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 15-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 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 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.

Tongue ties range in severity and symptoms. Knowing whether it is an issue that is causing problems or just a normal part of your newborn can be difficult. Some common complaints by parents:

•  Nipple pain that doesn’t improve with 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

• Postural issues

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.

•    Stress and a crying baby during feedings can slow the digestive system down

• Swallowing of air, causes gas, bloating, and discomfort

• Spitting up, though common in babies, can be exacerbated with a tongue tie

•  Tongue ties are 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 is associated with Obstructive Sleep Apnea (OSA). OSA occurs with inefficient breathing and continues later in life if it goes untreated.

 Sleep can also be affected by the need to feed more frequently. If trouble breastfeeding leads to your baby not getting enough milk, they may need to feed more often, causing them to sleep restlessly. 

Speech Impediments

When a child is learning to speak, restricted tongue movement 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.

Some children may be hard to understand, leading to frustration for both the listener and the child who doesn’t feel heard. These impediments can also cause delays in learning to speak as well as social challenges later in life. Children who become frustrated, afraid, or self-conscious about their speaking may avoid socializing or school activities. A referral to a Speech Pathologist is recommended in these cases.

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.

 I offer individualized care and support for you and your baby in both oral assessments and craniosacral therapy!

 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