Frequently Asked Questions
What is a Tongue Tie?
A tongue tie occurs when the thin membrane under the baby’s tongue (the lingual frenulum) restricts the movement of the tongue. All babies are born with some of this tissue, but for approximately 5-12% of newborns, it is so tight that they cannot move their tongues freely. This can affect their ability to breastfeed and lead to poor latch, nipple pain and trauma, decreased milk intake and a decline in milk supply over time. The medical term for tongue tie is ankyloglossia and studies show the defect is hereditary.
What is a Lip Tie?
Many babies with a tongue tie, also have an abnormally tight membrane attaching their upper lip to their upper gums (the labial frenulum). This is called a lip tie. Babies with a lip tie often have difficulty flanging their lips properly to feed and cannot create the proper seal at the breast. This can cause them to take in excess air during breastfeeding, which often makes these babies gassy and fussy.
How are tongue and lip ties diagnosed?
Tongue and lips are only to be considered tied if their movement is “restricted”, impairing mobility. Correct examination of infants requires the infant be placed on the examiner’s lap with the infant’s head facing the same direction as the person evaluating the infant. It is important to note that not all ties cause problems and require correction. Each case is assessed by Dr. Prokopets on an individual basis. Tongue tie is a diagnosis based upon function, so what your baby’s tongue looks like can sometimes be less important than how it can move.
Can you describe the treatment for a baby that is tongue tied, does it hurt?
The revisions (called frenectomies) remove the tissue or tight frenulum under the tongue or upper lip. Dr Prokopets using a state of the art laser for a quick and safe procedure that allows for greater tongue and lip mobility. In some instances, frenectomies can aid in prevention of other health problems like dental decay or spacing, speech difficulties and digestive issues.
Laser vs. Scissors?
While the procedure can be done with laser or scissors/scalpel, advantages of using a laser include: minimal discomfort, minimal bleeding during and after the procedure, faster healing, bactericidal properties, increased precision of tie removal.
What are some common breast feeding and bottle issues that mothers experience with babies that are tied?
Uncoordinated suck-swallow patterns
Unproductive suction
Exaggerated tongue protrusion
Nipple problems and clogged milk ducts
Trauma to the nipples
Poor labial seal on nipple
Spillage during feeding
Gastrointestinal problems
How to tongue or lip ties impact solid feeding and drinking?
Difficulty transitioning to solid foods
Biting cups, straws, and spoons to help stabilize
Poor labial seal and spillage during eating and drinking
Disordered and immature swallow patterns
Poor and inefficient chewing
GI problems
Poor bolus control and transit
Picky eating
Why is a lactation consultant important to the outcome of your baby’s treatment?
If your baby is struggling to breast or bottle feed it is crucial to the success of the procedure to establish a protocol and plan for feeding after the tie release. A lactation consultant will help in planning sessions with you both before and after to ensure a successful transition post surgery.
What are aftercare “stretching” protocols for a tie release?
Stretch each site for 5 seconds every 5-7 hours or approximately 4x daily. You do not need to wake your infant while he/she is sleeping during the night but instead, be sure to complete a thorough stretch after he/she wakes. You will be given a handout with details of the stretching protocol that Dr. Prokopets prefers.
Remember that stretches are key to getting an optimal result. These stretches are not meant to be forceful or prolonged. It is best to be quick and precise with your movements. We highly encourage that you approach these exercises in a positive manner!
What are some normal behaviors or occurrences post treatment?
Bleeding after stretching
Trouble with latching during first week
Increased choking or spitting up
Increased drooling and saliva bubbles
Increased sleeping
Fever greater than 101.5F, uncontrolled bleeding, or refusal to feed (bottle and/or breast for over eight hours) please call the office at 301-841-6280.