ANKYLOGLOSSIA BODYWORKERS - INACTIVE SITE
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PARENT RESOURCES:

WHAT IS ANKYLOGLOSSIA (TONGUE TIE)?

Ankyloglossia, colloquially known as "tongue-tie", is an unusually shortened, thickened, or tightened lingual frenul​um, a normal structure located between the tongue and the floor of the mouth; this anomaly restricts the tongue's normal movements.  Babies with ankyloglossia will often have a low tongue posture, which means that the tongue rests on the floor of the mouth as opposed to the roof of the mouth.  When this is the case, babies have an inability or diminished capacity to raise their tongues up to contact the nipple during breastfeeding, resulting in weak intra-oral pressure which may interfere with breastfeeding.  A baby with ankyloglossia may have trouble lateralizing their tongue (moving it the the sides of their mouth), which is necessary for optimal hard palate and cranial development. 
Cranial compression (or molding) or low vagus nerve function may mimic true ankyloglossia by inhibiting the upwards mobility of the tongue, in function but not structural capacity.  In these cases, the best intervention is to address the functional movement with techniques such as TummyTime!™.  

ANKYLOGLOSSIA MAY PRESENT AS:


  • The end of the tongue may be heart shaped
  • Latching difficulty
  • Discoordination of suck-swallow-breathe
  • Possible plugged ducts, mastitis, and breast and nipple pain
  • Possible increased air ingestion creating excess gas and fussiness 
  • White coated tongue (microbiome development on surface of tongue)
  • Possible GI microbiome deficiencies
  • A high arched palate
  • Palatine tori (or boney development in the center of the hard palate)
  • Hypersensitive gag reflex
  • Baby may still hungry after a twenty minute sucking period on the breast
  • Persistent swallowing deficits
  • Low tongue posture which may contribute to sleep disordered breathing and sleep apnea
  • Possible open mouth posture associated with an imbalance in skeletal structure,
  • Nipples may be extremely sore with a flat crease after baby has attempted to eat
  • Possible difficulty with mouth opening, latch, and tongue movement
  • When baby cries the tongue may lay flat in the bottom of the mouth (babies tongue should elevate when they are crying)



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Additionally, toddlers or older children may exhibit:
  • Delayed speech development
  • Picky eating
  • Poor chewing
  • Dental hygiene issues
  • Drooling
  • Snoring
  • Mouth breathing
  • High arched palate, consequent narrowing of airways, and the potential for sleep apnea or sleep disordered breathing patterns
  • Sleep disturbances

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SOME OTHER RESTRICTIONS YOU MAY HEAR ABOUT:​

LIP TIES (MAXILLARY LABIAL FRENUM): THESE ARE ALL POSSIBILITIES WHICH HAVE BEEN PROPOSED BUT NOT PROVEN IN PEER REVIEWED EVIDENCED BASED STUDIES:

  • Difficulty with lip flanging
  • Decreased jaw opening
  • Air swallowing
  • Fussiness after eating
  • Excess gas
  • May cause gingival recession
  • May cause a maxillary midline diastema (gap between top front teeth)
 Disclaimer:  The above examples have been reported by parents and other professionals. 

    
​BUCCAL TIES: THESE ARE ALL POSSIBILITIES WHICH HAVE BEEN PROPOSED BUT NOT PROVEN IN PEER REVIEWED EVIDENCED BASED STUDIES:

  • Difficulty with jaw opening
  • Difficulty with lip flanging
  • Compensation of facial muscles
Disclaimer:  The above examples have been reported by parents and other professionals. ​

WHAT ARE THE LONGTERM CONSEQUENCES OF ANKYLOGLOSSIA?

Also see ​Consequences of untreated ties 

WHAT IS A FRENECTOMY?

A FRENECTOMY (also known as frenulectomy) is the removal of a frenulum, a small fold of tissue that prevents an organ in the body from moving too far.  It can refer to frenula in several places on the human body.  It is related to frenuloplasty, a surgical alteration in a frenulum.
A FRENOTOMY or frenulotomy is cutting without removal of tissue while laser obliterates the tissue.
Though as bodyworkers, we seek to address functional deficits resulting from ankyloglossia, in instances which require frenectomy, bodywork is not substitute. 

WHEN IS IT APPROPRIATE TO HAVE YOUR CHILD ASSESSED FOR TONGUE TIE?

The moment you have a concern.  An assessment is painless and inexpensive.  Knowledge is power, and the more you have, the more likely you will be able to help your child. 

ANKYLOGLOSSIA ASSESSMENT TOOL (ATLFF):

Many bodyworkers and health professionals use The Assessment Tool for Lingual Frenulum Function (ATLFF).  This tool was developed by Alison Hazelbaker, PhD, IBCLC, CST, RCST,  author of Tongue-Tie Morphogenesis, Impact, and Assessment and Treatment. The tool is used to assess tongue function, taking the subjectiveness out of the equation. The resulting score dictates the recommendation regarding frenotomy. 

WHAT TO DO IF YOU ENCOUNTER RESISTANCE FROM YOUR CHILD'S PEDIATRICIAN: 

Always remember, you are your child's advocate.  It is your right to advocate; any pediatrician, primary care doctor, or health care practitioner who does not support that role, does not have your child's best interests in the forefront of their mind.  Parents are gifted with biological intuition.  Do not turn away from your instincts simply because you feel they must know better.  Share your resources and have an open dialog about the next step.  The best healthcare is the result of a trusting partnership.  First, trust yourselves.  


PARENT SUPPORT GROUPS:

Tongue Tie Lip Tie Babies Support Group
Tongue Tie Babies Support Group
Purple Crying
The Fussy Baby Site

LACTATION SUPPORT: 

It is strongly advised that breastfed babies and toddlers see an IBCLC before pursuing treatment with any other provider. The IBCLC's role is to properly assess oral function, address all related breastfeeding issues, refer for diagnosis and treatment to bodyworkers and/or release providers, prepare the family for release, including oral exercises, communicate with other providers to optimize care and follow-up until breastfeeding is fully functional. 
​This is a public map demarcating International Board Certified Lactation Consultants (IBCLCs) who address ankyloglossia, otherwise known as tongue tie or tethered oral tissues (TOTs).
DISCLAIMER: Please recognize that this map does not – and cannot – represent a specific endorsement or guarantee of excellence nor liability related to the outcome of care. Approach may vary from IBCLC to IBCLC, as does education in this specialty.  Not all IBCLCs will have the same skill set in this area of specialty. Please direct questions as to skills and experience to the IBCLC directly.  Readers are advised to make direct contact with IBCLCs on this list to ascertain the best match. Each IBCLC is assumed to carry their own liability insurance.  Ankyloglossia Bodyworkers does NOT assume any liability, and by using this website, you consent to those terms and release this organization of any responsibility thereof.
If you are an IBCLC who would like to add yourself to this map, log into your google account and click HERE
INSTRUCTIONS: To add yourself to the list, please click edit, plug in your address and press enter, click "add to map", then edit. Add your name, your business name, business address if applicable or area you cover, a phone number, website and a brief description of your specialty and/or training. 
This listing is only open to IBCLCs. ​

POST-FRENECTOMY CARE:

  • Bodywork within 48 hours BEFORE frenectomy
  • Ask frenectomy provider for traditional and alternative pain relief recommendations
  • Follow-up with an experienced IBCLC if breastfeeding
  • Bodywork within 48 hours AFTER frenectomy
  • After-care exercises with Melissa Cole​

THE ROLE OF MYOFUNCTIONAL THERAPY and other exercises: 

Joy Moeller about Myofunctional Therapy
Dr. Mercola interviews Joy Moeller
Find a therapist who is trained in the Beckman Protocol
Feeding, mouth and speech development with Diane Bahr
What Every Parent Needs to Know about Mouth Development from Birth: What Can Go Wrong and Why ​

READING AND RESOURCE LIST:

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Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More


Dr. Ghaheri's Resource List
Dr. Kotlow's Articles
“Touch is the most basic, the most nonconceptual form of communication that we have. In touch there are no language barriers; anything that can walk, fly, creep, crawl, or swim already speaks it.” ― Ina May Gaskin, Spiritual Midwifery
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