Recognizing and Treating Tongue-Tie: What Every Parent Should Know

Every year, many babies are born with tongue and lip ties. Early diagnosis and treatment is recommended for young children to support optimal growth and function while helping to avoid long-term side effects.

Seeking chiropractic care can be an important part of care and rehab following tongue tie and lip tie revisions, helping to ensure proper alignment and function of the tongue, mouth, head, neck, and the rest of the Deep Front Line (DFL) anatomy train which includes the diaphragm, spinal stabilizing muscles, hips flexors, and intrinsic knee and foot muscles!

What is a tongue or lip tie?

Tongue tie (or ankyloglossia) is an unusually short, thick, or tight frenulum (the band of tissue that connects the bottom of the tongue to the floor of the mouth). For many instances of tongue tie, a lip tie is also present. Similarly, to tongue tie, a lip tie is when the band of tissue that connects the upper lip to the gums is too tight, short, or thick. Ties are congenital issues. When an embryo is growing in the womb, the tongue and the floor of the mouth fuse together. Over time, the tongue separates from the floor of the mouth. Eventually, only a thin cord of tissue, the frenulum, connects the bottom of the tongue to the mouth floor. As an infant grows, the frenulum usually thins and shrinks. In children who are affected by a tongue tie, the frenulum remains thick or attached to the tongue tip and does not recede, which makes it difficult to move the tongue.

What are the signs and symptoms of a tongue or lip tie?

There are several signs and symptoms for babies with ties.

Signs and symptoms commonly seen in tongue tied infants include, but are not limited to:

·        Clicking while nursing

·        Colic

·        Difficulty nursing (including not able to finish sessions)

·        Excessive drooling

·        Excessive spitting up

·        Fussiness

·        Gagging

·        Gassiness

·        Hiccups

·        Milk blisters

·        Mucous in stool

·        Poor latch or suction

·        Reflux

·        Restricted tongue movement

·        Sleeping with mouth open

·        Slow weight gain

·        Stiffness or back arching

·        Torticollis

·        Uncomfortable or fussy when in a car seat

·        Weight loss

Note: these signs/symptoms may also be associated with other issues or dysfunctions. Consult your healthcare provider if your baby is experiencing any of the issues listed.

Signs and symptoms commonly seen in mamas of tongue-tied babies include, but are not limited to:

·        Bruising on or around nipple

·        Breasts frequently not feeling emptied after nursing sessions

·        Clogged ducts

·        Engorgement

·        Flattened or creased nipple after nursing session

·        Mastitis or inflammation of breasts

·        Overactive or delayed milk ejection

·        Pain (during or after nursing)

·        Supply issues

·        Uncomfortable or unnatural feeding positions

Why do babies need to be evaluated and diagnosed for ties?

If you think your child may have a tongue and/or lip tie, they should be evaluated, diagnosed, and given care as soon as possible. There are several pediatric specialists who can evaluate and diagnose ties including lactation consultants, pediatric dentists, chiropractors, ear/nose/throat (ENT) specialists, pediatricians, physical therapists, and occupational therapists. Tongue and lip ties can affect an infant’s ability to properly nurse/feed, swallow, breath, and even self-soothe. If the tongue cannot move in a full and functional range of motion, it is unable to properly shape the hard palate (roof of the mouth) which also plays a critical role in normal feeding, movements, and overall growth and development. Unaddressed ties may even have long-lasting affects including speech delays or impediments, challenges with normal movement or functional development, vagus nerve interference, behavioral issues, head and neck tension, headaches, TMJ dysfunction, crowding of teeth, and sleep disorders.

How is it treated?

Once a tongue tie has been properly diagnosed, often the next step recommended is to have it revised (or “clipped”). The procedure is typically very quick and minimally invasive.  Modern techniques with laser revisions are quick, effective, and often babies sleep through the procedure! Babies usually can nurse immediately following the correction. Your baby’s revision specialist will typically recommend follow up care including consulting a chiropractor or craniosacral therapist along with home care to help with the healing.

Follow-up care: Chiropractic Care and Craniosacral Therapy

Following the revision, it is beneficial to consult a chiropractor and/or craniosacral therapist (or ideally both!). These practitioners help ensure proper alignment and function of the surrounding areas as well as teach you stretches and retraining exercises, so full functionality is returned as soon as possible. It is also beneficial to schedule an appointment with a lactation consultant to ensure there are no other challenges interfering with optimal nursing.

Many may not think of utilizing chiropractic care for tongue tie treatments and post revision care. Everything in the body is connected; when restriction is present due to a tethered tongue, it often leads to restriction and tension of the surrounding muscles and fascia of the Deep Front Line (DFL). This may result in abnormal movement and positioning of spinal segments, affecting the nervous system and other motor patterns or functional development. Checking and maintaining proper movement and function of the spine and related soft tissue may result in faster healing and more optimal functionality not only of the tongue and the surrounding muscles, but the entire body as well.

Craniosacral therapy may help reduce stress and tension in the body and remove interferences to the cranial bones and nerves caused or related to tongue tie. The restriction not only affects the tongue but can also limit motion of the cranial bones which can affect proper shaping of the head, including molding the hard palate. When the cranial bones are unable to move optimally, flattening of the skull can occur.

We can help!

At Cleveland Chiropractic, our chiropractors are trained to recognize the signs and symptoms of tongue and lip ties, collaborate with lactation consultants and specialists to diagnose and revise the ties, and help support a child’s healing and function through specific adjustments and craniosacral therapy. If you have any questions about how we may help your baby, call our office or schedule a consultation. 

In health,

Dr. Abbey