How can Occupational Therapy help with Tongue Ties?

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.

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