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Natural Awakenings Metro Phoenix & Northern Arizona

Addressing Tongue and Lip Tie in Breastfeeding: The importance of breastfeeding in the first six months of life is well documented and Dr. Jesika DiCampli describes these often-overlooked issues

Jul 30, 2013 09:17AM ● By Jesika DiCampli NMD

August is National Breastfeeding Awareness Month, and the importance of breastfeeding through the first six months of life is well documented. It provides the perfect balance of nutrients, immune defense, hydration and comfort to a growing infant. Despite the known benefits of breastfeeding, 43 percent of moms start out breastfeeding at the birth of their baby, but only 13 percent are still exclusively breastfeeding at six months of age, according to the Centers for Disease Control.

Some new moms discontinue breastfeeding because newborns may not be getting enough milk and nutrients, causing inadequate weight gain, weight loss, nipple trauma and mastitis (inflammation of the breast), leading to stress, pain and sleepless nights. Unfortunately, milk supply declines, supplementing with formula takes over and breastfeeding stops. Many factors may play a role in the discontinuation of breastfeeding, but there is one reason that continually gets overlooked—tongue and lip tie.

Tongue tie (ankyloglossia) and lip ties are restrictive tissue, or frenums, that tether the tongue to the floor of the mouth or the lips to the gums, causing a decrease in the normal range of movement. There is a varying degree of severity regarding ties. These thick, tight, and/or short attachments of tissue can cause an improper shallow latch that leads to unsuccessful, traumatic breastfeeding. Inability to breastfeed successfully in the presence of a tongue and/or lip tie can cause a variety of challenges for the infant. Symptoms of tongue and lip tie may include difficulty lifting the tongue to the upward, outward, or side-to-side. The classic heart-shaped tongue can be seen when the tongue is protruded, but is not always obvious. There is a varying degree of severity regarding tongue and lip ties because no two mouths are exactly the same. Untreated ties can cause significant nipple pain and interfere with a baby's ability to transfer breast milk, resulting in decreased caloric and nutrition intake, and even failure to thrive. This ends in the mother terminating breastfeeding prematurely.

The tight frenum may be obvious or could be hidden. A posterior tongue tie is not seen from plain view and requires palpation to determine if there is indeed a tongue tie. Having a proper feeding evaluation is imperative in every newborn to help eliminate any potential unnecessary issues during breastfeeding. Some pediatricians, lactation consultants, naturopathic physicians, and midwives assess for tongue and lip ties in newborn babies. The sooner the tie is corrected, the better the outcome for breastfeeding, as poor feeding habits and compensation set in quickly. Unfortunately, there are very few healthcare providers that are assessing, evaluating and diagnosing tongue and lip tie. Without assessment, there is no referral for treatment, and treatment is necessary to correct the tie and facilitate healthy, painless, adequate feeding for breastfeeding longevity.

Correction of tight frenulums may include surgical or laser resection through a frenotomy. Conventional treatment involves severing the frenum by cutting with a scalpel or scissors, which usually requires sutures and general anesthetic. In a laser procedure, anesthetic is applied topically or locally. Healing time is reduced drastically and tissue trauma can be minimized. The procedure takes from five to 15 minutes. Frenotomy is relatively simple, yet it can yield great results by restoring normal feeding function, easing speech and boosting self-esteem as the child grows. Other adjunctive treatments for tongue and lip tie include cranial sacral therapy to release tight jaw muscles and correct misalignment. It is always important to work with a lactation consultant providing support and supervision.

Dr. Jesika DiCampli is a naturopathic physician and certified professional midwife who practices family-style medicine, with emphasis on pediatrics, women's health and prenatal care.. For more information, call 602-493-2273 or visit

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