You actually have a photo of some babies who have an upper lip size so this probably better explains where you’re discussing right correct yeah so the upper lip in fact look at the picture in the very center do you see there’s like a little bubble on the baby’s lip yeah that’s a blister like from from nursing with your lip color being able right and you see how tight that is you should you know baby without a time you should be able to pull that lip right up over the nose okay and and then also if you look at that Center when you see the tongue is coming up but it’s still held down at the base right and so those tongue ties can be very difficult to diagnose just by looking at them right some of them are way back deep at the base of the tongue and unless you know what symptoms to look for you might say oh well looks okay to me so in that case what symptoms are you looking at I’m looking at inability to latch I’m looking at mouth breathing no baby should breathe through its mouth these babies often hate lying on their backs okay because they can’t keep their tongue out of their airway they these are some symptoms that are typically listed difficulty lifting the tongue sometimes just the front of the tongue will lift up the trouble sticking out of the tongue is is a symptom that’s frequently listed but some babies with tongue ties literally have a tongue thrust because the only direction they can move their tongue in is forward but what you really need for nursing is up against the roof of the mouth why not just forward and so once we release that type frenum the baby might take awhile to learn that thrusting isn’t what we want the tongue to do we want it to go up but they’re very clever they learn really finessed jennifer let me ask you do you see this often with maybe some infants or even we’re gonna discuss toddlers that have difficulty and and because of this tongue type we actually do see a lot of babies come into the hospital with what dr. holler is as mentioned we see a significant population with gastro esophageal reflux disease accord they do a lot of choking they do a lot of aspirating they do a lot of spitting up or vomiting we see a big population of small babies who come in with some respiratory distress that maybe is not infectious and we really haven’t been able to diagnose what’s been going on right but they do come in with these symptoms and these complaints where maybe the tongue-tie hasn’t been addressed you