Tongue-Tie and Lip-Tie In Infants: Can It Impact Your Baby’s Sleep?
ASK YOURSELF THESE QUESTIONS…
Does your baby have feeding issues where they are unable to latch properly?
Make clicking noises?
Are they unable to extend their tongue?
Or are they unable to flange their upper lip on their own?
If you answered yes, it is possible that your baby may have a tongue-tie (ankyloglossia) or lip-tie. In this blog we discuss if and how tongue-ties and lip-ties impact your baby’s sleep. Before we talk about the sleep aspect we need to understand the basics.
WHAT EXACTLY IS A TONGUE-TIE?
An infant with a tongue-tie, also known as ankyloglossia, will have a frenulum that is either too short or too thick, restricting the tongue's movement. The frenulum is a tiny band of tissue that runs from the mouth's floor to the tongue's bottom.
Why might this be a concern? Tongue-ties can be a factor that influences nutrition which in turn can determine your child’s sleep quality. If the tongue is restricted, depending on the level of severity, it is possible that due to the baby not getting enough nutrition, they are not sleeping well.
More importantly tongue-ties may interfere with baby’s inability to latch properly causing:
Poor breastmilk intake
A decrease in milk supply over time
Nipple pain/trauma
Some signs of a tongue-tie are:
The baby's tongue cannot stretch beyond his or her lips.
The tongue cannot be moved sideways.
The tip of the tongue can be notched or heart-shaped.
When the tongue is extended, the tip of the tongue can appear flat or square rather than pointed.
It can also make it difficult for babies to latch and nurse properly resulting in them becoming frustrated and still hungry after a feeding session. Since they are unable to get full feedings, they are more likely to have poor sleep.
Nursing complications include:
Nipple soreness and a misshapen nipple as a result of a bad latch.
A compression/stripe mark on the nipple after breastfeeding
Baby frequently loses suction on the breast during breastfeeding
A clicking sound while the baby is feeding
Inadequate weight gain (The Royal Women's Hospital, Tongue-tie)
Other ties:
Besides the tongue tie, there are two other oral ties, upper lip tie and buccals.
An upper lip-tie, also known as the superior labial frenulum, is the soft tissue that connects the top lip to the anterior gums, similar to a tongue-tie. Although all newborns have some degree of upper lip attachment, feeding issues might arise if the upper lips are unable to move due to a tight or stiff lip-tie. When a child's teeth start to come in, an untreated lip-tie can lead to tooth decay and other dental issues.
A buccal tie, which is an unnatural tie stretching from the cheeks to the gums, is also present in certain newborns, although it is uncommon.
Even though several studies show that correcting anterior tongue-ties can help with breastfeeding, upper lip-ties are still being researched for better evidence-based diagnosis and treatment recommendations (Lindberg, 2020).
Aside from feeding difficulties, there are two reasons as to why parents would want to release the tongue/lip tie:
Releasing the tongue-tie would help with speech issues in the future.
Releasing the lip-tie can prevent dental related outcomes such as gaps in the teeth.
How common are tongue ties?
About 4 to 11 percent of babies are born with tongue-tie (Rohini Radhakrishnan, 2021). A study was performed between June 2014-April 2015 in a private practice. This investigation aimed to determine the impact of surgical tongue-tie/lip-tie release on breastfeeding impairment. Participants consisted of breastfeeding mother–infant (0–12 weeks old) pairs and found that the surgical release of tongue-tie/lip-tie improves breastfeeding success significantly. Early improvements occurred as soon as 1 week post-op and continue to improve over the next month (Ghaheri et al., 2016).
HOW TONGUE-TIE AND LIP-TIE IMPACTS SLEEP:
Tongue-ties can impact sleep not only because your baby is not getting the nutrition they need to sleep but through other mechanisms as well. If you are not able to get your tongue into its natural position it can affect how airways develop. The airways stay narrow causing sleep issues to occur.
SLEEP ISSUES CAUSES BY UNTREATED TONGUE-TIE:
Sleep apnea
Snoring
Constant wake-ups
Teeth grinding
Hard to settle without a feed/pacifier/thumb
Mouth breathing
HOW TO TREAT SLEEP ISSUES CAUSED BY TONGUE-TIE/LIP-TIE:
A tongue-tie release is a simple and safe surgery that can aid with breastfeeding issues. A procedure called Frenectomy, is performed to release the tongue-tie/lip-tie. Most dentists or ENT’s perform this procedure. They either use scissors or a laser to release the ties. The procedure itself only takes a couple of minutes and infants are given topical anesthesia.
If your child is experiencing symptoms as listed above or you have any questions or concerns about your baby's tongue-tie/lip-tie then please contact your local lactation consultant, pediatric care provider, or other specialist experienced in diagnosing them for a confirmed diagnosis and potential treatment plan. (The Royal Women's Hospital, Tongue-tie).
Written by: Humam Siddiqui, MPH Candidate @ Mercer University
Reviewed and Edited by: Unnati Patel, MPH
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References:
Ghaheri, B. A., Cole, M., Fausel, S. C., Chuop, M., & Mace, J. C. (2016, September 19). Breastfeeding improvement following tongue‐tie and lip‐tie release: A prospective cohort study. Wiley Online Library. Retrieved October 8, 2021, from https://onlinelibrary.wiley.com/doi/full/10.1002/lary.26306
Lindberg, S. (2020, July 31). Tongue-tie: What it is and how it's treated. Healthline. Retrieved November 5, 2021, from https://www.healthline.com/health/baby/tongue-tie#other-oral-ties
Rohini Radhakrishnan, E. N. T. (2021, August 23). How common is tongue-tie in babies? Newborns and Ankyloglossia. MedicineNet. Retrieved October 5, 2021, from https://www.medicinenet.com/how_common_is_tongue-tie_in_babies/article.htm
The Royal Women's Hospital. (n.d.). Tongue-tie. The Royal Women's Hospital. Retrieved October 5, 2021, from https://www.thewomens.org.au/health-information/breastfeeding/breastfeeding-problems/tongue-tie