Baby’s Tongue and Overall Well Being
Hooray! After 9 months of pregnancy and the birth of your new little one(s) things are just as they should be. After a few days of breastfeeding, you notice your nipples are compressed or lipstick shaped and you are in pain, it’s time to have things checked out.
As a 16-year International Board Certified Lactation Consultant (IBCLC), the most common reason for consult requests, is poor latching and painful nipples. Lactation Consultants are experts in helping you find the right position for that optimal latch without pain to get you back on track. When our tips and tricks aren’t working, it is our role to investigate further. Our certifying organization IBCLE, requires that we meet clinical competencies, one of which includes, assessing oral anatomy, neurological responses, and reflexes of the infant. IBCLCs have multiple assessment tools at our disposal to help sleuth what might be happening and refer to the appropriate skilled health care provider. We do not diagnose, we assess and refer.
Challenges to Breastfeeding
Compensations for poor tongue mobility can lead to severe nipple pain, discouraging mothers from breastfeeding. Symptoms like soreness, cracking, and bleeding can be so painful that breastfeeding can feel impossible. An alarming number of mothers stop breastfeeding altogether due to the pain and frustration.
You may have heard of the term “tongue tie”. The medical term is ankyloglossia, and it is a condition in which the frenulum (a fold of mucus membrane located under the center portion of your tongue) can be abnormally short or tight affecting mobility. This may sound like a small thing, but can cause a cascade of events.
When the tongue doesn’t function well, it can impact your baby’s ability to eat, breathe, sleep, and digest well. This can lead to frustration for both Mama and Baby, sometimes to the point of giving up on breastfeeding altogether. A skilled expert that knows how to assess is invaluable when making decisions about your baby’s health.
Signs to look out for:
Nipple pain that doesn’t improve with expert help
Difficulty latching
Poor milk transfer with breastfeeding
Newborn difficulty gaining weight in early weeks
Other symptoms seen in babies and children:
Poor Digestion
Restless Sleep
Obstructed Airways
Oral Health Issues
Speech impediments later in life
Difficulty Breathing
Tongue movement is essential for efficient breathing. When a tongue is tied, it obstructs the airway, making breathing more difficult- especially during sleep. Some babies compensate by breathing through their mouths, leading to dry mouth.
This study on adults with OSA showed that releasing tongue ties significantly improved their symptoms, suggesting that a procedure could reduce tongue collapse and allow for better breathing.
Poor Digestion
How the tongue moves during feeding and swallowing can also affect the GI system.
Spitting up, though common in babies, can be exacerbated with a tongue tie
Tongue ties can be associated with gastrointestinal reflux (GERD) symptoms
Restless Sleep
When a tongue’s mobility is limited, airways can become obstructed, leading to mouth breathing but also restless sleep and snoring. Mouth breathing might not seem like a big deal, but it can become an issue as an adult.
Speech Impediments
When a child is learning to speak, a restricted anterior tongue tie can prevent them from making sounds that require the tongue to reach the roof of the mouth or extend past the teeth. For example, sounds like “t,” “d,” “n,” “l,” and “th” are especially difficult or even impossible.
Postural issues
Babies with compensations to breathe, eat, and sleep can lead to tension and imbalances in the neck, jaw, and shoulders due to the fascial system in the body.
As the baby grows and movement patterns develop, they may start to present a head-forward posture. This is a postural alignment in which the head juts forward of the shoulders, putting strain on the neck and upper back. Initially, it may be uncomfortable but over time it can lead to musculoskeletal issues that will be harder to address in the future. Head-forward posture is often associated with inefficient breathing and can even exacerbate it.
What do I do next?
If you suspect your baby has a tongue tie and it is affecting your breastfeeding relationship, talk to a skilled lactation consultant. An IBCLC, is equipped to assess your feeding challenges and help you decide if further intervention is needed. When appropriate and desired, I will provide you with a referral to a recommended health care provider or pediatric dentist well experienced with newborn oral ties.
Current options, are a procedure that surgically releases the frenulum, either with scissor or laser procedure, or no release of the frenulum. Babies who undergo a frenotomy, frenectomy, or frenulectomy, may have improved mobility of their tongue. The procedure requires following up with specific oral exercises that are done 3-5 times a day for the tongue to heal properly and get reacquainted with the functions of the mouth. Working with a trained IBCLC is invaluable during this time.
Craniosacral therapy is another treatment option that benefits oral tissue and other restrictions in the body. This is a subtle, hands-on manual therapy that releases restrictions in the body. Because it is gentle and non-invasive, it can be beneficial on its own or before and after a tongue tie release.
To book a consult with me, click here. https://milklove.org/request-consultation
Resources:
https://www.ejpd.eu/pdf/EJPD_2020_21_04_10.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821269/
https://www.tonguetieinstitute.com/seminars/watch-movie-online-trolls-2016-subtitle-english/
https://iblce.org/wp-content/uploads/2018/12/clinical-competencies-2018.pdf