Upper Lip Tie?

[x Helen x]

Does anyone have any information on this, and how it affects breastfeeding?

My son was diagnosed with almost 100% tongue-tie at birth which was snipped at 3 days old. Massive improvement in his latch but still struggle to get a deep latch and have the 'lipstick' shaped nipples after a feed. It's not overly painful or uncomfortable now (he's three weeks old) but I have had a few complications such as a plugged duct and now a particularly bad bout of mastitis for which I am on antibiotics. I read online somewhere to check for 'lip tie' so off I went and had a look and I think this might be it?? But I'm not sure as have nothing to compare to!

I breastfed my daughter for 18 months with no problems at all which makes me more aware that something is just not right this time. I will of course be continuing to breastfeed but hoping to find out where the problem stems from so that I can try and fix it.

--- can't upload photo on my phone so will try to do it on laptop

 

[itsnowmyturn]

No advice but I was looking for threads on this as I think my daughter has upper lip tie, I believe the two go hand in hand, can cause lots of issues with breastfeeding

 

[Marythefairy]

I would get tongue tie checked again sometimes they need doing again because the posterior tie is still there after the first snip. I read somewhere that even with a lip tie it in usually the tongue tie that's still causing a problem. My lo is nearly one and still bf. I think she has a posterior tongue tie and upper lip tie which I ignored and just Carried on with for ages but am due to finally see a paediatrician next week so will let you know. I just got better at modifying her latch to get as much upper lip movement as possible to reduce the discomfort

 

[_Meep_]

With a lip tie, there is almost always a posterior tongue tie. Mine had both ... now she has just the lip tie as in the UK there is one place I know of that will treat a lip-tied baby with laser.

Lip ties tend to cause problems by affecting the baby's seal on the breast. They often a. can't open their mouths very wide and b. can't flange their top lip out properly because it is tight. The mucous membrane on the inside of the lip is far preferable to other surfaces of the lip when creating a seal - thus a lip-tied baby, as I understand it, can have difficulty properly latching or maintaining a good latch, lose suction, swallow a lot of air, etc.

Does your baby's lip tuck in when he tries to feed? If you try to gain a deeper latch by flipping his lip out or positioning the nipple further back in his mouth, does he slip back so that his latch is shallower? Push your baby's lip up. Can you flange it up so it touches the nose? Where does the little bit of skin underneath attach? When you flange the lip, does the frenum turn white? If so, it is certainly tight and very capable of causing problems.

With lip and posterior tongue tie you are also likely to see certain anatomical features such as a receded chin and a high arched palate due to the pull of the tie under the tongue and the lack of flattening action from the tongue that the palate will have received while the baby was in utero - a posterior tie makes it very difficult for the baby to raise the tongue, though they can often stick it out. These anatomical differences can also make breastfeeding more challenging.

I don't know where you live, but if you are in the UK and still have suspicions about your baby's tongue, I can suggest someone who will once and for all be able to tell you if there is residual tie, and treat it if needs be. She is a private IBCLC, so she costs. But very few out there actually know what they are looking for when it comes to posterior ties, or so I have heard. This (wonderful) lady treated my daughter at 4.5 months.

With regard to the lip tie, if you're both coping ok, it's probably best to leave it. Again, I don't know where you live, but here in Britain, basically there is very little help available. I can guarantee though that in ten years or whatever, lip tie diagnosis and treatment will be as commonplace as tongue tie.

Hope this helps.

 

[itsnowmyturn]

Meep I'm in the UK, could u send me some info please, I have an appointment for my daughter in March but I'm certain her tongue tie is posterior, she has a good range of movement at the tip of her tongue but not so much further back, she can touch the roof of her mouth with the tip but I'm not sure she can with the middlE.
She has a lip tie too n as u say ppl won't consider that as treatment but I was told to ask for a referral to ent to get it looked at but Dr will only refer if they think it's an issue and as they don't no much about them it unlikely they will refer, and even if they do getting a Dr in the hospital that nos about them is unlikely so will probably end up being sent home being told not causing problems.

 

[_Meep_]

Doctors sadly are often absolute crap. Posterior tongue tie is totally overlooked in so many cases. Because of this we paid to see a private paediatrician who said N's tongue was normal and if she had a tongue tie you'd be able to see it ... (!!!!)

Not true!

Trusted my instinct and searched around and eventually found Tatiana Mela. She operates in Cardiff but I think she is Russian (speaks perfect English though). She is a tongue tie specialist (as well as a registered midwife and IBCLC) and has been doing tongue ties for 7 years I believe. She treats babies of all ages, but obviously the younger the better. She also teaches stretching exercises to stop the tie reattaching after it is cut.

Tatiana has a drop in thing at Chapter Arts in Cardiff where you can go and have the baby assessed/have a chat for £35. I think revision of the tie was £160.

She was very helpful following the revision and we are still in contact now. You can call/text/email her if you are interested - her website is www.mummebaby.com

Good luck!

 

[itsnowmyturn]

Ah that's a bit far, I no there is a specialist around here that is private but wud rather have someone recommend the. Really bugs me that they don't do anything about lip, my lo is 6 weeks old and is trying to smile but is finding it difficult with her top lip, it sort of stays straight while her bottom one does what it shoul, although obviously it could be wind lol but her eyes light up when she tries.

 

[Rhapsodi]

I just found my baby has 2 lip ties (top very thick and pronounced, bottom is thin and tight)! I can't see a tongue tie but I can't get a good look either. I'm waiting to here from ENT on when we can be seen.

He has always had a shallow latch, sometimes it looked lazy, he has reflux issues, fell asleep while eating frequently, I've had 1 milk blister and when he comes off I get the lipstick nipple too.

I can't believe it wasn't caught until today! Thankfully dr google gave me a hint!

Here is a picture of his top lip tie (the bottom is too tight to get a pic).

 

[itsnowmyturn]

This is my baby girls upper lip tie, never thought about the bottom tbh. Going to wait and see what happens with the tongue on 2nd March before I take the lip any further as if it helps I won't need to touch the lip

 

[_Meep_]

myturn - I am sure the specialist round your way will be qualified to identify any issue. If they are a private specialist or IBCLC especially, I would trust them. The NHS training sadly just doesn't seem to focus enough on posterior tie - my HV hadn't even heard of it. Cardiff was a long way for us too but it was worth it in the end.

Rhapsodi, you can be almost certain your LO has a tongue tie. Many posterior ties, like my daughter's, are under the membrane, so you can't see them. If you press under the tongue though, you might feel a tough string and see the tongue dip or spoon in the middle.

As myturn said, it's definitely best to deal with the tongue first and then worry about the lip tie if needs be. I think our issues have improved enough for us to leave N's lip tie, but breastfeeding for us will never be perfect or very easy. I'm uploading a picture of N's tie too ... it isn't a thick one, but as you can see, it attaches between her teeth and turns white when it is stretched even a little. She usually prefers to breastfeed with her top lip tucked in.

 

[itsnowmyturn]

At least if her lip is tucked in she can't nibble on u lol. I think sophie is learning to work around the lip tie and although she gets reflux and trapped wind they could go when the tongue is dealt with. By the time she gets a referral and consultation for the lip she would be at the age where general anaesthetic is needed so I wud rather not put her through that if I can help it

 

[_Meep_]

Lol yes, she has bitten me once or twice but is generally gentle. I think her lip tie causes issues maintaining suction only these days, and as she gets bigger, that is improving. Her tongue tie, however, was a different story. She used to 'click' during every feed and she swallowed so much air that in all her early photos she has a really bloated belly. She also struggled to cope with my flow and suffered with silent reflux which would worsen in waves - if she was teething for example, she just wouldn't be able to swallow quickly enough to cope with the drool AND the breast milk and she'd end up gagging and spluttering, swallowing a ton of air which made her reflux so much worse and caused periods of total breast refusal ...

It took a month to see a real improvement as she'd been using her tongue wrong all her life (4.5 months), but now she breastfeeds with few problems. She has no issues with my fast flow at all. Yes, our latch is probably rubbish and we can only now feed comfortably lying down in bed as she slips off easily ... I also usually have to hold my boob in place throughout an entire feed and she may well get it wrong occasionally and have the odd click, gulp or splutter. BUT things are so much better that I am pretty much content. She's a big, strong, beautiful girl who is thriving and doing so well with her solid foods, which I am sure probably wouldn't be the case if her tongue was still tethered to the floor of her mouth.

Ladies, I urge you to fix your LOs' tongue ties first and give them time to relearn and improve - then worry about lip tie if nothing changes.

 

[itsnowmyturn]

Uv just described everything about sophie. She's on reflux medication now n gets really gassy. I think i have a fast flow n she struggles with it, clicks with feeding. Poor bubs is so uncomfortable with gas she squirms around in pain and strains to push the gas out, it's affecting her daytime sleep n ends up overtired by the evening. Most of the time I'm tethered to her in the day, I'm lucky if I can get away to have a wee or make a drink because she will wake up n cry n squirm around every 5 or 10 minutes. Giving the ranitidine a few days then going to add in gripe water too.

I honestly never thought her tongue was an issue because she can poke it out but iv obviously now learnt that that's a common myth about tongue ti, just hope the place I go for her appointment know plenty about posterior tie.

Like ur lo sophie doesn't get great suction due to the top lip but I think they figure out how to live with it, amazingly I dedecided to look on myself n I have both tongue n lip, I wonder if my mum had issues, don't think much was known about it 26 years ago

 

[Rhapsodi]

_meep_ I found the tongue tie. I'm not sure if it's a problem but I'm definitely bringing it up to the ENT on Wednesday.

Our issue is getting a good seal so air doesn't go in the corners. But I could see how the tongue could affect that too.

 

[_Meep_]

myturn, I know how you feel. It can be absolute hell. I can say though that N now suffers far less with silent reflux flares than she did before we had her tongue snipped. I think she has had two dodgy episodes since it was done. Compared to total breast refusal on and off every other week, that's a massive improvement for us. I can't say for sure that the frenectomy brought about the change - she may simply be growing out of her digestive troubles - but what I CAN tell you is that one day she just woke up and fed perfectly from my right side (the side she had previously hated and refused the most due to its aggressive pressure-hose spray!) without a single click or splutter. She far prefers my right side now.

Sophie being able to stick her tongue out will probably have saved you the misery of sore/damaged nipples (another reason why posterior tie often goes overlooked - 'No pain, no problem!' - bullshit), but that is all. I NEVER had sore nipples, even to begin with. In order to effectively compress and milk the breast, as I understand it, the whole tongue needs to be able to undulate.

I believe midline defects, such as tongue/lip ties, cleft chin, etc. (and other more serious issues such as cleft palate), can be hereditary. I think it's related to closure of the neural tube (don't quote me on that one though) - N, for example, as well as her tongue and lip tie, has a forked crease at the top of her bottom where (so I was told) her skin was pinched in when her neural tube closed! Nothing to worry about, but interesting that these things all occur on the same line of the body. My niece has the forked bum too.

If the place you go to doesn't give you a satisfactory answer or make you feel at ease that Sophie's tongue is normal or otherwise, I really would recommend just making the trip to Cardiff. Tatiana definitely will tell you once and for all.

Rhapsodi, if you're having problems, it's likely the tongue has something to do with it. Since you're in America though, I think it's easier for you to get treatment for both issues than it is for us. I hope it's all solved for you soon!

 

[Rhapsodi]

My LO has a issue with his bottom too. It's not forked but it's definitely unique!

And he has a cleft chin too.

Thanks for the info! Crazy that it's all linked!

 

[itsnowmyturn]

Meep that's one thing that doesn't go with mine, I do get sore nipples, not damaged at the moment but have been cracked in the past probably a mixture of sophie and improper pumpin, but i do still get sore, less so now than before but I remember at first it was toe curling n my partner used to say 'shes on thrn' because he could tell by my face!!

I added the gripe water in, so much easier to burp her now! Sometimes I don't even need to, just putting her on my knee to do it brings it up (but only immediately after having the gripe) she's vomiting still though so maybe her ranitidine dose needs increasing, she's on 0.24 three times a day.

It's interesting u say about the neural thing, sophie has a dimple above her bum crack, where it closes up, the midwife had to double check that she cud see the end of the dimple or she wud have needed a scan to check it

 

[Rhapsodi]

Yeah my LO has a dimpe too. Looks like it could be a very mild form of spinal bifida! Eek! Will be bringing it up to the Ped! It says it's usually caught during a NB exam but, unless you are spreading the cheeks you can't tell.

I can't believe how many things are coming together. The SB could explain his bowel issues and kidney issues (in utero). Wow... A little scary but, maybe I'm wrong!

 

[_Meep_]

Oh dear myturn! Maybe your LO is using jaw compression to extract the milk rather than stripping it out with her tongue because its movement is restricted, and that's why you still get sore?

Glad to hear she's doing better with her burps, but sucks about the vomiting. Following her possible tongue tie revision, without all that swallowed air to come up, she may well improve. Here's hoping.

I am fascinated to hear that both your LOs have sacral dimples. Incidentally, N DOESN'T have one (she does have what I think may well be the beginning of a cleft chin though, which she got from her dad!). I hope you aren't worrying now, Rhapsodi ... sacral dimples are common and as myturn said, if you or a professional is able to locate the bottom of it, i.e. if it is not open, then it's nothing to worry about. They can also be hereditary so check yours and your partner's butt cracks ladies! Lol.

Spina bifida occulta, which I think is maybe the mild form you were referring to is also relatively common and most people never find out they have it ... those that do find out usually do so during examinations for completely unrelated reasons.

Sorry if I caused you to get scared! I suppose at least if it IS something then at least now your son will be seen to.

 

[itsnowmyturn]

Ul have to let us no what ur ped say. I have thought of bringing it up but only for my next pregnancy to get high dose of folic acid.

I think she has a really strong suck and sucks with her cheeks like we wud through a straw and maybe that's y it hurts.