Problems with breastfeeding can cause a lot of pain and confusion. When breastfeeding is hard, many mothers worry that their bond with their baby won’t be as strong. This is especially true if their delivery did not go as planned. Often, problems like poor weight gain, dribbling, or biting the nipple can be signs of a tongue tie. The fussiness that comes with difficult breastfeeding is often related to the stress of trying to feed despite a tongue-tie.

What is a tongue-tie?

“The condition of tongue-tie and the process of releasing the tongue was noted in early Japanese writings, other historical documents, and even the Bible. It was believed that Moses was tongue-tied.”  —Tongue Tied by Richard Baxter, DMD, MS

Tongue-tie is a condition that restricts the range of motion of a baby's tongue. The "tie" is a short, thick or tight band of tissue called the lingual frenulum. This tie tethers the bottom of the tongue's tip to the floor of the mouth. This restricts the tongue's movement and that makes breast-feeding really hard for the baby.

What are the symptoms of a tongue-tie?

Babies with a tongue-tie may show the following symptoms:

• poor weight gain
• gagging
• frequent spit-up
• choking
• fussy often
• clicking or smacking noises while eating
• biting the nipple
• milk dribbling out of mouth

What causes tongue-ties?

Some babies are born with tongue-ties, known as ankyloglossia. When the tissue under the tongue fails to completely resorb during development in the womb, a tongue-tie results.

How do you diagnose a tongue-tie?

I recently saw a patient we'll call "Baby K."

Baby K was biting his mother’s nipple during breastfeeding and flailing his tongue out and around. He couldn’t open his mouth very wide, either.

After seeing a local lactation consultant, Baby K was referred to me for a potential tie assessment.

I discovered that Baby K had a tongue-tie by performing the Murphy Maneuver. I swept my index finger underneath Baby K's tongue to feel for a “speed bump” or “fence” in my way. Sure enough, Baby K had a tongue tie.

How do you treat tongue-ties?

Chiropractic eases the tension caused by difficult feeding.

Tongue-tied babies are using muscles other than the tongue to extract the milk. This difficult feeding effort is exhausting and leaves them with tension in their jaw and neck.

With Baby K, I performed adjustments and cranial work to release tension in the jaw. Then I had Baby K breastfeed and mom noticed a difference immediately.

Baby K was able to open his mouth wider, flare his lips, and pull the nipple in, deepening his latch. He is now able to get more milk with feedings and not biting mom so much.

Sometimes tongue-ties require surgical intervention. 

For Baby K, the tongue-tie remained. He began to regress a week after his chiropractic treatment. Sometimes after non-surgical care is explored, a surgical revision may be recommended. Revisions can also benefit the child’s speech formation.

A revision, also called frenotomy or frenectomy, is performed by a board certified pediatric dentist. The best way is to use a laser, but some practitioners prefer to use a scalpel. The revision procedure takes 5-10 seconds and recovery time is about 2 weeks. The only rare serious complication of a revision (less than 1 out of 100) is moderate bleeding.

How does chiropractic treatment work with tongue-ties?

Regular adjustments and cranial work can remove interference and tension in both the neck and jaw. Relaxing this tension allows for more ease with feeding, sleep and much more.

What can I do at home to help my baby with tongue-ties?

At-home care consists of intra-oral exercises and stretches that the parents perform on their infant.

Where can I learn more about tongue ties?

If you want to learn all about tongue-ties, I highly recommend the book Tongue Tied by Richard Baxter, DMD, MS.

You may also want to check out the International Affiliation of Tongue-Tie Professionals (IATP). Dr. Michaela is a member.

If your baby is struggling with difficulty feeding, sleeping or feeling good, Dr. Michaela can help. She specializes in chiropractic for babies, and can help your baby feel better fast. Make an appointment to see Dr. Michaela here in Aptos.