Infant Tongue-Tie

infant tongue-tie

Infant tongue-tie is present when a band of tissue (the lingual frenulum) anchors the tongue to the floor of the mouth, not allowing the tongue to move freely. This tissue should typically fall away between 8-10 weeks in utero, much like the webbing between the fingers and toes falls away before a baby’s birth.

This process doesn’t occur for any number of reasons and may cause issues once the baby is born. It can interfere with normal movement and function of the tongue and is described as a tongue-tie or dysfunctional frenulum

Varying Types of Tongue-Ties

There are different types of tongue-ties.  Where the frenulum is attached close to or at the tongue tip, a notch will be visible on the tip of the tongue, and the tongue will appear heart-shaped or forked. However, where the frenulum is attached further back along the underside of the tongue, it will be less noticeable, although it may be seen if the tongue is lifted, perhaps during crying. 

Some tongue-ties, known as posterior tongue-ties, can be hidden at the base of the tongue, sometimes under the lining of the mouth, and are easily missed at first glance. These ties are pretty easy to identify by pushing a fingertip under the midline of the tongue and pressing against the base of the tongue to see if there is resistance or by sweeping the finger laterally under the tongue, across the base, and feeling for a bump or ‘fence.’

In terms of how tongue-tie affects an infant, the type or appearance doesn’t matter.  It is the level of restriction in tongue movement and function that is important and should form the basis of treatment decisions.

Most babies who have an anterior tie have a posterior component. If they are having difficulty breastfeeding, then both the anterior and posterior components need to be assessed for a possible release.

Signs and Symptoms of Tongue Ties

The cause of tongue-tie is not known, but some studies suggest there may be a genetic link or the use of the improper form of folic acid taken in the mother’s prenatal vitamin. Some of the signs and symptoms of tongue-tie include:

  • Restricted tongue movement – a baby may be unable to poke his tongue out or lick his lips. During crying, the tongue may remain on the floor of the mouth or just the edges may curl up, forming a “dish” shape. 
  • The inability to open the mouth wide when attaching to the breast results in biting/grinding behavior.
  • Unsettled/fussy behavior when latching to the breast and during feeds 
  • Coughing with milk flow 
  • Difficulty staying attached to the breast 
  • Falling asleep at the breast before the end of a feed 
  • Frequent or very long feeds 
  • Excessive early weight loss/ poor weight gain/faltering growth 
  • Clicking noises and/ or dribbling during feeds
  • Reflux (vomiting after feeding)

This is not an exhaustive list. You can find additional information about tongue-tie signs and symptoms here

Management of Tongue-Tie

If your baby displays any of the signs and symptoms listed above, it is important to seek help from someone with expertise in the assessment and management of breastfeeding and feeding issues related to tongue-tie. Know this may not be your pediatrician. 

If your infant needs a release procedure, please be sure you have a fully vetted team for the best results. A specially trained dentist or ENT, a chiropractor who utilizes craniosacral therapy, and a certified lactation consultant for proper feeding support can help moms with proper latch and supply issues. Most babies have been performing a sucking pattern since 20 weeks in utero. So, it takes a while to retrain that neurological pattern.

For a child that is no longer breastfeeding a consultation with a myofunctional therapist may be suggested as well. 

How Chiropractic Care and Craniosacral Therapy Can Help With Tongue-Tie

Most people may opt for a laser procedure from a specially trained dentist or ENT. Whether or not a child goes through a procedure, it is vital to take a whole-body approach to this issue. The lingual frenulum is connected through a network called fascia that runs the length of the entire body. That is why most babies diagnosed with tongue-tie feel stiff and rigid instead of floppy. Several will also have correlating torticollis from increased muscular tension in their body.

That is why these infants need to be evaluated by a chiropractor who has experience in these cases and can utilize craniosacral techniques (CST) to release overall tension throughout the body.

Dr. Lydia has been working with tongue-tie cases for 10+ years, including with her own son. The typical treatment plan for these infants is five to eight visits, one to two before release, and four to six post-release. 

We want you to have the best outcome with these procedures, so let us know how Vaida Wellness can help if your infant has been diagnosed with tongue-tie.

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