Tongue Ties, Chiropractic and Craniosacral Therapy

​Over the past 18 months, I’ve have been supporting an influx of very specific population in my practice, infants that are receiving a frenectomy. A frenectomy is a medical procedure to alleviate excessive tightness of the tissue under the baby’s tongue or up inside the top lip. This condition is commonly referred to as a “tongue tie” or “lip tie.” There are varying degrees of the tie. Many people go their whole lives with one and never know, whereas some people can't even raise their tongue because it's so tight.
 
Lip or tongue tie is typically diagnosed when there is difficulty latching and feeding. Common signs are the baby can't suck at all, falls asleep at the breast because they are tired from working so hard, and the mother gets repeated bouts of mastitis or blistered nipples. It's the worst. There are a whole lot of tears and frustration for all concerned. I have so much to say about this but I am going to keep it brief and relevant to how craniosacral and chiropractic help this situation.
 
Tongue or lip tie is often discovered when a mother’s nursing experience is not quite right. Either the baby is in distress or it becomes very painful to latch the baby onto her nipple. This is when hopefully, she seeks counsel with a reputable lactation consultant (LC) who diagnoses and refers to a professional who can do the frenectomy procedure.

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http://www.mommypotamus.com/a-step-by-step-guide-to-diagnosing-tonguelip-ties/

​While I sometimes will be a part of the baby's process before the procedure, I’m typically always a part of the process once the procedure is complete. My intention is to support the little one's nervous system with integrating the new space that is made in the mouth and to encourage the functioning of the tongue, jaw, lips, neck, and cranial bones to adjust and coordinate in order to successfully feed after the procedure.
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Now, for some babies this is all very straight forward. There is dysfunction in the system, it is corrected and voila! - breastfeeding goes forward smoothly. However, there is another type of experience that occurs after the procedure when things get all stirred up and there is more dysfunction to correct.
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​As detailed in this wonderful article, these are the babies that have tension not only in their mouths but throughout their body. In these cases, the frenectomy addresses the tension in the mouth, but not the tension in the rest of the body, so there are more symptoms to support. These are the babies that generally have a stressed nervous system - from the womb or from the birthing process - and they need more comprehensive care through craniosacral and chiropractic work.

"Until I began bringing my son to Dr. Maura, I was on the verge of quitting breastfeeding.  My son had just gone through a lip and tongue tie procedure with countless follow-ups (that were traumatizing for me and my son since the wounds were being torn open again to avoid them healing back together) and I had not seen any difference in feeding him. I was so frustrated!  The best way I could explain the pain I experienced while feeding him was that it felt like I was nursing a shark.  I was daydreaming of how easy it would be to just give up and move to formula.  In addition to the troubles with feeding, we were also dealing with spitting up, constipation, gas, choking and I had thrush pretty much all the time.

Luckily, I found Dr. Maura through the recommendation of my Lactation Consultant.  Even after our first visit, we saw an immediate improvement.  Dr. Maura helped my son loosen up his mouth and learn how to nurse properly and all of her work helped with all of the other symptoms as well!  I am now more confident in breastfeeding my son since it does not feel like a battle anymore and is definitely not as painful as it was before I saw her.  She is the reason I was able to continue breastfeeding!  Not only is her work amazing but she as a person is so nurturing and attentive that both Mom and Baby leave restored after her sessions."
- Kaitlin Ormesher

What I’ve noticed after sessions of work on these babies is that they are relaxed, not as stiff, and their belly and neck begin to soften. What is also commonly seen is that they are able to tolerate being in the car seat and the quality of their sleep improves. Basically, the baby is more content and comfortable in their body, demonstrating a healthy nervous system. And this is when their mouths are able to coordinate the latch more efficiently.

Tongue and lip ties can be tricky though. For some babies it is diagnosed later on, such as when they have unexplained cavities, when solids are introduced and they have trouble swallowing properly, or even with chronic constipation. It is only until parents try EVERYTHING to no avail that the tongue tie is recognized. And these babies are the ones that need comprehensive care to help their bodies unwind. Think about it - the entire digestive tract starts with the tongue. If that is tense and working improperly, it affects the functioning of the entire digestive tract. This is why tongue tie is often correlated with food allergies. Trippy, right?
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It needs to be clarified that babies don't just "grow out" of tension. If it is not released, it manifests differently as they grow - TMJ pain, headaches, subluxation, GI distress - all are common manifestations. Like most things in life, it's easier to address sooner rather than later, and checking and correcting any subluxations and tension stored in the tissues allows the body to perform as designed.

Interpreting Trauma

There is a third category of babies that have gone through the frenectomy experience and seem to be worse from it. This is when the baby has interpreted the frenectomy as a traumatic experience. I have seen time and time again that certain babies are fine after the procedure and certain babies are in considerable distress, sometimes for many weeks after the procedure.

For instance, it’s not uncommon for a mother to come in and say that her baby had a frenectomy and several follow-up appointments where the tie is re-opened so that the tie doesn't grow back. She’ll remark how her baby has not been the same since these procedures. Commonly, the baby develops reflux, is constipated, is clingy, upset, generally not themselves and definitely not happy. This baby is clearly stressed and their body is in a state of fight or flight.

Think about when you are stressed or in fear. Generally, your stomach is uneasy, you have sweaty palms, your heart races, you feel jittery...etc. Now imagine what a baby's body feels like, commonly it is a - tight diaphragm, stiff body, needing comfort. Bodywork is the key to relieving this stress; specifically craniosacral and chiropractic care because these modalities support their nervous systems to get out of the constant fight or flight mode and function appropriately.   

The Polyvagal Theory is a cutting edge description of how this system is triggered when we interpret danger and make adaptive neural responses. The vagal system (Vagus Nerve, Cranial Nerve X) is involved with the regulation and coordination of heart rate, sucking, swallowing, digestion, vocalizations and breathing, among many, many others. Dr. Stephen Porges is the world’s leading expert on this issue. If you are interested in learning more about his work, I highly recommend you watch this lecture of his titled, Human Nature and Early Experience. It’s fascinating.

These babies’ bodies have interpreted the frenectomy or the after-care procedures as dangerous. As a result, they drop into the reptilian part of their brain to cope with the trauma. They shut down as a protection mechanism. Imagine a baby who passes out due to serious crying. These babies then develop symptoms above and below the diaphragm, and symptoms of reflux and constipation which can be further explained with the polyvagal theory. In fact, Dr. Porges emphasizes the physiology behind the importance of nursing for comfort and how this stimulates the vagus nerve which supports the baby’s regulation of their nervous system.​

What Can Parents Do?

Find a reputable team of practitioners that you trust, finding one practitioner will lead to others. Talk to your baby; let them know what you are doing, where you are going, what to expect during the visit. And honor how your baby feels around practitioners. It's all about trust and when a baby connects with the practitioner, they can go to vulnerable places together which results in more effective healing work.
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What you can do at home with your baby is the greatest part. The action of sucking is one of nature’s ways of soothing the nervous system. Nursing your baby (or bottle feeding) stimulates the vagus nerve with each swallowing action. So while feeding your baby, really take advantage of the opportunity to talk to them in a soothing way and touching them with compassion. This will encourage the feeling of safety a baby needs and this helps settle their nervous system.

I understand that the lip and tongue tie is a newer conversation for parents and a real source of healing for those that need it. There are support groups and a lot of quality information online. I’ve included several links in this post that would be great places to start. You are not alone and there are solutions.
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From my heart,
Dr. Maura

For additional information on tongue and lip ties, please visit Dr. Ghaheri’s website.