are trained to make the correct diagnosis.
"We saw so many doctors," she says, "a pediatrician, speech therapist, neurologist, gastroenterologist and even a developmental pediatrician. They kept saying our kids would grow out of it but they were completely wrong."
"We finally got a correct diagnosis from a dentist that specializes in tethered oral tissues," Rothschild adds, "[My kids] were miserable before treatment but afterward all the symptoms went away. They could drink more at each feeding and started burping naturally. Their bodies were more relaxed, they slept with closed mouths, became nasal breathers and had no more digestive issues."
How does a baby's tongue-tie affect breastfeeding?
Leigh Anne O'Connor is a lactation consultant and mom of three children, two of which were born with tongue-ties.
In addition to the tongue-tie symptoms babies may show, O'Connor says breastfeeding moms may notice physical symptoms of their own that could be clues to the presence of a tongue-tie in their baby. In addition to low milk supply, moms may notice their nipples are sore: When a baby is tongue-tied, their range of motion is limited and the way they are only able to suck on the tip of the nipple can cause compression of the nipple, cracks or soreness.
"This also limits the amount of milk a baby gets," O'Connor says. "Think cocktail straw for a smoothie as opposed to a full-sized straw, which can lead to poor weight gain."
What happens when a tongue-tie is untreated?
Dickerson says tongue- ties can lead to more than just feeding issues.
"An excessive attachment under the tongue often leads to speech issues," he explains. "Most people can make that connection, but what most do not understand is that excess attachment often leads to poor tongue posture as well, which can cause significant issues in jaw development."
Dickerson says many of these oral issues are related and can have a cascade effect. "Low tongue posture may lead to a narrow palatal vault, posterior skeletal crossbite as well as anterior open bite, which are all major dental issues," he says.
"A tongue-tied person cannot easily keep their tongue on the roof of the mouth, where it should be all of the time, including when you swallow," Dickerson adds."Not having the tongue on the roof of the mouth ... leads to a more narrow jaw and crowding of the teeth."
In addition, Dickerson says people with an untreated tongue-tie are more likely to have allergy and sinus issues, as well as an increased chance of needing dental surgery for impacted cuspids.
"Cuspids, also known as canines or fangs, are the third tooth in each quadrant of the mouth," Dickerson explains. "Since the cuspids come in later, they may become blocked or deflected due to a tongue-tie and not have the ability or room to erupt. When a tooth cannot erupt, it becomes impacted."
How is a tongue-tie treated?
And a tongue-tie doesn't resolve on its own: Long-term tongue-tie symptoms in growing children include poor oral hygiene, stunted oral growth, sleep apnea, mouth breathing and even tension in the neck and shoulders. "All of these can impact children in other areas of development," O'Connor says, "including learning struggles, speech impediments and a multitude of issues while eating."
But there's hope. O'Connor says the surgical release of a tongue-tie is simple.
"As difficult as it can be to have these oral issues diagnosed, the procedure to release the ties is simple, especially in babies," she says. "[The tie is] released using a laser or surgical scissors and generally takes about five minutes."
Dickerson suggests children see an orthodontist by age 7: That way if a tongue, lip, or cheek-tie went previously undetected, it can be caught before causing long-term health problems in the teen and adult years.
Relief for tongue-tied babies
Krissy Hadick, who lives in California and blogs at The Hadicks, says her son had a tongue-tie that went undiagnosed until he was 4 months old. Hadick says her baby showed symptoms of colic from birth, but neither his pediatrician nor lactation consultants ever caught the tongue-tie.
"He would nurse around the clock every hour," she recalls. "Being a first-time parent, I assumed he just had colic."
Hadick shares having a diagnosis, followed by what she describes as a "fairly simple procedure" to correct the condition was life-changing.
"It was when I described the patterns of my son's constant feeding and not sleeping that our local sleep training consultant suggested I should get him analyzed for a tongue-tie," she says. "It was like night and day. After our son's tongue-tie was fixed, the crying finally began to subside."
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