If your baby has a tongue tie, you may know you need to get a release. But do you know, that your baby likely also needs therapy to achieve the best possible outcome?
Fortunately, the idea of tongue tie therapy has become more popular and release providers (like pediatric dentists and ENT doctors) are realizing the best way to give their patients the best result is with more support. While a tongue tie release can give your baby new possible tongue movement, they often don’t know how to move their tongue in new ways. That’s where tongue tie therapy comes in!
But I get it…I’ve been there too. You already invested in a release and it may have been traumatic, expensive, and not exactly something to look forward to. You would probably prefer to just take your baby to this one appointment and be done with it. I truly wish that it was this easy. But unfortunately, it’s not usually that simple. Tongue-tie treatment needs to be holistic in order to be effective.
So what is a tongue tie therapist and how do you know if your baby needs to see one? It’s not as simple as asking your baby’s pediatrician what they think. Most healthcare providers are not trained to assess oral function. Tongue tie therapy is indicated if there is a functional limitation or if a functional limitation is anticipated in the future considering a lack of tongue movement or other issues.
But what is a functional limitation? If a baby’s frenulum attaches at the tip of the tongue, it’s a bit more obvious that function may be an issue. If a baby has a posterior tongue-tie (or what now is called a mid tongue restriction), it may be less obvious if and how function is affected. Proper tongue function impacts more than just breastfeeding or bottle feeding. Nipple pain, poor weight gain, and inefficient feeding are the more obvious signs of tongue-tie related issues. But for optimal function, baby’s need full strength and coordination of their oral structures. They need to keep their mouth closed and breathe through their nose. They need proper tongue resting posture to help properly form their palate and create space for all their future teeth.
I always recommend working with an infant feeding professional if your baby has a tongue tie, lip tie, or buccal ties. This could be a lactation consultant, occupational therapist, or speech therapist. The healthcare provider you choose should have experience working with babies with oral ties. They should be able to do an oral exam and tell you if baby is moving their tongue and other oral structures properly. They should be able to assess baby’s tongue, floor of the mouth, cheeks, lips, palate, and any teeth they may have.
What do tongue tie therapists do?
Tongue tie therapists do different things based on their scope of practice, training, and experience. They typically will do exercises in and around your baby’s mouth and assess feeding skills. Some therapists may have experience to address breastfeeding issues while others may only address bottle feeding. If your baby is old enough, they should be able to assess their ability to eat solids and drink from a cup as well.
A tongue tie therapist should give you tongue exercises as well as exercises for other structures in baby’s mouth and exercises for their body as well. Everything in our body is connected and the whole body must be addressed to achieve an optimal outcome. In essence, tongue tie therapy should address 1) baby’s mouth and 2) baby’s body.
What if I don’t do tongue tie therapy?
You always have a choice when it comes to making decisions about your child. You are their parent and you know your child best. I always recommend listening to your parent gut above all else. I don’t believe in fear mongering or inducing mom (or dad) guilt or shame. The truth is, yes many of the possible long term consequences of tongue tie can be addressed later on in myofunctional therapy, occupational therapy, physical therapy, or speech therapy with older children. Is it harder though after years of habits have taken place? Also, yes.
The problem with saying that tongue tie therapy is only necessary if there is a functional issue is that, most healthcare providers don’t know how to properly assess function. So your baby’s doctor (or even lactation consultant or other provider if they lack the proper training or experience) may tell you that everything is fine, when they really don’t know if it is or it isn’t.
I won’t go into depth here about what the future may hold without tongue tie therapy, but a child’s speech sounds, breathing, oral motor skills, body tension, body symmetry, motor skills, and regulation may all be impacted. Many people worry that their baby with tongue tie may have future speech problems, but it can be so much more than that. Sleep apnea, enlarged tonsils and adenoids, tooth decay, and behavioral challenges are all on the list of possibilities. If you want to dive into what else is possible, check out my article Long Term Effects of Tongue Tie.
How to find a tongue tie therapist
Finding the right help can be tricky sometimes. I have another blog post that can help give you a lot of ideas to help you find the right support.
Sometimes you may not be able to find one single healthcare provider to meet all of your baby’s needs. There are therapists that do manual therapy/bodywork exclusively and there are therapists that address oral function and feeding. If you’re lucky, you may find one that does both (like me!). If you’re located in or near the Santa Clarita Valley (in North Los Angeles County), reach out to me! I offer a free 15 minute call to listen to your baby’s history and tell you if and how I can help. I also offer telehealth if you are located anywhere in California.
For those in other states or countries, I have a blog post about how to find the right support. Click here to read more about How to Find Professionals Who Treat Tongue Tie.
And while it may not be a replacement for hands on therapy, I created a digital Therapy Program for Babies with Tongue Tie to help you get you started.