How did we diagnose the tongue tie? And, what new information did I learn that has changed the way I now diagnose it and makes me feel like I’ve probably overlooked/missed many of these ties in the past? The sad part is that the diagnosis is pretty simple! I, and many of my colleagues (chiropractic and midwifery), simply weren’t taught to diagnose the tongue ties like Dr. Kotlow has now taught me. In fact, we feel like this is so important and has so dramatically affected and changed our lives that we have invited Dr. Kotlow to come to Texas for a seminar. I’ll keep you posted!
When I asked Dr. Kotlow to show me exactly how to diagnose these ties and what specifically to be looking for, he quickly grabbed my paperwork… ”You checked off every symptom on here. What else could cause all of this?” This statement so put my mind at ease. Listen to mom, mom knows her body and her baby best! If you, or a mom you know, is checking off every symptom that I mention in this post, then chances are your/her baby is tongue tied. See, what I used to check for is that baby could protrude his/her tongue past his/her bottom gum line. I also made sure that the frenum didn’t pull on the end of the tongue, causing a heart shaped looking tongue. As seen in this picture:
To easily check the tongue for a tie, put your index finger under your baby’s tongue and sweep across the floor of the mouth from one side to the other. You should be able to slide the finger under the tongue across the mouth floor from where the molars will eventually come in without running into any tissue. If you feel a smooth mouth floor, then there’s no problem. However, if you run into what Dr. Kotlow describes as a “small speed bump”, you may have an issue. If there’s a large speed bump, then there’s definitely a problem. If the membrane under the tongue (that attaches it onto the floor of the mouth) feels like a very thin and strong- like a fine wire- then push on it and look to see if the tongue’s tip indents or bows. This suggests baby has a tie under the mucous membrane in the back. Remember that most of these ties whether presenting as small, medium or large bumps will usually turn into problems if not addressed.
Ellington has a very long tongue, and she could move it way past her bottom gum; these two factors led me away from diagnosing her as tied. However, she was unable to move her tongue properly when nursing and never could really press it against her palate. As she nursed, she’d gum at my breasts, which of course made me sore, caused me to peel, blister and develop and itchy rash with crack on my skin. Her upper frenum- as the ENT in Dallas has shown me- came down into her gum line. Therefore, she could not move her upper lip effectively, which also greatly affected our nursing. Additionally, you could never see her gums when she smiled- something we didn’t really notice until after the surgery.
As we researched and found this to be congenital and genetic, we discovered that JB is pretty severely tongue tied too. He was adopted and never breastfed, therefore it stands to reason that his issue was never discovered. Interestingly enough though, his family always talks about what a colicky baby he was and the constant digestive issues he had from that. It turns out that Harper- our toddler- has a maxillary tie too. I went through my guilt stage over this; but, in the end, even though we missed it on him I’m so grateful that we’ve walked this journey. Because of everything we went through with Harper, I really feel I have a whole new level of understanding for families with this, and I look closely for it now.
You see this diagnosis is so important because if a person is tied- baby or not, breastfeeding or not- he/she can not move their tongue and lips properly. So much is affected by this! Nutritional problem arise. Why? Because food can not be extracted properly (especially in the case of breastmilk), and it can’t be properly placed and digested completely. Colic can occur because of this improper function more air is swallowed. Babies tend to drool a lot, again because their mouth/tongue doesn’t work properly. Gagging may occur. You might see sleep problems like snoring and apnea. And, it’s common for teeth/jaw issues to arise later because the teeth are pulled inwards toward the tongue or there might be gaps where the frenum comes between the teeth. Speech problems have also been noted from this.
Even though Harper is weaned, we are still looking at possibly having his clipped. We will still choose the laser, but it gets a little more complicated with older children. The younger you can do this the better! When a baby is only a few days old, there is very little blood flow to these frenums and hardly- if any- sensation. Therefore, not only is it less painful- if at all painful- to cut, but it’s easier because newborns are swaddled and don’t fight the procedure as much. Not to mention their nursing patterns and habits don’t have to be re-trained.
Looking back, we believe Harper wouldn’t have had as many sleep issues had we known about this and had it addressed. He nursed around the clock, and once he fell asleep, he’d quickly wake up after very little sleep to nurse again. Also, he was always very small for his age, especially for as much as he ate. I now wonder if he’d have gained a lot more and faster too. As his teeth came in, he developed deep notches with brown spots on them on two of his front teeth. This bothered me so much. How could a child raised mostly on vegetables and no sugar- outside of fruit- have this problem? Well, Dr. Kotlow has now educated us on that too. Even though he is not against co-sleeping and night nursing, he explained to me that when Harper nursed since his upper lip is tied tightly to his front gum line that lip and tongue don’t move normally. They are unable to clear and clean milk (and now that he eats solid, foods) from his teeth. You risk high chances of anterior caries (rotting teeth in the front) with this condition. What’s that saying? ”Hindsight is 20/20!” Oh how I wish I’d have known!
Share with me: Have you or anyone in your family dealt with this? I want to hear your stories!
Stay tuned, I’ll continue the series tomorrow!
michelle allison
April 28, 2011
11:15 PM
Hmmm… I am so curious if this is what our daughter Holland is dealing with. We see Dr JB and came in at 2 weeks after birth. My first born, Alora who is 7 was VERY colicy and I assumed that this is what Holland was going through. She was adjusted in the office, she really didnt have much to adjust. She cries so much, its hard to even find words to explain. The worst of my day is getting her to go in a awing, bouncer and above ALL THINGS… THE CAR SEAT. Ive prayed and prayed and tried so many things, nothing works. She cries 100% of the WHOLE TIME WE ARE IN THE CAR and yes, we have tried numerous car seats and both of our cars. NO difference either way.
We used Kathy as our doula and when she did our post visit, she said Holland had the picture perfect latch. I nursed her for 2 hrs immediately after birth… I still am nursing her, shes about to be 9 weeks old. I am dealing with a baby that cannot go 2 hours with out nursing. She does not sleep well. She cannot stay awake to nurse a lot when i do nurse her. Ive pumped and glass bottle fed and it still doesnt seem like shes eating a lot at one time. She does a lot of clicking noises but seems to latch well. There is no obvious tie underneath and seems good but this maxillary tie might be it. Is there a way that you can describe to me to know if she has it? I am having such a hard time… I cannot even put her in a stroller and I am wanting SO BAD to go to the stroller strides stuff but am terrified because I KNOW that she will cry most of the time, if not the whole time. I havent had her back in the office but I guess I can bring her back in to get checked out. Everyone just keeps telling me that shes a fussy colicy breastfed baby and that ive “spoiled” her by holding her so much and am now dealing with the consequences. UGH!
PLEASE HELP.