Tongue Ties and Lip Ties – When Should You Worry and Who Should You Consult?

Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue's range of motion.
With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth, so it may interfere with breast-feeding. Someone who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows
Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction. The gold standard procedure (frenotomy or frenulectomy) uses a spatula device to lift the tongue and simple scissors to cut the thin webbing underneath. This can be done by pediatricians in the birth hospital or office, and causes minimal pain or bleeding. Some dentists offer laser surgery at very high prices to remove the webbing. We have seen babies in severe pain after this procedure sometimes resulting in oral aversion (refusing to eat).
Signs and symptoms of tongue-tie include:

Difficulty lifting the tongue to the upper teeth or moving the tongue from side to side
Trouble sticking out the tongue past the lower front teeth
A tongue that appears notched or heart shaped when stuck out
Breast-feeding problems. Breast-feeding requires a baby to keep his or her tongue over the lower gum while sucking. If unable to move the tongue or keep it in the right position, the baby might chew instead of suck on the nipple. This can cause significant nipple pain and interfere with a baby's ability to get breast milk. Ultimately, poor breast-feeding can lead to inadequate nutrition and failure to thrive. Frenotomy or frenulectomy alone are not always sufficient to resolve the latch issues and mothers should continue to work with lactation consultants to maximize comfort and milk transfer.
Speech difficulties. Tongue-tie can interfere with the ability to make certain sounds — such as "t," "d," "z," "s," "th," "r" and "l."
Poor oral hygiene. For an older child or adult, tongue-tie can make it difficult to sweep food debris from the teeth. This can contribute to tooth decay and inflammation of the gums (gingivitis). Tongue-tie can also lead to the formation of a gap or space between the two bottom front teeth.
Challenges with other oral activities. Tongue-tie can interfere with activities such as licking an ice cream cone, licking the lips, kissing or playing a wind instrument.

A word about lip frenulums and lip tie. Many babies are born with a prominent upper frenulum that appears to cause a gap in their teeth once the teeth come in. There is rarely a reason to cut or laser this normal and common tissue. Studies are very mixed as to the benefits of surgery on this tissue. There are studies that demonstrate cutting heals better than laser surgery. If you think your baby has a restrictive upper frenlum, please give us a call. We will exam your child and then we may refer you to a breastfeeding specialist or ear, nose, and throat doctor. But more often than not we recommend observation.

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February 26 Community Courier

March 7, 2026

Dr. Cindy Spicker is Retiring

March 7, 2026

After 35 years of holding tiny babies, reassuring new parents, and watching generations of children grow, I am stepping away from my pediatric career with a full heart. After much reflection, I will be retiring on July 1, 2026. Being a pediatrician is a calling like no other. To play even a small role in shaping our future has been the honor of a lifetime. I have been especially fortunate to spend most of my career at Pediatric Associates of NKy. Throughout my 31 years here, I have had the privilege of working alongside many intelligent, compassionate and deeply dedicated colleagues. Our office truly feels like a family. We celebrate milestones together, support one another through challenges, and share a common purpose: providing the best possible care for our patients and their families One of the greatest joys of pediatrics is the continuity—caring for patients as they grow from newborns into confident young adults. There is something profoundly special about watching a child you once held in your arms return years later as a parent, trusting you to care for their own newborn. Moments like these are gentle reminders of the deep relationships and lasting connections that make this profession so meaningful. In addition to providing direct patient care, it has been a privilege to help train future medical providers by mentoring young adults early in their journeys. Seeing them grow into compassionate professionals has been incredibly rewarding. I am deeply thankful for my husband and our three children, who supported me unconditionally throughout the years, even when the demands of my work meant time away from home. Their love, patience, and encouragement made this journey possible. As I close this chapter, I do so with immense gratitude—for the families who entrusted me with their children’s care, for the colleagues who became lifelong friends and for a career that has given me more joy and purpose than I ever could have imagined. I will carry your stories and smiles with me always. Fondly, CINDY SPICKER

MYTH OF THE MONTH: "RAW MILK IS BETTER THAN PASTEURIZED MILK"

March 7, 2026

Raw (unpasteurized) milk is sometimes marketed as a more “natural” or more nutritious alternative to pasteurized milk. But the idea that raw milk is healthier doesn’t hold up well when you look at safety and nutrition evidence. What pasteurization means: Pasteurization is a process in which milk is heated to a specific temperature for a specific amount of time and then rapidly cooled in order to kill harmful bacteria and reduce the risk of foodborne illness. Raw (unpasteurized) milk can carry dangerous bacteria. Because it has not been treated to kill harmful microbes, raw milk can lead to infections from Campylobacter, Brucella, Listeria monocytogenes, Salmonella, and E. coli. These infections can be serious even in otherwise healthy people, and raw milk exposure can be particularly harmful to children. Certain types of E. coli can cause life‑threatening kidney disease in children. Even healthy older children can develop severe diarrhea and dehydration from these bacterial infections. Some of these bacteria are especially dangerous during pregnancy. For example, infections such as Listeria monocytogenes can be passed from a pregnant person to the unborn infant and may result in birth defects, miscarriage, stillbirth, or serious infection in the newborn. Key nutrients are mostly unchanged: A common claim is that pasteurization “destroys” the nutritional value of milk. However, multiple studies have shown that pasteurized milk contains essentially equivalent nutrients compared with unpasteurized (raw) milk products. In other words, pasteurization makes milk safer without meaningfully reducing its core nutritional benefits. The nutrients children commonly rely on milk for remain largely intact after pasteurization: -Minerals such as calcium and phosphorus are unchanged, and these are among the most important nutrients milk provides for growing children. -There may be some deactivation (denaturation) of proteins, but the overall difference is small and does not meaningfully reduce milk’s protein value in the diet. -A few vitamins—especially vitamin C and some B vitamins, may decrease somewhat. However, milk is not a primary source of vitamin C or many B vitamins in most diets, so these small reductions generally have little nutritional impact. Risk vs. Benefits: In summary, the potential risk of infection from bacteria in raw or unpasteurized milk outweighs any claimed benefits, and we recommend against the consumption of raw milk.