TONGUE TIE: What and Why?

If your infant is having any kind of feeding difficulty, the first line of free-advice-giving typically lands on "Do they have a tongue tie?!" followed by the advice-giver poking around in the baby's mouth and then saying something like, "Ah! See it! Right there! In the front!" and then the baby makes a big gag and their jaw opens wide and the tongue comes all the way out as they gag, and the person says, "Well, they can stick their tongue out of their mouth so it is probably not that...."

WHAT IS IT: The piece of tissue that runs under the tongue and connects to the underside of the tongue, sometimes running all the way up to the tip of the tongue, is often called a tongue tie. But it is actually just a piece of connective tissue. There are lots of them in an infant's mouth: under the upper lip, under the lower lip, to the sides under the nasolabial line, along the gums and cheeks. Those pieces of tissue are part of typical embryonic development. I think of it like the package shipping material, keeping everything in place. As the fetus-infant grows older (more mature) and as the oral muscles are used more, those anchors/tethers winnow away.

FUN FACT: A full-term, 40-week gestation infant swallows around 500-700 mL of amniotic fluid a day, and a full-term infant will consume about 500-700 mL of breastmilk/formula fluid in a day. (Thank you, Heidi Schaffer and Dr. Google) Pretty cool to think that biology has been prepping the baby to be ready for the needs of the extrauterine world.

Okay, Rae, you may be saying, if a baby has been working on the skill to be ready to eat, why are there so many more of them being diagnosed?

First, we have more eyes on a baby; there is more general awareness of ties, so more are being identified. We have more information, more access to care, more disposable income, more entrepreneurship, and more marketing.

SECOND: Mommas don't move around as much as they used to. When babies were first invented a long, long, long, long, long time ago, early mommas were moving endlessly. All-day-every-day to survive. (Wait! Don't throw your phone! I know you are very busy and running around all the time! I get it! And I am definitely NOT SAYING pregnant moms need to exercise more! Insert picture of an annoying smiley person on a treadmill holding a thumbs up at 8 months pregnant.)

What I am saying is, back in the day, like the dawn-of-human-kind-day, life was veeeeeerrrrryyyy different than the post-industrial revolution plus another 350 years. There is no way to replicate that type of lifestyle. There is just NOT. External life, our society, and its task demands have changed; the internal life of the baby's biology has not. And there are consequences.

Positive consequences: Infant and maternal mortality are WAAAYYY down

Negative consequences: Persistent oral tissues that can restrict oral motor movement

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