Looks Like Infant Acid Reflux: Lip and Tongue Ties
In one of my previous posts "Looks Like Infant Acid Reflux: Pyloric Stenosis" we talked about the condition pyloric stenosis and how it can often be mistaken for acid reflux in infants. There are also additional structural issues that can mimic acid reflux. One such issue is a lip or tongue tie.
Both the lip tie (maxillary lip tie) and tongue tie (ankyloglossia) involve an unusually short band of tissue interfering with proper connection to the inside of the mouth. In the case of the tongue tie the shortened tissue connects the tongue to the floor of the mouth too tightly and prevents proper motion of the tongue. Similarly, the shortened tissue found in the lip tie connects the lip to the gum area too tightly, also restricting proper movement.
For some infants, the tongue or lip tie may be so mild that it does not produce any symptoms, but for others the tie can cause huge issues. When this occurs, some of the symptoms can range from inability to latch, poor weight gain or weight loss, clicking noises while feeding, milk dripping out of the mouth while feeding, swallowing issues and bobbing off and on the breast or bottle while feeding. These issues may be more easily spotted while breastfeeding because it requires more work for the feeding than bottle feedings.
An infant with a serious case of tongue or lip tie can have symptoms that closely mimic acid reflux disease. The poor feedings, lack of proper weight gain, swallowing issues and subsequent pain from swallowing too much air can all look very much like acid reflux. Many parents with tongue or tip tied infants have told me that their initial diagnosis and treatment revolved around acid reflux disease. Only after acid reflux treatment failed was further evaluation done, which was how the lip or tongue tie was found.
Treatment for a tongue or tip tie can be controversial. Some doctors want to fix it right away while others may have a "wait and see" approach. If your baby has gotten to the point where proper feeding is an issue or they are choking constantly then it is likely that the tie needs to be fixed. Some ties can be snipped quickly while more considerable ones may have to be [fixed surgically]. Aftercare may involve some tongue exercises to increase the range of motion and prevent additional scarring.
If your child has acid reflux and the above symptoms you may want to have your pediatrician evaluate for a tongue or lip tie. Parents I have worked with said that the majority of what they thought were acid reflux symptoms resolved after the tie was fixed.
_**Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).