Before Your Baby’s Visit
We understand that it can be stressful to navigate the tongue tie world, and we hope that we can provide you with a clearer understanding of what might be happening in your child's mouth that could be affecting their ability to latch, suck, swallow, and move comfortably. Here are some suggestions of ways to prepare for your child's appointment to help ensure your visit is as productive and stress-free as possible!
Work with an IBCLC
It is critical to have an IBCLC or other feeding specialist (e.g. SLP) working with you and your child prior to any treatment. This is because many infants struggle with feeding for reasons other than a tongue tie, and only a feeding specialist has the skills to evaluate and treat these issues. Sometimes feeding issues can be resolved without resorting to surgery, and treating a tongue tie without addressing other potential underlying issues may not help (and in some cases may make feeding worse).
Regardless of whether your baby is breast fed or bottle fed, all babies should be working with an IBCLC or SLP prior to any tongue tie treatment. Our office will ask for the feeding therapist’s notes to be sent over prior to your consultation.
If you are not working with an IBCLC, or if you saw someone in the past but you are no longer working with them, please call our office and we will be happy to provide you with a list of IBCLCs who are knowledgeable about tongue ties.
Working with an IBCLC prior to treatment also allows you to learn wound management and, more importantly, to practice doing the tongue exercises in your baby's mouth before any treatment is started. This allows you to get comfortable lifting your baby's tongue and putting your fingers in their mouth, which makes it much easier to do the wound care after treatment.
It is also important to follow up with your IBCLC/SLP after a tongue tie procedure. This is so the tongue can learn the proper way to move during feeding, and a feeding specialist is the best provider to help with suck therapy, oral desensitization, latching, bottle positioning, etc. and to identify any issues that may need additional therapy.
Get Started with Bodywork
When a baby has a tongue tie, their body has to compensate for the limited mobility of the tongue by tightening up in other areas. The birthing process itself may introduce tension in the baby’s body, especially if there is a traumatic labor/delivery, the baby gets “stuck,” a vacuum/forceps is used, or if the baby was in a sub-optimal position during the pregnancy or birth (e.g. breech, transverse, “sunny side up,” etc.)
“Bodywork” is a generalized term used to refer to hands-on touch and manual therapy to allow a baby’s soft tissues to release tension and reorganize. This involves slow, gentle movements across the baby’s body, paying particular attention to the head and neck, the shoulders, trunk, hips, and feet. It helps to relax the fascia throughout the body, allowing for improved sucking, swallowing, and digesting.
Some babies are compensating more than others, and there may be a need for multiple sessions with a bodyworker (e.g. chiropractor) before the body is ready to handle a tongue tie release. Other babies need very little prep work and may be “ready for release” quickly.
Click HERE for a list of bodyworkers that we work with frequently. There are dozens of other highly skilled chiropractors, osteopaths, and craniosacral therapists who can help your child prepare for a release - we encourage you to reach out to your IBCLC, pediatrician, or other references to get names of other providers in your area! Just make sure that they are trained to work on infants!
While working with an IBCLC/SLP is a requirement for release, bodywork is not always required. It is always beneficial, so we do strongly encourage having a bodyworker on board both pre- and post-operatively, but there are some cases where it is not necessary. That being said, there may also be cases where an infant has not seen a bodyworker and Dr. Aaronson notices tension or strain that will require delaying treatment until a bodyworker can do some therapy to optimize the baby’s body for a release.
Prepare Your Home
There are a few things you can do at home to make sure you are prepared to comfort your baby after a tongue tie procedure.
First, have some pain management on hand. Dr. Aaronson will review the different types of pain management with you during the consultation, but it is helpful to have a bottle of Tylenol (acetaminophen), Motrin/Advil (ibuprofen) for babies 6+ months, Camilia drops, Arnica, or other types of homeopathic treatments. We also recommend freezing a small amount of milk in an easy-to-break format (e.g. in a flat ziplock bag or in a popsicle mold) to be able to give your baby milk chips.
If possible, have some pumped milk or formula on hand in case your baby has trouble latching. While not always needed, it is helpful to have an alternative way to feed your baby other than the breast, in case there is some soreness.
If you have other children at home, it may be helpful to ensure someone will be able to tend to them while you are comforting your infant on the day of the procedure. The fussiest time tends to be about 4 hours after the procedure, lasting for a few hours and/or into the night. Some babies experience no pain at all, while others may be very fussy. Both are normal, but it is helpful to expect a fussy baby so that you can ensure other children's needs are tended to.
What's next?