The Curse of the Upper Lip Tie

The Curse of the Upper Lip Tip | www.toiletsarentforturtles.com

While I’d heard of Tongue Ties before, I’d never heard of an Upper Lip Tie until it turned our lives upside down after the arrival of my second child.

L-Plate Mum

When Little Miss was born 3 years ago, she refused to take my breast for the first 24 hours, and I had to feed her my colostrum through a syringe. It was a pretty worrying time for me, wondering if she’d ever be able to breastfeed.

After a day she seemed to get the hang of it and would latch on, but really, our first few weeks of breastfeeding were pretty awful. She’d scream and turn her head away whenever I offered the breast, and it would take a lot of persistence on my part to actually get her attached. Once on, she fed pretty well, so we (me, Mr McD and all the Dr’s and nurses we saw in those first weeks) all put it down to her being born three weeks early, and still a little immature.

After the first two weeks or so we found our groove and things got much easier; we ended up having a wonderful breastfeeding relationship until she self-weaned at 16 months (by which time I was four months pregnant with the Stuntman).

Second time is easier?

When the Stuntman came along, I was prepared for a similar initial breast refusal, but in fact he wriggled and maneuvered his way up my chest like a newly hatched baby turtle, and attached himself to my boob less than five minutes after he came out. It was the most beautiful moment, and I remember crying and exclaiming “he’s doing it, he’s doing it!!” to Mr McD and my mum in the birthing suite, so excited that it seemed he had this breastfeeding business under control.

The Curse of the Upper Lip Tip | www.toiletsarentforturtles.com

The Stuntman – 1 day old

A few hours and several feeds later, I noticed my nipples were shaped like lipsticks with a weird line down the centre. It didn’t hurt though, so I wasn’t too concerned about it. I got the hospital’s Lactation Consultant to assess our latch, as well as a couple of midwives, and they all said it looked fine, and that if it didn’t hurt, I shouldn’t worry.

No pain, no problem?

The Stuntman was checked over by the hospital Paediatrician, given the all clear, and we were sent on our way home after one night’s stay.

The next few days and nights turned into a blur of excruciating nipple pain, endless puddles of vomit, and some serious sleep deprivation. The Stuntman was wanting to feed every 1.5 hours round the clock, and then vomiting most of it up before falling asleep for less than an hour, then repeating the whole cycle again. My nipples were cracked and bleeding and the poor little Stuntman just wasn’t happy.

It’s safe to say I was not having a very good time, and I’m pretty sure it was only my Placenta capsules that kept me from going over the edge.

I’d been seeing a gorgeous woman, Jo from MumaMilk, throughout my pregnancy for some wonderful reflexology and massage (to deal with SPD), and she offered me a post-natal treatment as well, to get things back in alignment and re-balance my hormones. To my great fortune, she was also a very experienced counsellor with the Australian Breastfeeding Association, and offered to have a look at what was going on for us. After two minutes of watching the Stuntman feeding, she did a quick check and told me that she thought he had an upper lip tie, and potentially a tongue tie as well.

The Stuntman at this point was about 10 days old, and had been assessed by two different paediatricians, my GP, several midwives at the hospital, the home visiting midwife, and a nurse at the Early Childhood Clinic. No one had even mentioned a lip or tongue tie, and all had just told me to ‘work on our latch’ to improve the situation. As a second time mum, it was just assumed that I knew what I was doing and could work it out.

Call in the experts

Within an hour of seeing Jo, I had an appointment for the Stuntman with a wonderful husband and wife team in Sydney who specialise in lip and tongue ties in babies. The Stuntman was diagnosed as having a Class IV upper lip tie as well as a posterior tongue tie. An upper lip tie is where the piece of skin under a baby’s top lip (‘maxillary labial frenulum’) is attached too tightly to the gum, and looks like this:

The Curse of the Upper Lip Tie | www.toiletsarentforturtles.com

A Class IV upper lip tie. Photo courtesy of Dr Lawrence Kotlow

A Class IV upper lip tie means that the labial frenulum extends down between where the two front teeth will come in, and wraps around and attaches to the hard palette underneath.

The Snip

We had both ties snipped then and there. It was a quick procedure performed by a surgeon (who was also the Lactation Consultant’s husband), and, while I can’t say it was painless for the Stuntman, I think the worst part of it for him was being tightly wrapped and held down on the table while it was happening. There was some blood and some screaming, but I think I was in worse shape than him!

As soon as the procedure was performed, I was encouraged to pop him straight on the breast. Apparently breast milk acts as an analgesic and can also stop bleeding. The difference I felt on that first post-snip feed was amazing; there was still some pain as my nipples were in really bad shape, but it was only ‘surface pain’, and not the excruciating agony I had been experiencing up until that point. He had the longest feed he’d ever had, and actually fell asleep on the boob – something he had never done before. The consultant explained that he’d had to work so hard to feed before the snip, that he’d probably never quite gotten to that milk drunk stage.

The Curse of the Upper Lip Tie | www.toiletsarentforturtles.com

Milk drunk at last!

We had to do some lip-stretching exercises over the next few weeks to make sure that the frenulum didn’t heal back onto the gum line, but that was it. This simple procedure actually changed mine and the Stuntman’s lives; without it I really doubt I could have continued breastfeeding (and certainly not still be going strong 18 months later!).
If you have any suspicion or worry that your baby might have an upper lip or tongue tie, I urge you to go and see a qualified Lactation Consultant for an assessment. Early correction can make a huge difference.

Signs of a tongue or lip tie

Some of the signs that a baby may have a tongue or lip tie that is interfering with breastfeeding include:

  • nipple pain and damage
  • the nipple looks flattened after breastfeeding (‘lipstick’ shaped)
  • you can see a compression/stripe mark on the nipple at the end of a breastfeed
  • the baby keeps losing suction while feeding and sucks in air
  • the baby makes a clicking sound when feeding
  • the baby fails to gain weight
  • the baby cannot poke his tongue out beyond his gum or lips his tongue cannot move sideways
  • the tip of his tongue may be notched or heart-shaped when he cries he may readily gag
  • the tip of the tongue may look flat or square instead of pointed.

(Source: Australian Breastfeeding Association)

Speech issues from Upper Lip Tie

I now realise that Little Miss also has an upper lip tie, and that this was most likely the cause of our early breastfeeding issues. She also now has a small gap between her front teeth, and is unable to say the letters ‘f’ or ‘v’. She actually can’t move her top lip up off her front teeth enough to be able to touch her front teeth to her bottom lip (which is how you say ‘f’ and ‘v’ – you’re doing it right now, aren’t you!). So it looks like we may have to get hers corrected too, but, at her age, the procedure is going to be much more of a big deal. A paediatric dentist will perform it, most likely using a laser to cut the frenulum. I’m somewhat reluctant to move forward with this, but I know I should do it sooner rather than later, or speech therapy might be required for her as well.

I wish I could say that this simple procedure put an end to all of our troubles, but unfortunately we then had to contend with milk over supply (due to the constant feeding), and a long road to discovering that his sleeplessness, fussiness and excessive vomiting was in fact due to a cow’s milk and soy protein intolerance (CMPI / MSPI) (Read my post How we came to be dairy and soy free for more background).

Links for further reading about tongue and lip ties

Personally, I’m almost convinced that there is some kind of link between a tongue and/or lip tie and CMPI / MSPI. So many mums of CMPI babies that I’ve spoken with have also discovered that their little one has a tie –too many to be a coincidence in my opinion!

What about you – does your baby have CMPI and a lip tie and/or tongue tie?
Please leave a comment below!

 

44 comments

  • Chrissy

    How do the puddles of vomit relate to the upper lip tie?

    My son has been projectile vomiting since about week 1 of life. He’s 12 weeks now and still no better. Drs thought pyloric stenosis, but have settled on “probably severe reflux” he’s on his third medication which is no help to the vomiting. He has a little nodule from his upper lip to his gum like the picture of your sons. Did the revision help your son not up vomit after feeding?

  • Yolanda

    This could be related to a genetic mutation – MTHFR – which shows up externally as center line defects such as tongue tie, lip tie, etc. Basically, the detox pathways are not working as well and methylated b vitamins are recommended. I just found out that the problem with babies creating a lot of gas from cruciferous vegetables is linked to this as well. My kids are all grown – what I wish I’d known.

  • Jessica

    Thank you for sharing this! LO is just about 1, he has had mild undiagnosed torticollis until I forced a referal for pt at 8 mths. He had gerd for the first 7 mths of life, and the worst painful latch. He was checked for a tounge tie but it never went further. I was told I had nipple blanching and lost blood flow when he latched on. I finally got a speech therapist in to see him, he was finally checked and diagnosed with an upper lip tie and posterior tounge tie. He has also been diagnosed with the allergy to milk and soy proteins. He has grown out of the effects of dairy and soy in my milk, but he cannot have dairy himself. Researching all of this today is blowing me away that this could have all been intertwined and taken care of from the beginning! Pediatricians truly have no idea what they are doing!

  • Wow! I didn’t realise this either. What a tricky start to life. I’m sure he will go on to do great things. I wonder what causes that?
    Mandy @ barbie bieber and beyond recently posted…14 Ways To Improve Your Relationship With Your DaughtersMy Profile

    • Yolanda

      It’s possible that this is related to a genetic mutation as these ties are one of the symptoms – look into MTHFR for more information.

  • Cassandra

    Very interesting article. My son has a lip tie that I had to revise at 10 days old due to feeding issues. He also has the milk and soy allergy. I now realize my 12 year old daughter has a lip tie and that is most likely the reason we had years of frustrating speech therapy and speech issues. I wish I would have known earlier for my daughter. I am now also having both kids tested for the MTHFR gene mutation, since it is related to lip ties.

  • Amber

    The five babies I know of that were diagnosed with MSPI also had tongue or lip tie revisions! I also think that there is a link. I just wish I knew if it were environmental or genetic.

  • Emma

    Both my boys (now 3 and 1) were upper and lower tongue tied. Midwives picked it up within the first day both times thankfully and we had the procedure done before each of them was a week old. The relief was immediate!
    I’m glad someone is talking about it/posting about it because the pain of breast feeding a tongue-tied baby is immense and I’m sure it has caused many mums to give up.
    Interestingly, I am 100% lower tongue tied but it hasn’t had any impact on my language or teeth.

    • So glad both your boys had their ties picked up early! There needs to be a lot more education around TT and ULT. It is the cause of a lot of mums stopping breastfeeding before they want to.

  • Wow, I could have written this haha my first daughter didn’t latch for about 24 hours so we did syringe feeds & took a while to get the hang of it. My new bub latched about 15 minutes after birth and I felt so happy that we weren’t having the same drama. The midwife that did our final check before moving to the birth suite identified a slight tongue tie in Violet though & within days I had agonising nipples & am doing half boob / half expressed feeds to let them heal. We are looking to get hers snipped soon to avoid future issues. Amazing how common it seems to be. Poor little darlings! 🙁
    Holly recently posted…How To Avoid Feeling Overwhelmed By DeclutteringMy Profile

  • P.S
    There is an International Association of Tongue Tie Professionals, and an Australian branch.
    They are online, and singing from the same song page. It is illuminating !

  • Hello, I am an RN/MW, IBCLC and ABA Counsellor working in General Practice and I am seeing MummaMCD’s story over and over again. I have refered many a baby to a husband and wife team in Sydney, and some other providers as per parent choice, for their help with upper lip/lower lip/tongue tie release procedures. The information you are all sharing here is crucial and needs to be shared more. World wide there is a significant gap in the knowledge of/recognition by Paediatricians, Midwives and a bunch of other professionals around this significant issue. Be wary of unsettled, demanding babies, often with symptoms of reflux and defensive behaviour at the breast, generally I will find a tie of some description and usually the various ties coexist in varying degrees. Speak up mums when you have a concern, ties can have an affect on breast and bottle feeds, and can have an affect on other mundane (licking an icecream), social (french kissing), or communication (making certain letters and sounds) issues later in life. Persistent tongue ties have also been known to affect a person’s dental hygiene, orthodontic development, orofacial development and breathing (many known to become persistent nose breathers, open mouth breathers at night, and snorers). Seek out a Lactation Consultant, especially if you here of one who is knowledgeable in this area. GP or Nurse Lactation Consultants, will also help out with bottle feeding issues where able, using their knowledge of infant sucking/suckling, and will certainly assess the baby’s mouth. Be also wary of the sneaky tongue tie known as the posterior tongue tie. It is often difficult to assess, but there are some classic, easy to use assessment tools. If you think your baby has some form of restriction, look at tongue tie images on line, see if your baby’s mouth matches any thing you see there and get help. The IBCLC have a register of LCs in your area.

    Destae.

  • Ness W

    I just googled CMPI & lip tie & this came up. Your journey above sounds all too familiar with our expeience! The reason I googled it is because I also think that there is connection between the two, & tongue ties too. My 6 month old is being assessed tomorrow, & then revised if required. If only it was picked up sooner!

  • If you decide to go through with the surgery for your three year old, please write about it or tell me how it goes if you don't mind. You can email me at mummywifeme@gmail.com Thank you 🙂

  • I've found this post really interesting. Thank you. When my first daughter breastfed she would take in a lot of air and would be quite colicky. We assumed this was because of her tongue tie which we discovered at birth.At the time the paed advised against snipping and my parents told me I was tongue tied as a baby, so we let it be. It stretched naturally at 6 months. With my second daughter it was like de ja vu. She also had a tongue tie and the paed advised against snipping. Feeding was incredibly painful, I got mastitis etc. It was just not fun. I put it down to the tongue tie. When she started smiling I noticed she had an upper lip tie. I didn't know what it was at the time of course. Even our local GP seemed freaked out about it. Back to the paed we went and he advised against snipping.Again! We really didn't know what the best thing to do was. I had finished feeding by this stage, but worried about her speech and her physical appearance too. She is now two. You can't see anything now unless she smiles a really really big smile. Plus, her speech seems fine apart from a few sssssssss sounds. I do worry whether or not we did the right thing taking our paeds advice and whether or not she'll hate us down the track for not snipping it when she was a babe. It was just a tough and confusing time. Anyway, thanks for sharing your story and sorry about the ramble.

    • Thanks Renee, and I'm so sorry you had such a run-around with your daughters! Hopefully all will be ok – if her speech is sounding OK then she's probably fine and it was the right decision to leave it… I'm really dreading the next steps with my 3 year old – I'll definitely write about it here once I work up the guts to make the appointment!!

  • Wow, I had no idea about this condition. This post may be helpful to so many new mums. It almost makes me wonder whether my first born ever had this, I didn't continue BF him after two months. He is 22 now so a little too late to tell.

    • You can still have a look if he has one! If he's got a gap between his two front teeth then that is often caused by a lip tie. I think it's a condition that is slowly gaining more recognition, but the medical community is still lagging behind in diagnosing it…

  • Gosh I bet that must have been just so hard! My 1st was a very fussy drinker but at 4 weeks was diagnosed with chronic reflux, it was horrific I struggled on breastfeeding, like 1 minute each side for an hour but she'd vomit acidic smelling milk, never slept and was a very unsettled baby. It wasn't until she could walk, about 1 year that life got better. I feel for you. Some great advice there for other mums!

  • Friends of mine had children with tongue tie, this is such a great post, it will help and reassure many. Thanks for linking up to #brilliantblogposts

    • Thanks Vicki, it still makes me so mad thinking about all those doctors we saw who brushed us off. I'm so glad I trusted my instinct to keep asking questions – and I'm very grateful to my lactation counsellor friend who pointed me in the right direction.

  • Poor Bub and Mumma. My son had a mild tongue tie but it didn't affect his Bfing thank goodness.

  • I have never heard of this condition, how interesting. x

    • Hi SarahIt's amazing how many people haven't heard of it, considering it's not an uncommon condition! I think a lot of poor bubbas (and mummas) go undiagnosed so just have to stop breastfeeding and don't know why!

  • Scarlett sometimes flattens my nipple and leaves a white line, but she does good long feeds (gets annoyed when my let down is fast). I can't see under her tongue but there's a slight join. I think I'll get my gp to look at it :/

  • My guy has a tongue tie that was never fixed and it's caused us SO much trouble! Seriously debating whether to look at fixing it now, but he's old enough to be terrified by the prospect.

  • Great story and I love the pics. What shocks me is you had so many people (qualified people) assess you guys and no one picked it up. And you were a second time mum. No wonder the journey into parenthood for sum causes major anxiety.

    • Yep, it was a very frustrating few weeks! I'm just glad I kept asking questions… if it had been my first baby I probably would've just given up and dealt with it on my own!

  • Two out of three of my boys have had a lower tongue tie and the best decision we made was to snip them. It made such a difference to my breastfeeding experience.

  • Oh the relief you must have felt at that first 'milk drunk' bliss post feed. I'm so glad you found out about Stuntman's lip ties, & sorry that it wasn't picked up with your first daughter.I think word is slowly getting out more about lip ties – what to look for & how they affect feeding & speech as they get older. We've had several friends who either looked into the possibility of their baby having a lip tie based on a suggestion following feeding difficulties.

  • Thank you for sharing this experience. So valuable for new parents to be aware of it as you realise from your daughter's experience it can affect speech development.

  • Gosh! I didn't know babies could have an upper lip tie! What a crazy time you had with stuntman when he was born! He is just the most adorable baby in that picture. I'm sad to read that your three year old daughter has to have treatment to fix her lip and wish for you that it had been picked up when she was little. We'll done mumma on being a great mum and listening to your instincts. 🙂

    • Thanks RebeccaYes it was quite a full on start to his life!! Lucky he's so cute :)I think lots of people know about tongue ties now, but the lip tie is still a bit of a mystery. Thanks for stopping by 🙂 x

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