Tongue Tie (2023)
There are often visual signs of compensation or oral motor dysfunction in babies. In this new series of posts, I explain some of the visual signs that may indicate compensation or less effective movement patterns which can affect the quality of feeds. Many of these signs are indicators of a potential tongue or lip tie. If you have concerns that your baby has a tongue tie, the first step is to get a functional assessment done by an occupational therapist, speech therapist, physical therapist or IBCLC that specializes in infant oral function.
The tongue helps form the shape of the palate. When a tongue's movement is restricted from a tongue tie, it cannot reach the roof of the mouth. The absence of pressure from the tongue causes the palate to form in a bubble shape. You may notice that your baby sleeps with their mouth open or that their palate seems to dip in the front or the back. It could also be dome shaped. When this happens the the maxilla takes space from the nasal sinus which affects respiration. When space is taken from the nasal sinus this can affect your babies future ability to breath properly. Due to the limited space in the sinus, there is increased risk for future sleep apnea.
A high arched palate can cause also painful breastfeeds because the nipple now has to stretch further into the mouth to be correctly positioned. Improved positioning and a good latch can minimize painful feeds.
If you suspect your baby has a high arched palate, reach out to a skilled lactation consultant or therapist that specializes in lactation. If you are local to the Charleston area, I offer free consult calls to discuss your concerns.
Cobblestone blisters are also known as cobblestone blisters or sucking blisters. They can develop as a compensation because of restrictions in the lip or tongue. Babies who are over using their lips like this are using compensatory movement that is often not as effective for milk transfer. Feeds may take longer or baby may fatigue quickly.
When a baby has a tight restricted lingual frenulum, they might have an indentation in their tongue when they stick it out. We call this a heart shaped tongue.
Other signs of tongue tie
Babies with tethered oral tissues have restricted tongue or lip movement. You might notice clicking during feeds or that the latch is painful or has a chompy quality. It may be difficult to get a deep latch. Your baby may pop on and off the breast frequently or fall asleep quickly due to fatigue. Nipples may look like lipstick after feeds or you could have nipple damage. Gassiness and reflux are common because babies take in more air from not being able to sustain their latch. Feeding may take a long time and not just with breastfeeding but also with bottle feeding. A baby with tongue-tie may have a stronger-than-average gag reflex. Your baby might have slow weight gain too. Babies with oral ties often have difficulty sufficiently draining the breast. This can ultimately cause low supply because milk production is a supply and demand type relationship. Getting support to protect your milk supply is important if you suspect your baby has a tongue-tie.
If you suspect your baby has oral motor dysfunction or a tongue tie, reach out to a skilled lactation consultant or therapist that specializes in lactation. It's important to get help early and often, especially if breastfeeding is painful. Mothers who report having painful feeds are at a higher risk of weaning before they would have liked to.
As an occupational therapist and a lactation counselor trained in ties, I can help breastfeeding dyads who are having difficult feeds or have oral-ties. Many babies need a combination of skills to get improvement whether they decide to get a release or not. This might mean help with breast or bottle feeding, oral motor treatment, strengthening, or craniosacral therapy for tension. I offer comprehensive feeding and development services to address a broad range of infant needs. If you need help through this process I'm here for you. If you are local to the Charleston area, I offer free consult calls to discuss your concerns.
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