milk_matters
Specialty

Tongue-Tie/Lip-Tie Physical Therapy

How Specialized Pediatric Physical Therapy Treats Tongue-Tie/Lip-Tie

A baby’s ability to breastfeed well is dependent upon the ability to move the tongue freely and effectively. A baby’s tongue plays 3 important roles in breastfeeding: it grasps the breast; it shapes the breast to stabilize it in the mouth; and it helps to create the vacuum that pulls the milk out of the breast. In order to latch effectively, a baby’s tongue needs to extend past the lower gum, the sides of the tongue need to be able to lift so that it can cup the underside of the breast, and the front of the tongue needs to lift so that the back of the tongue can drop. When the back of the tongue drops, a vacuum of negative pressure is created, which pulls milk from the breast.

Infants with tongue-ties (also known as ankyloglossia) are not able to move their tongue freely in the ways they need to be able to breastfeed effectively because of the frenulum (the membrane that connects the base of the tongue to the floor of the mouth). The frenulum’s job is to help anchor the tongue to the floor of the mouth. In tongue-tie, the frenulum is attached too tightly to the tongue, anywhere from the base of the tongue to the very tip. It may look like a thin, stretchy band that is almost transparent, or it may be thick. A restrictive frenulum may be attached to the floor of the mouth anywhere from mid-way to just behind the lower gum.

Tongue-tie can lead to low milk production, since the baby cannot effectively remove milk from the breast. There may be earlier indications that a baby is tongue-tied: latch problems, chronic sore nipples, “clicking” or “popping” sounds while baby is breastfeeding, shortened feedings (baby quits early), or prolonged feedings because baby is not satisfied.

Treatment for tongue-tie consists of “clipping” the membrane with surgical scissors or by laser to release the tongue. This procedure is called a frenectomy or frenotomy. When a tongue-tie is released, the child has no muscle memory of how to use their tongue without the restriction there. It takes time for the brain to rewire itself and figure out how to suck effectively once the tie is released. Skilled, pediatric physical therapy is an important part of the process of treating tongue and lip-tie. It helps speed up the process of the infant figuring out how to suck effectively. I provide your baby with the necessary suck-training, help with proper latch, and specialized exercises & stretches after the frenectomy procedure.

**For This Type of Specialized Physical Therapy, Dr. Giselle Tadros Accepts Out of Network Benefits Only**

Common Tongue-Tie/Lip-Tie Symptoms

Poor latch/inability to latch
Sliding off the nipple
Fatigue during feeds
Sleepy feeds
Poor weight gain
"Clicking"/"Popping" during feeds
Nipple pain/damage (can feel like baby is compressing chewing, gumming, pinching, scraping the nipple, etc..)
Increased nipple/breast infections, low milk supply
Gastrointestinal issues (gasiness & reflux)
Aerophasia (Air swallowing which can cause gas & spitting up)

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