Tongue And Lip Ties
Overview and Reference Guide

Tethered Oral Tissues (TOTS aka Tongue-Tie)

Comprehensive Overview of Tongue and Lip Ties

We believe education is key to making fully informed decisions about the care of your growing family. The IBCLC’s at Milk Diva are ready to equip and navigate families through all the stages of infant feeding and oral habilitation.
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Milk Diva’s Tongue-Tie Quick Reference

Releasing the boat from the dock alone, cannot make it sail.

-Autumn R. Henning SLP, COM, IBCLC

Breastfeeding Symptoms

Tongue-ties or oral restrictions cannot be diagnosed just based on pictures or symptoms alone. A full functional and structural evaluation is required.

Mother’s Symptoms

  • Painful nursing
  • Creased or flattened nipples
  • Blistered or cut nipples
  • Incomplete breast drainage
  • Plugged ducts or mastitis
  • Inability to nurse without using a nipple shield
  • Decreased milk supply

Baby’s Symptoms

  • Poor latch
  • Poor weight gain
  • Reflux or frequent spitting up
  • Frequent gassiness and fussiness
  • Clicking or smacking noises when eating
  • Dribbling milk out of mouth
  • Frustration when eating
  • Inability to hold a pacifier
  • Prolonged nursing or bottle-feeding sessions
  • Mouth breathing
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Pieces of the TOTs Puzzle

Who knew so many of these symptoms could be related to oral restrictions?

Suck Blister

This not always normal.

Poor Seal

Leaking while drinking from bottle is not optimal for feeding and cause infant to suck air.

Unable to Hold Pacifier

Tongue cupping and lift is required to hold a pacifier in.

Mouth Breathing

Open mouth breathing can lead to many significant health issues.

Reflux

Small amounts of daily spit up, with no signs of pain or distress can be normal.

Colic

This can be caused by many reasons but sucking in air can be a cause.

Favoring One Side

Favoring a side is not normal. Babies are too young to have ‘favorites.’

Banana Shape Body

Body Asymmetry

Tongue Tie

Look at the lip tightness, blanching and thick lingual restriction (tie).

Lip Tie

These are not teeth! This white area is called blanching and means the lip frenum is so tight, it stops blood from circulating to the gums when lip is flanged.

Tongue Resting

The tongue should be able to freely lift and rest on the roof of the mouth when sleeping.

Parental & Provider Educational Videos

Tongue & Lip Ties Unraveling the Confusing & Conflicting Information

Parental Videos

Provider Videos

Tongue-Ties & Babies Presentation for Parents is presented by Dr. Richard Baxter, DMD, MS, of Alabama Tongue-Tie Center, is one of our country’s nationally recognized speakers on tongue-ties, instructor of the course Tongue-Tied Academy, and author of the best-selling book Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More.

Collaborative Care

For Optimal Outcomes

One of the biggest misunderstandings about frenectomies is that the actual procedure is all that is needed to “fix” a baby with tongue tie

The Board Certified Lactation Consultants (IBCLCs) at Milk Diva believe in an integrative, and collaborative approach to achieve long-term, optimal oral function.

The goal when treating ties is to restore optimal oral function; however, in many cases, in addition to the frenectomy, the parents and the child will need the help of multiple specialists to prepare for the procedure and work with the baby afterward in order to fully achieve their goal.

Finding the right help is important. Asking the right questions is key.

There are many types of providers that fall under each broad category, but the MOST important quality to look for, no matter which type of provider, is they are specifically trained in the problems and solutions related to ties and oral dysfunction – this means they have taken EXTRA education in these areas.

Do not assume these types of providers automatically know about ties and oral dysfunction. ASK if they have had specialized training before booking an appointment. A good place to start is with a specially trained International Board Certified Lactation Consultant (IBCLC), Speech Therapist/ Speech-Language Pathologist (SLP) or Occupational Therapist (OT). Any one of these professionals can identify ties and help find the best bodyworkers and release providers for your baby.

Schedule a Lactation Consultation
Learn about Procedure