When addressing tongue ties, I cannot emphasize enough the importance of working collaboratively with a tongue tie team for the best possible outcomes. Ties can impact several areas of development from feeding, digestion, sleep, airway, speech, and more. That said, we really need to look at both the mother, baby dyad holistically to address the root of challenges.

Navigating the sea of information online about tongue ties can leave many parents feeling confused, overwhelmed, and uncertain about the right steps to take or the appropriate professionals to consult. Between mixed messages, varying opinions, and an array of treatment options, parents can find it difficult to discern the best course of action for their baby. My hope is that this blog offers you clarity in understanding what to do and who to see to get the right support!

The Tongue Tie Team

There are 3 primary providers who should be a part of your tongue tie team:

Feeding Therapist: A feeding therapist may be an IBCLC, SLP, or OT who is skilled and trained in oral motor, feeding, and ties. They are your first line of defense if you suspect your baby is tied! Here’s what you can expect

• A thorough functional assessment that addresses BOTH baby and parent. Looking at symptoms and oral motor, feeding skills. This helps providers determine a baseline of skills and identify what may be contributing to you and your baby’s feeding difficulties
• If functional challenges are present, initiating feeding therapy may be recommended next, not a release. Why? Because a release alone will not improve symptoms and solve challenges. A release only gives your baby full range of motion. It does not teach them how to use their tongue functionally. This is where oral motor, feeding therapy comes in! We help establish and support neuromuscular re-education, which is a fancy way of saying we help your baby strengthen and improve range of motion, and coordination for feeding, sleep, airway, etc.. Oral motor feeding therapy is recommended pre AND post release.
• If a release is needed, your feeding therapist will help prepare you for the procedure. This includes getting baby more comfortable with intraoral input and practicing active wound care stretches. Wound care stretches are important to help reduce risk of reattachment and are different from oral motor exercises. Parents should feel confident with performing stretches PRIOR to release.

Bodywork: This is an umbrella term for a provider (i.e., OT, PT, CST, Chiropractor, Osteopath) who performs manual movement therapy. These providers use different modalities that involve manual movement and touch to help reduce tension within the body, improve body symmetry, digestive discomfort, and state regulation. Participating in bodywork is recommended pre AND post release.

Release Provider: Once you have participated in pre and post oral motor feeding therapy and bodywork, and you and your feeding therapist have determined your baby is ready for a release it’s time to schedule your consultation with a release provider! This may be a Pediatric dentist, ENT, or Oral surgeon. A CO2 laser is considered the gold standard technique used for performing a release. However, the training and skill set of the release provider is equally as important, if not more important!

As you can see, a tongue tie release is only one piece of the puzzle! When you work with a team of providers to address your challenges, you help ensure that the immediate and long-term effects of tongue ties are thoughtfully addressed to get the best possible outcomes. If you aren’t sure if your baby would benefit from a feeding evaluation, you might find this post helpful!

Final considerations

It’s important to note that some families may need to see more than the 3 providers listed above. If there are GI concerns, you may be referred to a gastroenterologist. If there are allergy/intolerances concerns, you may be referred to an allergist or nutritionist. You might even find that working with one type of bodyworker isn’t enough and/or another modality may be more helpful for your baby. Your tongue tie team should help guide and support in determining if additional referrals may be needed and the steps to take.

Also, you typically cannot visit any provider and assume they will be able to support you. Their skillset is really dependent on their continuing education and specialized training they have invested in. At Two Can Grow, you can rest assured that you will also receive holistic and individualized lactation care and support. Contact me today to schedule a consultation!