When is a tongue tie not a tongue tie? Basically it is when it is a biomechanical problem often of intrauterine (within the womb) or birth-related origin. So, what do I mean by that?
Firstly, what is a tongue tie? Open your mouth and lift your tongue up. Underneath you will see a thin strip of tissue. This is the frenulum. Everyone has one. You will notice that it runs from the floor of the mouth to the tongue. Now, although it does not control the movement of the tongue, positioning of it does, to a certain degree, anchor it. Imagine if it was very short and thick or if it came right up to the tip of the tongue, movement would be restricted. That is a tongue tie, when the frenulum is so short and thick or comes so far up the tongue that it limits its motion. Some tongue ties are very obvious being easily seen on examination. Some are less so. Sometimes the tongue acts like it is tied but doesn’t look it. So, what’s going on there?
The tongue is a muscle and is attached to the various bones of the head and face. If those bones are out of alignment then the tongue will, likewise, be out of alignment and therefore, its function compromised. The tongue doesn’t act alone. It works alongside other muscles. Together they control and coordinate feeding. These muscles are also attached to the bones of the head and face. The same principle applies, if the bones of the head and face are out of place then so are the attachments of these muscles and their function is altered. But what causes the bones of a baby’s head to be out of alignment?
There are a plethora of reasons. Firstly, how baby sits in utero. Some children are breech, (bottom or feet down). In these cases, the head is squashed up against the rib cage and the bones are easily put out of place. Others spend much of the pregnancy head down, low in the pelvis and again, this position can contort the bones of the head and face. Then there is the labour itself. How baby moves down the birth canal, position of mother as well as direct forces of contractions, not to mention use forceps; ventouse; births prolonged by slow dilatation or the child getting stuck; oxytocin, a medication that increases the frequency and force of the uterine contractions; emergency caesarean sections; and many more. Whatever the cause, out of place head and face bones alter local muscle function and as a result the child may struggle to feed as if they had a tongue tie.
So, what can be done? Here at Tri Osteopathy, I take time to listen, we talk about pregnancy and labour journey for clues to the presenting difficulties. A careful, primary-care level examination follows, in which I upturn as many biomechanical stones as I can, searching for the true cause of the problem. At the end of the day, it may be that there is a tongue tie and a frenulotomy (cutting of the frenulum) is the best course of action, or there may not be, in which case a series of osteopathic treatments may help to solve the issue. Whichever it is don’t suffer alone, just pop me a message or call and lets see what I can do to help you and your little one.
With Love
Em