We now offer Osteopathic Manual Medicine (OMM) services through Dr. Katie Neuer, DO! Check out the Bodywork page for more information.
Signs & Symptoms
The lingual frenulum (tongue tie) is the small band of tissue that connects the underside of the tongue to the floor of the mouth, and the labial frenulum (lip tie) is the tissue that connects the upper lip to the gum-line.
When this tissue is too tight, short, or thick, oral ties restrict movement, affecting breastfeeding mothers, infants, and children in a variety of ways.
Some signs and symptoms of oral ties include:
Breastfeeding mothers - nipple pain, cracked nipples, flattening of nipples, clogged ducts, mastitis, etc.
Infants - poor latch, clicking, leaking, choking/gagging, reflux, gas, long feed times, frustration, poor weight gain, difficult transition to solids, etc.
Older children - speech delay/difficulties, snoring, sleep apnea, teeth grinding, dental plaque, pocketing food, messy eating, long feed times, etc.
If you are considering the possibility of tongue or lip tie in your child who may also have feeding, speech, or sleep problems, you have come to the right place. With proper support and prompt treatment, these problems can be improved over time and positively resolved. From the time you schedule a consultation appointment with a provider to your final follow-up appointment, you and your child will be cared for with the utmost skill and compassion by each of our specialists.
If appropriate for your child, an initial consult with one of our specialist nurse practitioners will be scheduled for assessment of the tie(s). These consults can be booked for any one of our five locations.
Please contact us for more information.
Procedure & Aftercare
On the day of the procedure, Dr. Agarwal will assess your child once again and discuss the procedure and possible complications with you.
The procedure involves little to no pain for the child, and has improved feeding and speech for many children.
A CO2 laser is used to release and cauterize the tissue under the tongue or lip. As the tissue is being released, it is continually checked for any bleeding and appropriate range of motion such as lift and extension.
After the procedure Dr. Agarwal will show you the results. Exercises, wound care, and pain management will be reviewed with you. You will also be seen by a lactation consultant who will assist you with breast or bottlefeeding and will answer any additional questions you may have.
A post-procedure follow-up appointment is scheduled 2 weeks after the procedure to evaluate the healing process and address any issues that have not improved. We also offer a free post-procedure clinic at our Deer Valley and Chandler locations. Please contact us for more information.
The Agave Approach
Holistic Pediatric Lens: Agave Pediatrics, under the direction of Dr. Agarwal, has developed a clinically successful, evidence-based, compassionate, and thorough approach to the treatment of oral ties.
Lip Ties are Different: New evidence on this topic continues to emerge but current research does not support the necessity of performing both tongue and lip tie procedures at the same visit. In fact, many children never undergo release of the upper lip tie because of the improvement noted to feeding or speech after a tongue tie procedure alone.
Multi-disciplinary Approach: Our multi-disciplinary team of MD and DO physicians, lactation consultants, speech pathologists, and nurse practitioners specializes in diagnosing and treating children of varying ages with tongue ties and lip ties not just in Phoenix, but all over the state.
Do No Harm: With this concept as our guiding principle, Agave Pediatrics consistently follows a well-established protocol for the treatment of oral ties.
Education & Research: Our team has been very active & instrumental in disseminating information and educating providers about tongue tie all over the world.
Lactation services are provided at our locations around the valley by our in-house IBCLCs. As soon as you notice breastfeeding difficulties, we recommend making an appointment with one of our IBCLCs.
In the lactation session, the IBCLC explains how to stimulate suckling, adjusts the infant's position and helps with correct latch, teaches parents how to tell the infant is transferring milk, and more.
Bodywork is an important part of the tongue and lip tie program. Torticollis, plagiocephaly, and other musculoskeletal problems can lead to breastfeeding difficulties even in infants without oral ties. Gentle release of muscle tightness and tension through myofunctional therapy, craniosacral therapy, and Osteopathic Manipulative Medicine (OMM) can help treat these problems.
Click learn more to view some of the recent testimonials from satisfied moms, dads, and families. Please feel free to browse through these & numerous other accolades, testimonials, and praise that we have accumulated over more than a decade of tongue and lip tie management that are available on video, our companion site or social media.