It is completely natural for mothers and their newborns to experience any number of issues when breastfeeding, from latching problems to poor milk supply, but many do not realize that these may be linked to even large issues. One of the most significant is called TOTs, or Tethered Oral Tissues.
Here at 1st Step Family Wellness, Dr. Jeanne and Dr. Ryan Sandheinrich want to ensure that your family stays well-informed about such challenges, including how to identify if your child is Tongue Tied and what you can do to help them live a healthier, more comfortable life.
TOTS, or Tethered Oral Tissues, may occur when the thin portion of skin under a baby’s tongue limits movement of the tongue and/or when movement of the mouth is constrained by the upper lip being anchored to the gum.
This is found in anywhere between 0.2% and 2% of babies, believed to be genetic, and can cause a multitude of problems for both mom and baby. The condition is recognized as “tethered,” since it is the thin membrane of tissue that is meant to undergo cell death during the baby’s development in the womb, that instead becomes wrapped and remains secured to a portion of the inner mouth.
One of the initial signs of Tongue Tied may be difficulties breastfeeding within the initial weeks after birth, including the risk of stopping breastfeeding completely. Studies show there is a 10-26% chance of this risk during the first three weeks; which could be influenced by problems with latching or taking the breast, insufficient supply of milk, maternal nipple or breast pain or damage, and failure to thrive; however, problems associated with breastfeeding should not be the only concern to consider.
During infancy, due to the displacement of the epiglottis and larynx, TOTS can cause babies to have difficulties breathing, which can also influence developmental or neurological issues throughout their life. Their inability to form a strong latch around the nipple can also lead to symptoms relating to colic, reflux, and dental decay; which can result in the need for otherwise unnecessary medications and treatments. Such may also reduce their ability to maintain a healthy weight, cause blistered or calloused lips, and even cause certain nasal problems. Furthermore, even if the condition is not prominent during infancy or considered non-problematic, children with TOTS have shown to have speech difficulties as they age, if not treated.
Yes! Along with the emotional and financial hardship that having a child with tongue tie can cause, TOTS can also have its own physical concerns for the mother. When your newborn is unable to latch or latch properly, this may lead to swollen and over-engorged breasts that can lead to extreme pain, mastitis, or thrush. It can also make breastfeeding extremely painful if you child does not latch properly, leading to cracked or creased nipples, bleeding of the nipples, and plugged ducts. This inability to properly feed your baby may also lead to greater difficulties bonding and worsen the effects of postpartum depression.
Since the condition is found to be widely genetic, there is no sure proof way to prevent tongue tie before or during pregnancy. However, studies over the last 20 years have found that a rise in TOTS seems to be widely correlated with the addition of folic acid in foods, particularly that of enriched flours, grains, and other modified foods sold throughout the United States and Canada. Due to this, it is recommended that if you plan to become pregnant or are pregnant, you remove such enriched foods from your diet and instead stick to an intake of methyl-folate activated ( a form of folate in supplements), the active and natural form of the same substance, through a prenatal vitamin and dark green leafy vegetables. Talk with your physician and OB/GYN to determine which folate supplement will work best for you and to promote a healthy pregnancy.
If your child has been born with tongue tie, be sure to speak with any primary care professionals, and have an in-house assessment – including dentists and ENTs (ear, nose, throat) doctors – to address any surgical needs your child may need. It is important that whatever healthcare professionals you speak with have a strong understanding of TOTS, the methods of surgery (laser or the use of scissors), potential structural implications, after-surgery care, and long-term exercises to repair the tissues.
After your child has received surgery or any other necessary care and has healed, it is strongly recommended that they receive regular chiropractic spinal adjustments and cranial work. Why? Tongue Tie is considered a “midline” defect, which means that it directly affects the core anatomy of the human body. This may include the musculoskeletal system (i.e. the neck, cranium and face), which also affects the development of the rest of the body, both physically and psychologically. Thus, when your child receives consistent chiropractic care, this ensures that both their musculoskeletal structure and neurological functions are rebalanced. Having a balanced mind and body will guarantee that your child will live a happier, stronger, and healthier life for years to come.
Dr. Jeanne is a certified lactation counselor, and offers additional lactation services in the office to help mothers with their breastfeeding goals. In addition to her training in pediatrics and cranial work, Dr. Jeanne has had extensive training to retrain the suck after release. She has also found that babies respond better to the release when they have had chiropractic care prior to the release.
Still have questions about TOTS? Feel free to visit Dr. Jeanne and Dr. Ryan Sandheinrich at 1st Step Family Wellness of St. Louis, Missouri during our office hours. Or, give us a call at (314) 805-7837 to discuss how chiropractic care can help your family live a better life of health and wellness.