Tongue tie is a popular term for ankyloglossia which means anchored tongue. The anchoring is from a tight frenulum and fascia under the tongue that connects the tongue to the floor of the mouth and this can impact the tongue’s normal function. The frenulum can attach closer to the tip of the tongue or near the bas preventing it from moving normally.

The answer to that is no. You can live your entire life with a tongue-tie. HOWEVER it’s important to understand that the tongue is doing most of the work needed for a baby to remove milk effectively and efficiently from a bottle or breast. When that tongue is not moving properly there are a number of things that happen as a result in addition to all the symptoms mom and baby may have. Babies will either compensate and go onto feed and gain weight, at the expense of compensating with other muscles that are not meant to do the job. They will have tight jaw, tight necks and upper traps, and body wide tension really. That’s why I see babies with so much discomfort and they are not happy. Even when they are happy enough parents notice a huge difference in their body and spirit after having chiropractic care. For some babies they really can’t compensate and they either fall of growth curves, show signs of breast or bottle refusal, and they sort of shut down. A tongue-tie release may be necessary in either of these cases, it depends on a parents goals for their child, how everything else is going, and only with the right preparation and after we’ve ruled out all other causes.

It’s important to remember that unless your pediatrician or primary care doctor has post graduate education in lactation (which most do not) that assessing oral function is far from their specialty. Your family doctor has your best interests at heart, but they are not the right person to be doing oral or feeding assessments on your baby, that’s the job of a lactation consultant, OT, SLP, or lactation savvy PT or chiropractor. If your doctor gave you their opinion about oral restrictions for your baby, but didn’t put their finger in your baby’s mouth or do a suck assessment then you can be confident they educated guidance. Functional assessment is needed to identify a tongue-tie, it is not a visual diagnosis.

There are many ways I can help you and your baby navigate feeding challenges related to tongue-tie. Visits always begin with a thorough history and symptom workup and I help you understand through your story what may be going on. It’s easy to pair together symptoms with different causes. I do an oral motor and visual assessment of your baby and I walk you through every step in the process so you can learn the difference between what’s normal and what may be presenting in your baby. Once we understand where your baby is struggling most, we can then make a plan to support them. I work alongside lactation consultants who can help you with a feeding plan while I provide physical support for your baby who may be compensating creating uncomfortable muscle tension in their jaw, neck, and entire body. I see amazing improvements in feeding and comfort for baby and mom with chiropractic care and professional full body therapy.

For some families I will be the one to identify a tongue-tie and refer them to a lactation consultant and ENT, I will help prepare them and their baby for the procedure to get the best outcome and I work with them on post tongue-tie release therapy. For other families we focus on the most conservative care of bodywork, oral exercises, and eliciting babies reflexes to feed well. IN ALL CASES WE USE CONSERVATIVE CARE AS FIRST LINE OF TREATMENT TO AVOID UNECESSARY SURGERIES.

Colic is really a diagnosis of exclusion, meaning that when we can’t identify a cause we put a blanket label on it. “Colic is a condition in which a healthy infant cries for long periods of time without an obvious cause.” Well I can tell you a few causes for colic, that may not be “obvious” unless you see the right provider. Aerophagia (swallowing air due to a poor latch/seal often from a tongue-tie but sometimes feeding positioning), gas caused from irritants in moms diet, body tension and discomfort, and insufficient feeding will all make your baby incredibly fussy and inconsolable. If you have a fussy baby, why wait to bring them in when there are simple changes that we can make for them that vastly improve their little life.

There are essentially two ways that your baby is going to become gassy. They will either be swallowing air with their food or they will be producing gas as a digestive process based on their mothers diet impacting her breastmilk or depending on a formula’s ingredients. This is why I do an oral function assessment on every baby, I help mom look at positioning during feeding and baby’s feeding biomechanics at the bottle or breast to improve latch and milk transfer without air intake. I also talk to the nursing parent about her diet and digestion. Poor digestion is going to impact the size of proteins that are getting into her milk through her bloodstream, when that’s the case I recommend improving food breakdown and eliminating dietary antigens.

Symptoms include clicking while nursing, lip blisters, a painful latch, leaking milk out of the sides of the mouth, choking or gagging at the bottle or breast, a reduced milk supply, nipple trauma, milk tongue, heart shaped tongue, and poor milk transfer and sometimes slow weight gain. Babies with tongue-tie can present in so many different ways, they may be totally happy but causing a lot of nipple damage, or they may be inconsolable, fussy, and very challenging to feed. How they present will be largely influenced by how they are fed and milk supply if breastfed.

There is no question that weight gain is an important metric for assessing pediatric health, but it one of the lesser considerations when it comes to oral restrictions. That’s because a baby can be gaining weight well due to the moms milk supply and production despite a baby not being able to functionally nurse well. Often you’ll see an increase in symptoms after the milk supply has shifted from being hormonal driven to supply and demand.