Should I Revise My Baby's Tongue Tie?

Guest Blog: Dr. Alisa Sacker MD, IBCLC

As Chiropractor's treating the Newborn Population, tongue ties are a hot topic. Dr. Alisa Sacker MD, IBCLC has over 20years of pediatric experience with tongue ties and personal experience with ties as well. Dr. Sacker has helped thousands of families with breastfeeding issues caused by ties, but what if the ties aren't obstructing breastfeeding?


Dr. Sacker states "It is a much less difficult decision for a parent to fix ties when their newborn cannot latch to the breast or bottle and is not gaining weight. But what about those babies that are doing 'okay' and gaining weight and also have ties identified at birth or at a routine pediatric, lactation or chiropractic check?  Why release those ties? The number one medical reason for release of ties is airway compromise.  Babies should only breathe out of their nose.  Their mouth should be closed while sleeping or resting.  If the mouth is open, then the airway is compromised.  Babies open their mouths to get the tongue out of the airway.  The entire tongue should always rest suctioned up to the palate (roof of the mouth).  To check proper tongue position, pull down the lower jaw while your baby or child is sleeping and make sure that the tongue is staying up on the palate.  If the tongue comes down when pulling the jaw, then the tongue's attachment is restricted or the tongue is attached in the wrong location.  


Everyone has a tongue tie, what matters is where it is attached.  Abnormal attachments can interfere with proper tongue function.  The tongue tie should be attached from the middle of the tongue to the middle floor of the mouth in the soft tissue and away from the bony gum line.  An open mouth posture is very abnormal for babies, and most often associated with a submucosal tongue tie which is the most difficult tongue tie to diagnose. If the entire tongue is not resting flat up against the palate, then the upper jaw, nasal passages and sinus areas will not form properly.


The largest change in growth of the face occurs in the first 6 months of life. If we can correct these babies early, then we can make greater improvements in the development of the lower jaw and midface.  The earlier we catch this, the sooner it can correct naturally and not later with surgery and/or expensive and painful orthodontic treatments.  When we say "sleep like a baby" this refers to quiet nose breathing without any grunting or congested, wet noises and without being restless in bed. We understand so much more now about how important sleep is. This includes babies, children, and their parents.  


It is certainly easier for us to release ties younger as the ties are smaller and a bit softer to release.  The ties themselves are thick collagenous fibers and never stretch or go away with time.  The body can accommodate the ties and compensate for them, but that may be at the expense of other areas or cause future issues.  Healing is much faster in younger babies and they are certainly less aware emotionally than when they get older.  Young babies are much easier to distract, live in the moment and do not remember from one aftercare stretch to the next, or even the procedure itself.  


As babies get older, their muscles get more tense around the restrictions making it much more difficult for our chiropractors to get them relaxed.  We can release restrictions, but we need our bodyworkers to help with muscle and nervous system tension and repair.  


If babies do not nurse correctly and trigger the supply/demand system in the breast by the time the hormonal response decreases between 3-5 months, then we will start to see milk supplies decrease and often babies with weight gain issues.  These moms will often not have painful nursing, but as a red flag, may have a baby that nurses frequently for short periods of time.  Our goal is to help these babies as the milk supply is getting established in the first 6 weeks of life and certainly before the hormonal response starts decreasing so these moms and babies can have a long, beautiful breastfeeding journey.  


Why wait to see if your toddler has feeding issues with solids? Or wait to see if your child will have speech problems and/or dental problems? Why wait to see if your teen has TMJ issues, headaches, neck pain, or sleep problems? Let's improve the quality of our babies' lives now, so they have fewer issues as they get older.  Preventive care is so important for this new generation.  There is so much more information on our website, www.TeamTongueTie.com. We are here to help Moms and babies breastfeed better!"

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