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How to identify a tongue tie in your baby – and why does it matter?

By Dr. Alima Rahman (she/her), Chiropractor, Pediatric

Hi guys, my name is Dr. Alima, and I am a pediatric chiropractor at West End Mamas in the downtown location in Toronto. And I’m here to talk to you about tongue tie. So what is it? Tongue tie is a condition that some babies are born with that affects the movement of their tongue. So there is a tissue called the frenulum that runs from the bottom of the mouth to the underside of tongue. And when that frenulum is shortened, it restricts the movement of the tongue. The tongue is not able to move as freely as it normally would.

And why is this important? Well, we need to identify this, because it can affect feeding due to latch issues. Also, if you’re a breastfeeding mother, because that tongue isn’t moving as freely as it normally would, that can cause pain while breastfeeding. During speech and language development, some sounds may be difficult to make, because the tongue is not moving freely. So that may cause in some cases, may cause speech and language delays. And finally, when solids are introduced, it can become difficult for baby to clear those solids from the mouth. So when teeth are introduced, that can cause oral hygiene issues.

So what do you do at home? If you’re suspecting a tongue tie, if you just want to assess your baby, and check it out, start by observing your baby’s tongue. When they’re sticking their tongue out, when they’re moving their tongue side to side, notice what’s happening. Is the tongue going of past the bottom lip? Is the tongue moving freely from side to side? And is it moving freely evenly from side to side? Is your baby’s tongue able to reach the tip of, the top of its mouth? Sometimes depending on where that frenulum is shortened, and placed underside the tongue, it can cause a heart-shaped tongue, or cleft in the middle of the front of the tongue, or dimpling on the tongue, because that frenulum is pulling on the tongue. So these are all things that you want to notice. In conjunction with, is baby taking a really long time to feed? If you’re breastfeeding, is it painful? Is it excessively painful? All these things put together may give you an indication that your baby needs to be assessed for a tongue tie.

So what you want to do is go to a healthcare provider who is trained in assessing tongue ties. You can come to a pediatric chiropractor, pediatric physiotherapist, IBCLC lactation consultant, pediatric osteopath, speech language pathologist, or a pediatrician who’s trained in assessing tongue tie. And what we’ll do when you bring your baby in for this assessment is do a history, a physical examination, and we’ll use a tool to grade the tongue tie from mild to severe. And what that grading will do is give us an indication of how to proceed. So due to development, and with some manual care, we can conservatively treat these tongue ties. And what that means is I would go into the baby’s mouth, and treat certain muscles, and also underside the tongue.

So I’ll go right in on that frenulum, and around the tissues around the frenulum, and I will release those tissues, so that the tongue is able to move as freely as it can. And sometimes during development, as well as with the manual care, the tongue tie can resolve, and the baby can move their tongue quite freely, and we go on. But sometimes if the tongue tie’s more severe, or if it’s not responding to that manual care, I would refer out to a pediatric dentist, or a pediatrician trained in releasing tongue ties, and they can assess if they need to release the tongue tie.

And what that means is they in office, they can do a minor procedure, or laser that frenulum, and release it, so that the tongue is able to move freely again. And what’s great is, as a pediatric chiropractor, I can follow up, and go into the mouth again, and ensure optimal healing after that procedure as well. So, that’s about that.

If you have any questions, please feel free to reach out to the clinic. Come in, ask questions, call the clinic. We’re here to support you and serve you. I hope that helped, thanks so much.

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