There can be a range of reasons for this and may be due to problems with the nerves that supply the tongue of the baby, affecting how it can move forwards and upwards to cup the nipple.
This may be due to compression of sensitive areas of the baby’s soft skull when they are in the uterus or during childbirth. The passage down through the birth canal is estimated at 60 pounds per square inch on the baby. Vulnerable nerves include the vagus, the hypoglossal and glossopharyngeal nerves.
Babies also can have trouble breastfeeding if they are unable to open their jaw fully to take in a large area of breast around the nipple. This wide mouth opening is important in order to get a good lip seal so they are not sucking in air. It also helps the tongue cup the breast and create a good suction vacuum for milk to be drawn down from the breast milk glands.
The jaw also needs to be able to move forwards. If there has been compression or traction forces in this area affecting the temporal bones which the jaw joints sit in at the temporomandibular joints or TMJ, then this may adversely affect breast feeding.
The babies neck needs to be comfortable feeding both sides, we often see babies who like to feed on one side only and fuss on the other breast. Our highly trained osteopaths are able to gently treat the baby’s neck and sort out the problem. The treatment is very gentle so there is no risk to baby.
Sometimes, in about 5% of babies there is a posterior or submucosal tongue tie, this can be hard to see and at times may only be diagnosed by an experienced assessor. A submucosal tongue tie will affect the tongue’s ability to cup the breast and draw down milk.
If you suspect your baby may have a problem with their tongue you can see an experienced lactation consultant (we recommend Cheryl Ganly-Lewis in Wellington).
Initially you can self- assess it in the following way:
1) Does your baby's tongue poke out of the mouth, beyond the bottom lip?
2) Are they able to poke it to either side?
3) Can they cup your finger with their tongue and create a good coordinated sucking motion?
4) If you gently sweep your finger under their tongue, can you feel a strong central band?
If you answered no to any of the first three questions and yes to the last question then it would be a good idea to get your baby assessed as they can be helped!
We have found that by sensitively treating the tension in the tongue and surrounding tissues, this will often sort out the breastfeeding problem. We treat where the tongue connects into the connective tissue/fascia of the neck, throat and right down into the sternum or breast bone. Then about fifty percent of the time, there may no longer be a need for a snipping or lasering of the tissue under the back of the tongue.
We find that if a snip or laser is still required, then the results are much more effective as the tissues that have been tight in the area around the tongue due to the way the tongue tie formed embryologically, are already released.
It is also ideal to have 2-3 osteopathic sessions after a tongue tie release to help all the surrounding tissues come into balance with the newly freed up tongue.
Ideally a tongue problem is picked up and treated early in a newborn baby so they are able to breastfeed successfully. However we have also had very good results from osteopathic treatment of toddlers and preschool children who usually have had a big problem with breastfeeding as a baby and present to our practice with drooling and having difficulty speaking clearly due to the tongue tightness near the base. Often just a couple of treatments will sort out the problem for the young child and their family, in a non-traumatic way.
With the increasing awareness of tongue tie still present in adults, we have helped many a chronic or long term tight neck and jaw, just by gently releasing the tongue and associated tissues. Usually these adults were unable to be breastfed as babies and may have had a tight neck, jaw, head and even chronic sinus problems for most of their life.
With growing awareness of gentle cranial osteopathic treatment, we hope fewer babies are missed, breastfeeding is successful and long term problems such as neck and jaw tightness are avoided.
‘An Osteopathic Approach to Children’ Carreiro, Jane. Churchill Livingstone 2003
‘Supporting Sucking Skills in Breastfeeding Infants’ Watson Genna, Catherine 2013
‘The Cutting Edge’ Tongue Tie Conference notes Brisbane 2014
Melanie Young B.A., B.App.Sc. (Clin.Sc.), B. Osteo.Sc. Reg. Osteopath, MONZ
Director City Osteopaths
Level Four 166 Featherston St