Sometimes baby tongue tie holds down in the centre and lifts at the edges
forming a heart-shaped tongue

Symptoms & Signs of Tongue Tie in Babies:

Tongue tie in babies should be considered if you notice some of the following. You don’t have to experience all of them, and it doesn’t have to be terrible. You just might notice that things seem a little difficult to feed baby. So consider:

• Poor ability to latch or inability to stay latched – do you have to hold baby “just right” for latch?
  
• Sliding off the nipple – often results in grazing/damage of the nipple
• Falling asleep at the breast – a tired tongue puts baby to sleep
  
• Regular clicking during a feed – not getting a closed suction
  
• *Poor weight gain – HOWEVER, please NOTE  *plenty of babies with a tongue-tie can gain ample weight if mum has an oversupply!
  
• Maternal nipple pain or damage – Mastitis, cracks, and bleeding
• Compromised maternal milk supply – baby cannot drain well enough
  
• Dribbling milk at the breast of bottle – think how often you have to wipe or always need that cloth or you’ll be drenched
  
• Digestive issues such as increased gassiness or reflux – aerophagia (swallowing air during feeding)
• Poor control of the milk during swallowing – lack of coordination
• GAG reflux seem over-active – without good tongue movement, baby cannot move milk/food around their mouth away from the “gag” spot

What Else Might you Notice with a Baby Tongue-Tie?

• Head-turning preference
• Baby might really dislike tummy-time
• Baby goes from 0 to 100 in a split second – easily irritated
• A wiry body tone – even arching backwards

Types of tongue tie in babies:

There are 4 main types and some are easily missed.

1. Anterior to tip (classic heart-shaped tongue)
2. Anterior but inserts behind the tip of the tongue (no heart shape)
3. Posterior (or submucosal) with a visible tight frenulum
4. Posterior but no thin membrane is present, so this type of tie is the most commonly missed. (The front and sides elevate, but the mid-tongue cannot.)

Each type can show severe or mild symptoms with feeding. But remember that even if feeding is not a big issue, the sculpting of the face relies greatly on a mobile tongue!

Anterior Tongue Tie

Anterior is the anatomical word for nearer to the front. An anterior tongue tie therefore has a restrictive membrane that is either close to the front or right at the tip of the tongue. If the tongue tie connects all the way to the tip of the tongue it creates a characteristic shape of a heart because the middle of the tongue is pinned downwards. This heart-shaped tongue is unfortunately sometimes the only characteristic your health professional might weight to diagnose a tongue tie. It couldn’t be further from the truth.

Posterior Tongue Tie

Posterior is the anatomical word for nearer to the back. With regard to tongue tie, this does not mean in your throat. We are still looking under the front of the tongue in the floor of the mouth. A posterior tie is not a great name for the position of this tie, submucosal is another word that is used. Posterior tongue tie can cause considerable issues even though it seems it shouldn’t be as bad as an anterior so don’t be swayed by a common phrase of “it’s not too bad”.

But I’ve been told that baby’s tongue tie is not too bad. What should I do?

Tongue tie can affect more than just breastfeeding. As stated above, when we grow the tongue movement moulds the jaw bones to widen the palate and lower jaw so the teeth have ample room. Without good tongue movement, those bones can remain too narrow. Another important point is that when the tongue muscle does not have good ability to perform it’s functions eg. swallowing, speech, eating, other facial and neck muscles called called upon to do the extra work. Over years this may end up with neck pain and headaches from an inefficient process.

So sometimes a tongue-tie that’s said to be “not too bad” is actually an issue later down the track. Another assessment may be in need!

Are there other ties in the mouth possible?

Yes! Our assessments include checking for:

1. lip tie – under the top lip
2. buccal ties – inside the cheeks

Tongue Tie Treatment

Treatment from a dentist for a tongue tie will usually include using a laser, surgical scalpel, or scissors to release the tie.

Ideally seeing an Osteopath 1-2 days before the procedure and then 1-2 days after the procedure is optimal.  

Our job is to work closely with the dentist and myofunctional therapists to provide loosening-off treatment before and then following up after the tongue tie procedure for the soft tissues of the face, neck and mouth. 

Body work may involve palpating various muscles or the soft bones of the face, head or neck to help with flexibility, suppleness & stabilisation of the soft tissue.

It can release the pressure and tension that results from the limited tongue/lip/buccal movement that occurs due to a ties. It often has a flow-on effect throughout the body that is related to the potential for high body-tone, head-tuning preferences and even cranial nerves supply such as the Vagus nerve which affects the gut as well as other organs. 

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