Most people have heard the phrase that someone was “tongue tied” as a way to say they couldn’t speak in the moment. But a tongue tie is a medical situation where a person is born with a tongue frenulum that extends further up to the tip of their tongue than is typical for most people. This condition can have long-term impacts to a person’s health and lifestyle, including but not limited to sleep apnea, trouble speaking, and difficulty eating. Specifically, a baby with a tongue tie will have a harder time breast and bottle feeding. Obviously there are people who grow up with un-revised tongue ties, so it only makes sense that they were also able to get through feeding in infancy, but they must have had a tougher time getting the sucking mechanics down.

So what can parents do?

Watch For Signs

Tongue ties are not obvious if you don’t have your eye out for them. Watch for the signs that your child can’t move their tongue as fully as they should.

• When nursing, their bottom lip should be flipping down (picture the stereotypical pouty lip). If their tongue can’t come forward enough, the bottom lip might be pushed into their mouth in such a way that you can’t even see it.
• If Baby has prominent dimples on their cheeks when nursing but not any other time, they aren’t about to suck as effectively as they could with the full range of tongue motion.
• If you can, wash your hands and try to lift your baby’s tongue yourself. If it doesn’t look like their tongue ever leaves the floor of their mouth, get a second opinion from someone who has seen and revised tongue ties before.

Find Someone Who Can Professionally Revise a Pediatric Tongue Tie

This is more difficult than it should be.

Our son had a tongue tie when he was born, so from day 1 in the hospital we asked every nurse and doctor if we could get a revision ASAP. One of the pediatricians working while we were there said he’d done tongue ties in the past, but there’s so much blood involved. He also pointed out that he himself was tongue tied, implying it’s not a big deal.

Someone on a different shift came in and attempted to clip our son’s tongue tie. It was partially successful because they didn’t feel like they’d be able to safely clip further back, but they did revise some of it. There was no bleeding, and our son didn’t show any signs of pain. Needless to say, we got mixed results within the same hospital when it came to how our situation should have been handled.

The partial revision did show some positive results, but we learned over the coming weeks that our son was still having trouble with his sucking mechanics. A lactation consultant recommended we look into getting his tongue tie looked at again.

What we found was the most likely place to access the care we needed was at a pediatric dentist’s office. But the place we were referred to had prerequisites: go see a craniosacral therapist, and go to a chiropractor. They wouldn’t do any procedure without seeing multiple other specialists first. While these professions are respectable and have their place, we needed his tongue fixed, not his joints.

Luckily, we did find an amazing pediatric dentist in our area who did an assessment and concluded that a tongue tie was advisable. We got the procedure done minutes later. It was a laser procedure that cauterized the open wound under his tongue. Our son clearly came away with much more mobility in his tongue, and within a week he was significantly more effective at nursing.

In our story, there were a lot of ways that the system held back my son’s health. In the end he wasn’t able to nurse optimally for many of the first weeks of his life. We knew right away to watch for a tongue tie because of family history, but even with being aware of it from the beginning, we still struggled to find the right resources. Based on our experience, I recommend:

• If you’re still expecting, start looking into pediatric dentists before your child is born. You’ll want to know who to go to immediately if the need presents itself.
• When you’re in the hospital with your new baby, advocate for them right away and ask if any of the nurses, doctors, or lactation consultants can tell if they have a tongue tie. At the same time, ask around for any possibility that the revision can happen during your hospital stay. If it can, your medical insurance might either cover the procedure or at least get credited toward your deductible or out-of-pocket maximum.
• If your newborn shows signs of a tongue tie, make sure to add them as a dependent on your dental insurance if you have it. That insurance might lower the cost of a revision done outside of the hospital stay if necessary. Medical insurance is very unlikely to cover the procedure outside of the hospital, but you might at least get credit toward your dental deductible or out-of-pocket maximum, specifically if you get the procedure from a pediatric dentist.
• See a lactation consultant to assess how well your newborn is nursing. They’ll do a weighted feeding where they check Baby’s weight before and after they nurse to see how much they ate. This can help catch a feeding issue early so you and Mom can take necessary action right away.

Never Give Up

Above all, don’t give up. Even if your baby will be formula fed from the start, a tongue tie can cause them difficulty too. Revising a bona fide tongue tie will be good for your child’s long-term health and wellness. Don’t let the fear of a complicated healthcare system keep you from doing the right thing for your children.