Upper Lip Tie and Feeding Challenges
(article by ASHA)
How might an upper lip-tie impact the developmental process of feeding?
Breast Feeding– Inadequate latch:
An infant must flange the lips to create enough suction and adequate seal around the tissue that includes the areola and not just the nipple. It is essential that babies take in enough breast tissue to activate the suckling reflex, stimulating both the touch receptors in the lips and in the posterior oral cavity in order to extract enough milk without fatiguing.
Bottle Feeding – Inadequate Seal:
Because bottles and nipple shapes are interchangeable and adaptations can be made, it’s possible to compensate for poor lip seal. However, these compensatory strategies are often introduced because all attempts at breastfeeding became too painful, too frustrating or result in poor weight gain…and the culprit all along was the upper lip-tie. It is then assumed that the baby can only bottle feed.
- Inability to clean the spoon with the top lip
- Inadequate caloric intake due to inefficiency and fatigue
- Tactile oral sensitivity secondary to limited stimulation of gum tissue hidden beneath the tie
- Lip restriction may influence swallowing patterns and cause compensatory motor movements which may lead to additional complications
- Inability to manipulate food with top lip for biting, chewing and swallowing
- Possible development of picky, hesitant or selective eating because eating certain foods are challenging
- Lip restriction may influence swallowing patterns and using compensatory strategies (e.g. sucking in the cheeks to propel food posteriorly to be swallowed) which may lead to additional complications
Oral Hygiene & Dental Issues
- Early dental decay on upper teeth where milk residue and food is often trapped
- Significant gap between front teeth
- Periodontal disease in adulthood
- Possible changes in dentition with certain compensatory methods to propel bolus posteriorly for swallowing, such as finger sucking.