Tongue-Tie: Our Hamilton Osteopaths Overview of Types, Symptoms, and Treatment

What Is Tongue Tie?

Tongue-tie occurs in babies when the lingual frenulum, a short and tight membrane that stretches from the underside of the tongue to the floor of the mouth, restricts the movement and function of the tongue. This condition can cause symptoms such as nipple pain, soreness, and blanching for mothers, and restricted tongue movement, biting, clicking whilst feeding, and grinding behavior for babies.

Why do Tongue-Ties occur?

Tongue-tie has a ‘somewhat understood’ genetic component and affects mostly boys. There is otherwise no confirmed cause of tongue ties. We have been told that midwives used to tear the frenulum at birth but that practice stopped and that is why we see a higher prevalence of tongue tie now. There is also some suspicion that an increase in folic acid supplementation taken during pregnancy to avoid Spina bifida may be causing the increase in tongue ties. Although topical, neither of these statements are entirely verifiable.

What are the types of Tongue-Ties?

Tongue-ties come in different types, with some being more visible than others. While some are visible due to the appearance of the tongue, others may be hidden at the base of the tongue and easily missed at first glance. Palpating various muscles or the soft bones of the face, head, or neck can help identify these types of tongue-ties.

1. Anterior tongue-tie, which is located at the tip of the tongue and creates a classic heart-shaped appearance.

2. Anterior tongue-tie that inserts behind the tip of the tongue and does not produce a heart shape.

3. Posterior tongue-tie, which is located further back in the mouth and has a visible tight frenulum.

4. Posterior tongue-tie without a visible thin membrane, which is the most commonly missed type. In this case, the front and sides of the tongue can elevate, but the mid-tongue cannot.

Each type of tongue-tie can result in mild to severe feeding symptoms. However, it's important to note that having a mobile tongue is crucial for proper facial development, even if feeding is not a significant issue. Even a tongue tie deemed as ‘not too bad’ may be causing or go on to cause significant issues - so seeking a second opinion is often worthwhile.

Tongue Tie Impacts Beyond Breastfeeding

Tongue-tie can have a lasting impact beyond breastfeeding, affecting jaw and teeth development (especially crowding), speech, eating, and other facial and neck muscles. Over time, this can lead to neck pain and headaches from compensating muscles.

What are the Tongue Tie Treatment Options?

Research shows that releasing tongue-tie can lead to improvements in nipple pain and latch in breastfeeding. Osteopaths who work with infants can help identify tension, restrictions, and limitations in other structures that are affected by a tight frenulum. At TLC Osteopaths, we work closely with orthodontist and lactation consultants to provide treatment before and after the tongue-tie procedure for the soft tissues of the face, neck, and mouth. Osteopathic treatment can release pressure and tension, leading to improved mobility and function of the tongue, resulting in a greater potential for rapid improvement of function post-surgery.

Not all tongue ties need to be cut or lasered. Some low grade tongue ties may release with appropriate stretching. Midwifes, Plunket nurses(? Depending on the nurse ), osteopaths and the team at changing faces can assess and advise on the best treatment options for your baby.

Conclusion

Tongue-tie is a common condition that affects babies and can cause breastfeeding issues for both the mother and baby. It may also have lasting impacts on development that may lead to teeth crowding, neck pain, and headaches. While the exact cause of tongue-tie is unknown, it appears to run in families and is more common in boys. Osteopaths who work with infants can help identify tongue-ties and provide treatment before and after the procedure to enhance success. With growing awareness and understanding of tongue-tie and its impact on breastfeeding and other areas of development, it's important to seek a second assessment if needed and work with experienced professionals to ensure optimal outcomes.

Written By TLC Osteopaths Hamilton Osteopaths