Upper Lip Tie – Part 2

In Upper Lip Tie - Part 1, we discussed the implications of an Upper Lip Tie on the Newborn Infant and the Breastfeeding mother. However, there can be long term implications too.

▪Speech difficulties – due to the limited range of movement of the lips (and tongue), speech difficulties are more common and may be harder to treat.

▪Gap between the two front teeth – due to the tissue connecting the gum to the lip. This causes the top front teeth to have a gap.

▪Cavities – an upper-lip tie makes it more difficult (and painful) to properly clean the top front teeth, increasing the likelihood of dental decay.

▪Gagging – can cause problems with swallowing and gagging when eating solids (this is more commonly associated with a tongue-tie).

So what can be done? Referral to a specialist is paramount. This could be a Dentist, Paediatrician, ENT or Lactation Consultant. This specialist should be experienced in tongue-tie and upper-lip tie, and supportive of breastfeeding.

If revision is  necessary, the specialist will likely recommend laser treatment to release the tie. Laser is preferential over cutting with scissors as laser shows decreased swelling, pain and less likelihood of needing a second revision.

The Tongue Tie Babies Support Group on Facebook has a list of specialists that their users have positive experiences with and this can be a good starting off point. Your Midwife, GP or a Lactation Consultant may also be able to help. Knowledge is power. Arm yourself with as much good-quality information as possible and make an informed choice.

https://www.facebook.com/groups/tonguetiebabies/

No one knows your baby better that you. If a health care professional tells you nothing is wrong or it’s not that bed, but you feel there is – ask someone else and keep asking until you are heard.

♥ Bec

Upper Lip Tie - Part 1 http://belliesbirthsandbabies.blogspot.com/2013/04/upper-lip-tie_17.html

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

http://www.kiddsteeth.com/nursingbookaugfc2011.pdf

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

https://www.facebook.com/groups/tonguetiebabies/

http://www.kiddsteeth.com/index.html

https://www.breastfeeding.asn.au/bf-info/tongue-tie

http://www.analyticalarmadillo.co.uk/2011/06/top-ten-tongue-tie-myths.html

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.

♥ Bec

Upper Lip Tie - Part 2 - http://belliesbirthsandbabies.blogspot.com/2013/04/upper-lip-tie-part-2.html