Breastfeeding and Tongue Function

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TOTs (tethered oral tissues) Tongue / Lip and Buccal Ties
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Breastfeeding efficiently and effectively is vital and important fir all babies and moms.  Sore, painful nipples, difficulty with latch and frustration with breastfeeding can all lead to problems down the road.  Soft tissue bodywork / manual therapy helps with these problems. 

Neonatal Oral Motor Assessment Scale (NOMAS)  - diagnostic tool to evaluate neonatal reflexive sucking patterns.  It helps me to determine how a baby would best benefit from manual therapy techniques to improve feeding.
Carol Dobrich Tool screening tool to determine appearance of oral restrictions
Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) a standardized and reliable tool to determine whether baby has tongue tie (ankyloglossia) 

I strongly support breastfeeding as the primary means of baby's nutrition in the first year of life. 
Next to breastfeeding, offering expressed or pumped breastmilk through a bottle, cup or other device is optimal.   Feeding difficulties, especially breastfeeding, can interupt the bond between you and your baby.  In addition to bringing your baby to see me for a consultation, your baby will benefit from the help of an IBCLC/lactation consultant.
I also recommend connecting with the local La Leche League in addition to IBCLC support.
How can oral restrictions interfere with breastfeeding? 
A tongue tie is when the tongue is restricted in it's movement because of a piece of tissue that straps the tongue down the the floor of the mouth. There are varying degrees of this issue from not interferring with breastfeeding at all to severaly interferring with breastfeeding (even for moms with experience with breastfeeding).  CranioSacral therapy can be highly beneficial to help the muscles of the neck and tongue relax and move to help with latch and feeding.  In addition to this, CranioSacral therapy can be highly beneficial after a baby gets restrictions released by a professional (typically a dentist or ENT doctor).  I can refer you to many good professionals if you believe your baby has issues with tongue/ lip or buccal ties. 
How would you know if your baby has a
Tongue Tie?
  • extremely sore nipples with a flat crease after baby has attempted to eat
  • difficulty with mouth opening, latch and getting the tongue stable under the nipple
  • baby is still hungry after a twenty minute sucking period on the breast
  • the end of the tongue is heart shaped
  • when baby cries the tongue lays flat in the bottom of the mouth (babies tongue tip should elevate when they are crying)

Lip tie?


  • difficulty with lip flanging
  • decreased jaw opening
  • air swallowing
  • fussiness after eating
  • lots of gas


Buccal tie?


  • difficulty with jaw opening
  • difficulty with lip flanging
  • compensation of facial muscles
  • etc


When the neck and throat have areas of increased soft tissue tightness, it can affect feeding!  Help your baby relax by gently massage the neck area.

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