Before Your Toddler’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 eat, breathe, 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 a Feeding Specialist
It is critical to have a provider who specializes in toddler feeding working with you and your child prior to any treatment. This is because many toddlers 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 child is breast fed, bottle fed, or fully weaned, all toddlers should be working with an SLP, IBCLC, or OT 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 a feeding specialist, 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 providers who are knowledgeable about tongue ties.
Working with a specialist prior to treatment also allows you to learn wound management and, more importantly, to practice doing the tongue exercises in your toddler's mouth before any treatment is started. This allows you to get comfortable lifting your child'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 feeding specialist 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 feeding therapy, oral desensitization, speech. and to identify any issues that may need additional therapy.
Get Started with Bodywork
When a child 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 child'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 child's soft tissues to release tension and reorganize. This involves slow, gentle movements across their 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 toddlers 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. Others 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 toddlers!
While working with an SLP/OT 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 child'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 child 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), Camilia drops, Arnica, or other types of homeopathic treatments. We also recommend freezing some banana, avocado, yogurt, or other soft foods that they can suck/gnaw on.
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 child 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 children experience no pain at all, while others may be very fussy. Both are normal, but it is helpful to expect a fussy toddler so that you can ensure other children's needs are tended to.
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