You are right to suspect that a tongue and lip tie may be responsible for the feeding behaviours you have noticed. As these oral restrictions are present at birth, you may also have experienced challenges with breastfeeding during the newborn period. Nursing difficulties may continue to translate into challenges with solids as you have experienced. However, it is worth noting that there may be many other reasons for the feeding behaviour you have noticed e.g. food aversions.
In order to determine if there are oral restrictions affecting your child, first you have to decide who to consult with. You may wish to speak to your child's paediatrician or look for a paediatric dentist/ ENT/surgeon. While all these paediatric specialists should be able to do the assessments, in my experience, paediatricians are likely to refer you to see a paediatric dentist/ENT/surgeon for the actual treatment.
At the appointment, I would ensure 2 important steps are done during your consultation:
1. Your doctor/dentist looks at the structures: A detailed oral assessment which will include a look into your child's mouth to evaluate the oral structures.
2. Your doctor/dentist assesses function : Not all tongue and lip ties cause issues. Hence diagnosis is only complete with an assessment of your child's current level of oral competence. Just like walking and crawling are motor development milestones your paediatrician looks for, there are similar oral developmental milestones I would look for in our discussion. Nursing history would be one part of our discussion.
How urgent is this assessment?
Although you have not mentioned, it has been my experience that many parents who come to see me are also most concerned about the impact of such oral restrictions on future speech development. I suspect that may be on your mind as well. Thus, it is important that an oral assessment be made to rule out the presence of such restrictive oral ties soon. We do not want oral ties to negatively affect speech development.
Early diagnosis is also advantageous for your child due to the surgical nature of the treatment. While the procedure to loosen the tongue and lip tie is simple (the surgical procedure is commonly known as frenectomy or frenotomy), it does get more complex with age owing to his ability to cooperate. Parents know how difficult it is for a toddler to stay still even for a diaper change. In the same way, it can be challenging to do a surgical procedure safely in toddlers.
Thus, for some children, this procedure has to be conducted in a hospital setting under some level of sedation or general anaesthesia (children are asleep during the treatment). The earlier the treatment can be done, the less likely sedation or general anaesthesia will be required.
Hope this tidbit of information has helped! I certainly hope you will be able to find some answers soon for your son for I know how frustrating it can be when each meal time is a challenge!
