Approaches to Tongue Tie

There are many aspects to consider in order to improve a baby’s latch. The goal, as always, is for parents to understand their baby and to know their options.

A recent article in the New York Times “Inside the Booming Business of Cutting Babies’ Tongues*” described disastrous stories and implied it’s only a profitable scam. I am sorry for the families’ experiences and I am concerned about that particular IBCLC’s work. There is, however, much more to report about this topic.

The confusing controversy about tongue-tie was the subject of an excellent webinar: Let’s Talk About Tongue Tie: A Panel Discussion. It was presented by the Maine State Breastfeeding Coalition in August of 2022. The panel included the opinions of five different practitioners: a pediatric dentist, an Ear, Nose and Throat doctor, an IBCLC, a doctor of Osteopathy and a pediatrician.  A video of this presentation is on the Maine State Breastfeeding Coalition YouTube page. Each of the practitioners had their experience and perspective to share. It pointed out the need for collaboration and measured, not quick, decisions.

How a baby is latching and sucking is important. At 18 weeks in the womb, the growing fetus is already sucking. At five months, the fetus is sucking and swallowing. These are fundamental actions. For breastfeeding, the tongue needs to extend, grasp the nipple and move to suck effectively. When a baby has difficulty latching and feeding, it is concerning.

There are varied causes. First, it’s important to get a thorough history of the birth, of the baby and the parent. It’s equally important to observe carefully.

In my experience, I have seen how position changes, timing and learning baby’s cues can make a difference. Gentle exercises can facilitate better alignment. By relaxing tension in the neck and jaw, it may be easier for a baby to latch. I appreciate the whole child approach of Michelle Emanuel’s  TummyTime! Method  in addition to trainings with  Melissa Cole, Jaye Haleryn and Jewel Mohr.

Those are some of the resources from which I draw.  For more thorough and specific bodywork, I may refer to a chiropractor or an osteopath. Sometimes I refer to a pediatric dentist who is experienced with tongue-tie. I also consult with other IBCLCs if need be. Collaboration with others gives us the benefit of experience and provides more insight.

In my work, I refer to practitioners with whom I have had conversations and about whom I have received positive recommendations. Unlike the claim in the NYT article, I never get a fee for a referral. I know of no colleagues in my network who ask for or receive a fee for referrals.

Sometimes it is a tongue tie. Sometimes it is not. It takes patience and persistence to figure what works. Always, it’s helpful to understand sucking maneuvers, your baby’s own abilities and your options for treatment. It is, hopefully, a team effort of parents with practitioners.

 

• “Cutting Babies’ Tongues”… Technically, it’s not cutting the whole tongue. It involves the tissue under the tongue, the frenulum. ‘Tongue tie release’ refers to a “frenotomy: a surgical procedure to release the frenulum  so the tongue can move more freely”.

 

 

c.Robin Snyder-Drummond, 2023