Not Ties As In Shoes
Lip ties, tongue ties, and cheek ties are all types of oral tethered tissues (also called tethered oral tissues or TOTs). These occur when the frenulum (the small fold of tissue that anchors parts of the mouth) is too tight, short, or thick, restricting movement. This can impact feeding, speech, and oral development.
Symptoms of Oral Ties in Infants
1. Tongue Tie (Ankyloglossia):
Difficulty latching or staying latched during breastfeeding
Clicking sound while nursing
Gassy or fussy behavior during feeds
Poor weight gain or slow growth
Tongue appears heart-shaped when extended or has limited movement
Difficulty lifting or moving tongue side to side
Reflux symptoms or excessive spit-up
2. Lip Tie:
Shallow latch or loss of suction while feeding
Painful nursing for the parent (nipple damage, soreness)
Baby has difficulty flanging upper lip outward
Milk dribbling from mouth during feeds
Gaps between upper front teeth (in older infants/children)
Blisters on lips from friction
3. Cheek Tie (Buccal Tie):
Less commonly diagnosed, but may cause:
Difficulty creating suction
Pain for the nursing parent
Poor latch that slips frequently
Prolonged or inefficient feedings
Gagging or choking during feeding
How to Feed or Nurse a Baby with Oral Ties
Breastfeeding Tips:
Positioning is key: Try laid-back or upright positions to support better latch and gravity.
Deep latch: Encourage a deep latch by supporting baby’s shoulders and tilting the head slightly back.
Lip flip: Gently flip the upper lip out to help improve suction.
Breast compressions: Can help milk flow more easily, reducing frustration for baby.
Work with a lactation consultant (IBCLC): Especially one trained in oral ties.
Bottle Feeding Tips:
Use paced bottle feeding to mimic breastfeeding flow.
Choose a slow-flow nipple to help baby control milk intake.
Ensure baby’s chin is tilted down and mouth is wide open before inserting the bottle.
Burp often to manage gas or discomfort.
Additional Support
Craniosacral therapy or bodywork: May help with muscle tension related to oral ties.
Speech or feeding therapy: If older infants or children are struggling with solids or speech.
Frenectomy/frenotomy: A minor procedure to release the tight frenulum, typically done by a pediatric dentist, ENT, or specialist.
