What To Do If Your Baby Has a Tongue Tie

As doulas we have seen many families impacted by tongue ties. When a family struggles with tongue tie and breastfeeding they want solutions asap. Support and correct direction are key to overcoming tongue tie and its impacts on breastfeeding. One of our trusted providers, Bryant Harris of TruCentered Chiropractic, has partnered with other professionals that specialize in tongue ties to create a comprehensive care network to help families with these struggles. He filled us in on what Strong Ties mission is.

What is the mission of your company and how do you hope it will impact Maryland Families?

  Strong Ties offers all-encompassing encouragement and services from a variety of specialists – all within one practice. Through the comprehensive integration of orofacial, lactation, chiropractic care, mental health and maternity support services for families, the mission of Strong Ties is to provide sanctuary and comprehensive support to parents and babies who need it the most. Each service keeps the mother-infant relationship top of mind. Mothering isn’t easy, but with the right support system – every mom can truly achieve a sense of calm and balance.

When should you have your baby checked for tongue tie issues/feeding issues?

Prenatal lactation education is key for longer success in breastfeeding and/or milk production. Having an idea of what is “normal” or expected provides a better understanding for when things may not be working well, thus one could initiate earlier interventions. Working with an IBCLC well versed in Tethered Oral Tissues (TOTS) within the first week of life can better your chances of identifying if one may be present which could contribute to any feeding issues that are present. It should be known that
Tethered Oral Tissues are not limited to solely tongue ties, but also lip ties and buccal (cheek) ties.

To give you an idea of symptoms a mother may exhibit with a baby with TOTS, but not limited to:
 distorted, cracked, creased, blistered, bruised or bleeding nipples after feedings
 significant discomfort that may be described as pinching, chomping, or burning
 frequent plugged ducts or mastitis
 reoccurring thrush
 poor milk supply
A baby’s symptoms may include, but are not to:
 poor, shallow latch
 fatigue, falling asleep at the breast
 colic, reflux, excessive spit ups
 poor weight gain, failure to thrive
 reoccurring thrush.

Does insurance cover any of the procedures?

All of the services offered at Strong Ties have insurance support in various forms – all dependent on the policy and the associated benefits of the policy. Direct billing will be offered for some services yet reimbursement for out of network claims will be available for all services. Again, reimbursement will be dependent on the policy and the benefits
associated with that policy.
All providers work independently, so if you have specific questions regarding a certain service, it would be suggested that you reach out to that provider.

What can you expect for recovery with your baby?

Receiving a frenectomy may or may not be the answer to all your breastfeeding/feeding woes or other symptoms that may be seen. Recovery could be dependent on how long one has been compensating with the tethered tissues, one’s adherence to the pre-op education/recommendations and/or post- follow-up instructions.
It is common for babies to have good feedings while there may be other times when the feeds would be less than ideal, but remember these babies have developed compensatory strategies to survive (feed)
and it will take some time to relearn how to suck and properly use the tongue.

Working closely with your providers (Pediatric Chiropractor, IBCLC, Craniosacral Therapist, Speech Language Pathologist, etc..)
helps families understand how to care for their baby and what to expect to help with any concerns or question that may arise during this recovery/healing process.

How can parents support their baby through this time?


Educate yourself. Knowing what to expect is key. First off, working closely with your IBCLC to learn how to help with comfort measures and strategies for feedings through a post-frenectomy plan of care. Secondly, follow through with your chiropractic plan of care to help improve the suck and overall function of baby – anticipate multiple care visits for the first few weeks, it takes time to retrain these muscles and aberrant neurological patterns.

What kind of follow-up work should be expected after?


A post-frenectomy surgical follow up with the Pediatric Dentist or EENT will be scheduled to ensure proper healing, no infections or reattachment of tissues took place. Depending on the severity of the tie, it could be anticipated to see the IBCLC for 2 or more visits. If things, do not progress as expected due to the baby having a difficult time, you may need to seek the
care of a Speech Language Pathologist/Feeding Specialist for more specialized feeding support. Utilizing, chiropractic care can support the baby in normalizing the nervous system – allowing a proper
suck and root; in addition to correcting any compensatory patterning in the muscles and/or bony structures which may have been affected due to the tethered tissues (ie. torticollis, plagiocephaly, facial
asymmetries, etc..).

What kind of support will the baby and/family need after?


A team who understand how to assist in the babies healing and recovery process, as well as, educating the parents on how to provide care at home.
The at-home care will include performing daily oral exercises after the procedure to allow the wound to heal properly, orofacial myology stretches/massages and comfort care, when done in conjunction, can
aid in healing and improve the function more effectively, and lastly suck retraining exercises to improve the suck and function of the tongue.
Generally, your IBCLC/Pediatric Dentist should provide you with hands-on instruction on how to do the post-op care.

If a baby has been struggling or there are other areas that need support from a mother’s comforts and point and/or milk production to eliminating the use of nipple shield or bottle, your IBCLC is a wonderful resource for that. Remember, the release of a tether is just the beginning of improving function. Many of the feeding behaviors that were already established need to be changed/modified and that takes time. Working
with someone who understands how to support those changes and maintain a healthy, thriving baby and milk supply is crucial to success for the dyad.

Contact Strong Ties here

Our postpartum breastfeeding support doulas are also available to help a family recover after a tongue tie procedure. Hire them here.

And don’t forget to read our blog on how to establish a strong milk supply here

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