The tongue is attached to the floor of the mouth by an interwoven network of fascia, known as the frenulum. The frenulum forms in utero and typically changes before birth to allow the tongue to move more freely in the mouth. However, sometimes, the frenulum can remain too short, thickened, or tight and as a result, restricts the tongue’s movements and impacts function. This is known as ankyloglossia, or tongue tie.
Tongue ties can cause a wide range of symptoms. Some common signs of tongue ties are as follows:
BreastFeedings Symptoms
Difficulty Latching or Sustaining Latch Poor Feeding Endurance Poor Weight Gain Excessive Gas/Hiccups Re-flux Lip Blisters | Clicking Sounds when Feeding Combative Behaviors During Feeds Maternal Nipple Pain Recurrent Mastitis Constant Nursing Poor Milk Supply |
Bottle Feeding Symptoms
Anterior Milk Loss Increased Respiration Clicking Sounds when Feeding Poor Weight Gain Combative Behaviors During Feeds | Lip Blisters Reflux Excessive Gas/Hiccups Collapsing Bottle Nipple Extended Feedings |
Solid Feeding Symptoms
Gagging Pocketing Swallowing Whole Refusing Food | Reflux Poor weight Gain Constipation Diet Selectivity |
Treatment for tongue ties typically consists of releasing the fascia through a procedure known as a frenectomy or frenotomy. However, pre and post frenectomy care are imperative in helping to determine the optimal timing of release and in teaching the child how to use their tongue once it can move freely.
Occupational therapists are uniquely qualified to address challenges related to tongue tie, as we have an understanding of complex feeding processes and oral motor skills as well as training in how the body functions as a whole. This means that we can assess for restrictions both in the mouth and throughout the body and use neuro-muscular re-education, therapeutic handling, sensory-motor, and other techniques to help your child learn to use their tongue optimally and to help you navigate any co-existing conditions, like torticollis.