Ever since I started my instagram account, I’ve had many conversations with moms about eating challenges! Food aversions, food obsessions, weird habits, you name it. I’ve heard so many moms dismiss their struggles with comments like, “Oh, the doctor said he’ll just grow out of it!” “I just need to keep offering it to her and eventually she’ll love it!” “I was told I wasn’t trying hard enough.” “I was accused of not feeding my child as often as I should,” and so on and so forth.
There are so many reasons for kids having food aversions and obsessions: sensory processing disorder, addiction to processed food/sugar, an unidentified food allergy or intolerance, a vitamin or mineral deficiency, gut flora imbalance/over population of bad bacteria, etc. But I’m skipping over those, for now, and addressing the hidden and repeatedly misdiagnosed culprit that’s caused multiple issues for both my kids – tongue ties.
I had NO IDEA how huge of an effect they can have on eating. Heck, a year ago I hardly knew what they were. PLEASE, please don’t hit the X on this tab, thinking you know for a fact your child isn’t tied. Even if a professional has examined and told you your kid isn’t tied, humor me and read this post.
- Does your child gag and choke on food often?
- Do they chew and spit their food out?
- Do they pocket food in their cheeks or lips?
- Do they prefer purees or very soft cooked food?
- Do you have a difficult time getting them to eat things of certain textures/consistencies?
- Do they have an aversion to solids/eating in general?
- Will they only eat small amounts of food at a time before wanting to be done?
- Are they failure to thrive?
If you answered yes to even just one of these questions, please read on.
This is a post I’ve been planning to write for months now. It’s one of those parenting experiences that brought so much stress, questioning, and doubting. It required a lot of research, asking around, and pestering our doctor before getting answers. And it’s also left me wondering how many parents are unknowingly dealing with this problem as well.
What is a Tongue Tie?
I used to have a vague idea that tongue ties were a thin piece of skin that connected/tied down the tip of the tongue to the floor of the mouth. When I worked as a preschool teacher, I had one girl in particular who’s tongue tie was so bad and her parents refused to treat it that she had a huge fork in the tip of her tongue and couldn’t pronounce ANYTHING. She could only make garbled noises; It was very severe. And that’s what stuck in my head when I thought about tongue ties.
But here’s what I’ve since learned – there are FOUR classes of tongue tie and being tied at or near the tip of the tongue is only 2 of them. The majority of doctors and pediatricians are not properly trained on the subject, if they’re even taught about them at all, and if they know anything about ties will usually only know about class 1 and class 2. These ties are pretty obvious, if you know what you’re looking for and how to properly examine a baby for ties. A class 3 tongue tie [which both my kids had and I believe I have too] is a tie at the back of the tongue where the frenulum is visible. A class 4 tie is at the back of the tongue where the frenulum is under the skin of the tongue and not visible. EDIT: Check out my most recent post on ties – Visual Indicators of Tongue and Lip Ties to see an extensive list of visual clues and photographs to help you better understand what you’re looking at in your child’s mouth!
Here is a visual for each type of tie:
Why Does it Matter?
If my child can move their tongue around surely it’s not that big of a deal, right? Wrong.
If your child is tied, it can be a very big deal. The problem is that you can have 10 kids that are tongue tied and they can each be having different symptoms or combinations of symptoms. Even children that have the same “class” of tie can compensate for them differently. Emery and Cooper have the exact same ties – Emery refused to nurse but could chew and swallow any solid foods efficiently. Cooper was a nursing champ but couldn’t chew and swallow most solids to save his life.
I’m not going to get into how ties affect nursing. If you want to read Cooper’s Lip Tie story and how it effected nursing, you can find it HERE. There are tons of amazing articles I’m linking to below that cover how ties effect nursing wonderfully – there’s no need for me to rewrite the same thing. It’s sufficient for me to say that if you’re dealing with one or more of the following you could benefit greatly from reading the links below:
- Thrush for mom or baby
- Falling asleep while nursing
- Pain while nursing
- Frequent feedings
- Baby falls off the breast while nursing
- Baby is gassy, colicky, and/or spits up
- Has shallow latch
- Clicking sound when nursing
- Inability to drain you of milk/breasts still feel full after nursing
- Early weaning
- Easily distracted while nursing
- Waking frequently at night to nurse
- Low milk supply
- Over active let down
- Excessive milk supply
- Lip blisters
- Cupping of the tongue when crying
- And/or cracked/blistered/bleeding nipples
If one or more of these apply to you, please check out the following links:
- A Step-By-Step Guide To Diagnosing Tongue/Lip Ties
- The Myths about Painful Breastfeeding
- Weight Gain is not the only Marker of Successful Breastfeeding
- A Breastfeeding Mom’s Symptoms Are as Important as the Baby’s
- How Tongue Tie Affects Breastfeeding Mechanics
- The Evidence Supports Treating Tongue Tie for Breastfeeding Problems
- Breastfeeding Problems Can Affect the Emotional Health of Mom and Baby
But let’s say you’re past that stage.
Maybe you gave up nursing and bottle fed, thinking you had a supply problem or baby was just too distracted to nurse. Or maybe nursing went completely fine but all the sudden you’re faced with problems now that you’re trying to feed your little one solids. Maybe everyone around you is telling you it’s normal and they’ll just grow out of it. Or they’re telling you that kids are just picky, keep on trying mama! Sometimes I wonder if what well-meaning friends and even doctors label as normal is just a massive oversight of a widespread problem that needs addressing.
Let me explain.
Let’s address each symptom one by one:
DOES YOUR CHILD GAG AND CHOKE ON FOOD OFTEN?
When the frenulum is causing restriction, your child doesn’t have the ability to properly move their tongue to safely swallow certain foods. They frequently, if not always, gag and choke as the food moves back into their throat, past the point of what their tongue can control. No matter which “class” of tie your child has, a tie restricts the ability for the tongue to properly move UP. [I often have moms tell me, “My child can stick their tongue out so they’re definitely not tied.” Many tongue tied children can move their tongues out, it’s moving it up that’s the problem. For class 1 and 2 ties, the whole tongue can’t fully move up. For class 3 and 4, it’s just the back of the tongue that can’t move up, making it less obvious that there’s a problem.]
So try this out for me – go get a bite of food. Chew it up and try to swallow it WITHOUT lifting the back of your tongue up. Can you do it without choking? I can’t! I can’t really swallow, period.
Also important to note – the severity of the restriction or the way your child is compensating for their tie will enable them to swallow some types of foods and not others, depending on the consistency, leading some parents and doctors to blame their behavior on pickiness, not chewing their food well enough, or having a strong gag reflex.
DOES YOUR CHILD CHEW AND SPIT FOOD OUT?
I think this is the least common one I’ve come across, but it’s the one we happened to deal with. When introducing foods to Cooper, we initially used an approach called Baby Led Weaning but he quickly learned that he couldn’t swallow solids without choking [see previous section for more info.] The baffling part for me was that he wanted food SO BAD. He would scream at me until I would give him whatever I was eating – he wanted to eat anything and everything but he would never swallow. It seemed like the biggest waste of food – he would put it in his mouth, chew a few times, and spit it out. Put it in his mouth, chew a few times, and spit it out. Watermelon was his favorite food because he could get so much juice out of it without swallowing the solid pieces. Meal time was so, so messy! Once I discovered he was tongue tied, I realized this was a defense mechanism. He knew it wasn’t safe for him to swallow, no matter how much he loved what he was chewing.
DOES YOUR CHILD POCKET FOOD IN THEIR CHEEKS AND BEHIND THEIR LIPS?
Cooper did this as well, but not as often. The reasoning behind it is the same as above – they know they can’t safely swallow so they store it in their cheeks. Some kids also have a hard time moving their tongue forward to spit the food out and resort to this. Cooper will actually still pocket food occasionally if he needs CST/body work done and is out of line.
DO THEY PREFER PUREES OR VERY SOFT COOKED FOOD? DO YOU HAVE A DIFFICULT TIME GETTING THEM TO EAT CERTAIN TEXTURES/CONSISTENCIES?
Like I said earlier, every kid compensates for their ties differently. While some kids may not be able to swallow anything without difficulty, some children only struggle with certain things. Cooper could handle smoothies, purees, root veggies [peeled and boiled for a minimum of 20 minutes], and, surprisingly, meat. Some kids only eat yogurt and applesauce. Going back to the first symptom section, if you were to try to swallow foods without lifting the back of your tongue while swallowing, certain textures and consistencies are naturally going to be able to go down the throat easier than others.
This will often be misunderstood as pickiness or a sensory processing disorder.
DO THEY HAVE AN AVERSION TO SOLIDS/EATING IN GENERAL?
It’s common for a child who has choked or gagged on food to have an aversion to eating that particular food, other foods of similar consistency, or even all foods. They often remember what they ate and how it made them feel and have no desire to feel that way again.
This is often mistaken for pickiness, small appetite, or being too distracted/ too busy with other things to want to eat.
DOES YOUR CHILD ONLY EAT SMALL AMOUNTS OF FOOD AT A TIME BEFORE WANTING TO BE DONE/EAT SMALL AMOUNTS FREQUENTLY?
Another aspect of tongue ties is the strain it puts on the jaw, neck, head, and shoulders. The tie not only keeps the tongue down, but it also pulls the jaw into a position that prevents you from being able to relax it properly, causing frequent tension and jaw fatigue. Tongue tie symptoms in adults revolve around this – TMJ, frequent headaches/migraines, jaw tension, neck tension, jaw clenching, sleep apneas, etc.
But for children, this is manifest by:
- Eating small portions
- Eating more frequently
- Having a difficult time chewing harder foods [that require chewing for longer periods] like raw carrots or large pieces of tough meat
- And/or swallowing bites before they’re well chewed [which also often leads to choking].
I vividly remember, as a kid, wanting to be done with my meals before I was full because my jaw HURT. It felt tight and uncomfortable and I often stopped eating when I wanted to eat more, just because I didn’t like how I felt. I would still be sitting at the table long after my parents were done because I didn’t want to keep chewing. Or I would, and still do, swallow my food after only chewing a few times, to enable myself to be able to eat until I was full without my jaw getting sore. I’ve created many stomach aches this way!
This cluster of symptoms can often be blamed on a small appetite, the parent’s lack of discipline in forcing their children to finish their plate, the parent’s being too lax about snacks between meals which causes them to not be hungry enough for meal time.
ARE THEY DROPPING ON THE WEIGHT CHARTS OR FAILURE TO THRIVE?
This is not an uncommon result of tongue tie in babies and children – if your child is tied and unable to eat properly they likely aren’t getting the nutrients they need, especially if they’re no longer nursing and over the age of 1. However, not all children fall into this category.
My Child Deals with One or More of These Issues,
What Do I Do Now?
First, take a peek for yourself, just to get an idea of what’s going on. Here’s a link on How to Examine a Baby for Tongue or Lip Tie and this link will give you a visual and description on what you’re looking for. I recommend doing this with someone there to help you. We got by a window for good sun light and Andrew snapped pictures so we could examine the photos afterward [it’s almost impossible to get a good look easily, so we knew we would only have a few quick seconds.] I layed cooper down on the floor with his head at my crotch, between my legs, and his feet toward my feet. I pinned his arms under each of my legs to keep him still, and pried my fingers under, according to the instructions in the link above.
Second, find the preferred provider [tongue and lip tie experts] closest to you. It’s important to understand the risk of going to just any doctor, pediatrician, dentist, or ENT. The majority of professionals have not been trained on ties. Many parents see “expert” after “expert” after “expert” and never get the help they need. They will either say:
- The child is not tied
- The child is tied but it’s not that bad
- The child is tied but it’s not the cause of the problems
- The child is tied and they can fix it, but they don’t understand how to do a complete release and the problem isn’t solved
- The child is tied and they can fix it, but they completely botch it. [I’ve seen photos of a lip tie lasering where the professional lasered into the lip above the tie and didn’t even touch the actual tie.]
- The child is tied, they can fix it and do a quality job, but they don’t teach you about after care, which can result in reattachment or not enabling the tongue to fully function even if there is some improvement.
Many patients who do not see a preferred provider the first time often go through the procedures a second time after later seeking out a preferred provider to get proper care. This not only causes unnecessary pain for the child but unnecessarily wastes several hundred dollars that only needed to be spent once to get the procedure done correctly.
I also found the following links very helpful:
- How to Choose Your Provider: Does Laser vs Scissors Matter?
- Before, During and After Your Procedure – Patient Care Information
- It Takes a Team to Improve Breastfeeding After a Tongue Tie Procedure
- Pain Relief After Tongue and Lip Tie Procedure
Also, this facebook group was very helpful to me to ask questions of other moms and professionals. There’s a “Files” tab with additional helpful information!
Please know this post is not an exhaustive collection of information regarding ties. I wish I could fit it all in but I worry I would overwhelm people! [That, and I don’t know allllll the things!] If you want me to elaborate on something or have a question I didn’t address, please please please post it in the comments, ask me through instagram, or contact me through here.
It is my hope that this will be eye opening to even just one mom. I cannot convey to you the depth of my shock and relief when I realized many problems we’d encountered were due to overlooked/misdiagnosed lip and tongue ties. I’ve turned into that annoying mom that tells every person who hints at a symptom that their child could be tied. And I honestly don’t care if everyone thinks I’m crazy – if just one mom experiences the victory this information brought to our lives, I will be elated. Being a parent is hard enough without the stress of overlooked and misdiagnosed problems.
If you know of anyone who could benefit from this post, please share. If you have any additional questions or would like something clarified, please ask. I want you to get the answers you need so you and your family can thrive!
To read more of my posts on ties, click on the links below:
- How Cooper’s Lip Tie almost ruined our nursing relationship
- Visual Indicators of Tongue and Lip Ties