Wednesday, 17 April 2013

Upper Lip Tie - Part 1

Not much is known about Upper Lip Tie’s – try Googling it. Basically, it is like a cousin of Tongue Tie. An Upper Lip Tie - or Maxillary Labial Frenulum - is when the upper lip is abnormally attaches to the upper gum (sometimes extending as far as the hard palate). It is also possible to have a Lower Lip Tie.

A Tongue Tie – or Ankyloglossia - is where the tongue is abnormally attached to the floor of the mouth. All can cause big feeding issues for the newborn baby.

Basically, if any of these symptoms are present, the health care professional should assess for the presence of an Upper Lip Tie and Tongue Tie;

◦Nipple pain during and after Breastfeeds

◦Nipple Damage – cracking, bleeding, looking flattened when baby comes off, presence of a line or mark on the nipple indicating shallow attachment

◦Apparent shallow suck

◦Apparent ‘good’ attachment that still feels painful or not right for Mum

◦Top lip doesn’t flange out when attached to the breast

◦Baby makes clicking noise when feeding

◦Milk escapes out of corners of baby’s mouth

◦Signs of decreased breast emptying – baby not gaining weight adequately, low supply or over supply and engorgement, etc.

◦Baby’s tongue not extendable over lower gum

◦Mum saying it ‘doesn’t feel right’.

For bottle-feeding babies, many of these symptoms will still be present – shallow suck, bottle falling our of baby’s mouth, clicking noises, milk exceping, etc.

Assessment for Upper Lip Tie and Tongue Tie can be easily attended during the Newborn Assessment attended by Midwives after birth. Look into the baby’s mouth and lift the top lip. Feel under the baby’s tongue with a gloved index finger. Dr. Kotlow (based in the USA) has described the process very well with excellent pictures of what to look for here

Don’t assume these checks have been done - if any of the above symptoms are present, check again.

The following is a list of great resources regarding Upper Lip Tie and Tongue Tie. Especially useful is the articles contained on Dr. Kotlow’s website. I have used information from these sites in writing this article. Another place to find more information and support from parents is the Tongue Tie Babies Support Group on Facebook

As always, no one knows your baby better that you. If a health care professional tells you nothing is wrong but you feel there is – ask someone else and keep asking until you are heard.


Upper Lip Tie - Part 2 -

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