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Infant Tongue Tie- My Experience with Tongue Tie Release as a Mom and OT

What is a Tongue Tie?

Tongue ties have become a hot-button issue lately, yet many remain unfamiliar with what they entail or how to recognize them. Essentially, a tongue tie occurs when excess tissue tethers the tongue to the floor of the mouth, either anteriorly (at the front) or posteriorly (in the middle). Typically, accompanying a tongue tie, you might observe a lip or buccal (cheek) tie. Unlike most muscles in the body, the tongue lacks clear insertion points. When a tie occurs, the tongue forms an attachment to the hyoid bone, leading to difficulties in feeding, maintaining proper tongue posture for nasal breathing, and increased overall body tension, among other functional deficits. Essentially, tightness in the mouth from a tongue tie can have widespread effects on the entire body due to the interconnectedness of fascia from head to toe.

How I Knew My Kids Were Tongue-Tied

With my first baby, latching was incredibly challenging. We resorted to using formula to coax her onto the breast, and even then, each feeding session took almost an hour. She frequently fell asleep mid-feed, prompting us to employ various tactics to keep her awake and feeding. Despite our efforts, she struggled to gain weight and seemed consistently uncomfortable. Although my pediatrician confirmed my suspicions and promptly referred us to a lactation consultant, it’s worth noting that tongue ties are often overlooked by pediatricians. Thus, being aware of symptoms associated with tongue ties can empower parents to recognize and identify them. Both of my children also had significant lip ties, which are typically easier to spot by flipping the top lip upward to reveal a thick band of connective tissue attaching the lip to the gum line. Recognizing the significance of the lip ties, I suspected a tongue tie was also present. If unsure, specially trained professionals such as lactation consultants, speech language pathologists, occupational therapists, and dentists can assist in identification.

My second baby’s experience was markedly different. She latched immediately after birth and was gaining weight satisfactorily. However, her tight lip tie was noticeable as her upper lip would appear taut after feeds. My main concern, however, was the tension she exhibited, evident by red lines under her neck, closed fists, and a preference for turning her head to the right. Drawing from my experience treating babies with similar issues, I attempted to alleviate her tension, but progress was limited. Despite being able to feed relatively well and appearing generally content, she still displayed symptoms such as milk loss during feeds, preference for one side over the other, tongue clicking, limited milk transfer from the breast, and milk residue on her tongue and cheeks. After several visits to speech therapy at PediaSpeech and consultations with lactation specialists, I made the decision to proceed with the release.

Therapies and Preparation

Tongue tie releases are not a straightforward solution. Both of my daughters began therapy at PediaSpeech, including speech and occupational therapy, before they were two weeks old. These sessions involved bodywork and oral motor strengthening programs aimed at enhancing coordination and strength in oral motor skills. Additionally, we sought assistance from a chiropractor and craniosacral therapist. These therapies are crucial before releasing a tongue tie for several reasons. Babies develop swallowing abilities as early as 12 weeks in utero, meaning they’ve already developed compensatory strategies. Through neuromuscular reeducation, these professionals help ensure that the baby is prepared for the release and can use their tongue effectively afterward. Furthermore, not all tongue ties necessitate release, hence the importance of determining whether it’s warranted. Pre-release bodywork helps identify whether tension is solely due to the ties or other factors like positioning in utero or the birthing process. Releasing tension before the frenectomy not only aids in optimizing the results of the release but also assists in wound healing. While tension is common in babies after birth, both of my daughters exhibited tension beyond their initial weeks of life that couldn’t be fully addressed through professional intervention alone. Improvement in oral motor function might also render releases unnecessary. Hence, symptoms for both the mother (if breastfeeding) and the baby should be closely monitored.

Deciding to Get the Release

After seeking help from multiple professionals, I decided to proceed with the release for both of my daughters because they continued to struggle with feeding and muscle tension. Although therapy improved these issues to some extent, it wasn’t sufficient for long-term functioning. My older daughter still experienced reflux and fed slowly, while my younger daughter fatigued easily, requiring frequent feeding. Additionally, her tension and head turn preference were concerning, potentially leading to plagiocephaly or torticollis. Beyond their immediate needs, I recognized that untreated tongue ties could result in lifelong issues, including migraines, TMJ, sleep disturbances, and head and neck tension.

After-Release Care

The release is just the beginning of the journey. Stretching the wound every four hours is vital to prevent reattachment. This stretching regimen must be maintained day and night. Furthermore, oral motor and bodywork must continue to ensure optimal results and facilitate the baby’s ability to use their tongue effectively and build necessary strength. Both of my daughters coped well with their releases and were able to feed immediately afterward. While my older daughter fed more effectively and quickly post-release, my younger daughter struggled with organizing her suck and displayed significant weakness. However, through continued speech therapy at PediaSpeech, she made remarkable progress within two weeks, with even more improvement evident four weeks post-release. Despite initial challenges with her oral motor skills, her tension notably decreased post-release. Just one day after the release, the red lines under her neck disappeared, and her fists relaxed. We continued with diligent bodywork and neck stretching to prevent torticollis and eliminate her head turn preference, eventually leading to her discharge from speech therapy four weeks post-release. We still see a chiropractor regularly to manage tension and ensure symmetry.

Would I Do It Again?

Elective surgery decisions are undoubtedly difficult for any parent. However, having undergone two successful frenectomies, I would unquestionably make the same decision again. Understanding the ongoing work required to optimize the release and acknowledging that it’s not a quick fix, I’m confident that addressing my daughters’ tongue ties early has led to significant improvements in their oral motor skills and motor coordination. My youngest daughter, now four months old, is thriving during bottle feeds, and I have peace of mind knowing she can eat well under alternate caregivers while I work. Moreover, she’s meeting gross motor milestones more effectively and is progressing well with tummy time. Though the journey has been challenging, it has been undeniably worth every step.

A Note to Parents

I’m profoundly grateful for the support I received from my friends and colleagues at PediaSpeech for both of my daughters. Their passion for what they do and their commitment to continued education have been instrumental in my decision-making process, especially considering the mental health struggles I faced following my first pregnancy.  I recognize that I have the benefit of knowing each provider personally and trusting them; which is not easy with strangers.  I hope that sharing my experience instills confidence in other parents to seek the help they and their children need. While it’s not easy, we’re here to support your family every step of the way.