Tongue Tie Integrated Care Standards
Ankyloglossia, commonly known as tongue-tie, is a condition where the frenulum—the tissue connecting the tongue to the floor of the mouth—is unusually short or tight, limiting the tongue's movement. This condition affects approximately 1.7% to 10.7% of newborns and can lead to breastfeeding challenges, including poor latch, nipple pain, and inadequate milk transfer, which may affect infant growth.The American Academy of Pediatrics (AAP) has raised concerns about the rising rates of tongue-tie diagnoses and subsequent frenotomy surgeries, suggesting that these procedures are often unnecessary. Many breastfeeding difficulties are not directly linked to ankyloglossia, and lactation specialists can often provide effective support without surgical intervention.Key points to consider include:
- Assessment: A thorough evaluation of the breastfeeding relationship is essential, as not all infants with tongue-tie experience breastfeeding issues.
- Education: Understanding the physiological impacts of tongue-tie can help parents make informed decisions regarding treatment options.
- Support Options: Consulting with lactation specialists can provide practical strategies to improve breastfeeding without immediate recourse to surgery.
- Long-term Outcomes: More research is needed to establish clear guidelines for when frenotomy is appropriate and to assess the long-term benefits of such procedures.
WHAT TO EXPECT
- 1 Tongue (lip and/or cheek) Tie
- 3 practitioners
- 10 appointments
- Every 4 hours for 4 weeks wound care management
WHO IS ON THE TEAM
The release must be part of a fully integrated plan of care by a team of qualified specialists including an IBCLC, a dentist or similar and a bodyworker specifically concerned with newborns.
An IBCLC to supervise lactation and breastfeeding as well as provide oral exercises beyond wound care.
A qualified, well trained pediatric specialist bodyworker who can address motor function, cranial and muscle tissue work for imbalances created by the tongue tie during development and any associated issues during the birth process.
The dentist or other release provider must be willing to revise tongue, lip and/or buccal ties. They must teach wound care management that includes stretches and wound massage to that is frequent (every few hours for a few weeks) with a follow up visit.
The release itself does not magically normalize the function of the tongue and mouth.
WHEN AND HOW LONG?An initial and follow up appointment with the dentist or release provider.
A PRE release appointment with a skilled bodyworker and then 2-3 follow up visits after the release.
An initial intake appointment with an IBCLC and 2-3 follow up appointments to monitor progress and milk supply.
Tongue Tie revisions or releases are part of a comprehensive, integrative approach to care for tethered oral tissue requiring a team approach over time (about 10 appointments total) to ensure successful feeding.TIMELINE OF CAREThe ideal would be to see an IBCLC to rule out any other issues related to nipple pain or low supply or a gassy baby.
THEN...
If deemed necessary by the IBCLC see a skilled bodyworker to evaluate the form and function of the baby’s body.
If deemed necessary by the IBCLC see a skilled qualified provider for a tongue tie diagnosis and release of the tethered oral tissue.
Return to the bodyworker. Return to the IBCLC. Return to the release provider. Return to the bodyworker. Return to the IBCLC. Continue until all function is normalised and feeding is established.
Aftercare at home is a CRITICAL part of the wound management. Tongue ties can readhere quickly because babies are always growing. In order to keep the wound open while it heals, you must hook your fingers in the floor of the baby’s mouth while stretching the tongue up and away to visualize a diamond shape in the wound. This must be done every 4 hours around the clock for at least a month to guarantee best results.
An IBCLC to supervise lactation and breastfeeding as well as provide oral exercises beyond wound care.
A qualified, well trained pediatric specialist bodyworker who can address motor function, cranial and muscle tissue work for imbalances created by the tongue tie during development and any associated issues during the birth process.
The dentist or other release provider must be willing to revise tongue, lip and/or buccal ties. They must teach wound care management that includes stretches and wound massage to that is frequent (every few hours for a few weeks) with a follow up visit.
The release itself does not magically normalize the function of the tongue and mouth.
WHEN AND HOW LONG?An initial and follow up appointment with the dentist or release provider.
A PRE release appointment with a skilled bodyworker and then 2-3 follow up visits after the release.
An initial intake appointment with an IBCLC and 2-3 follow up appointments to monitor progress and milk supply.
Tongue Tie revisions or releases are part of a comprehensive, integrative approach to care for tethered oral tissue requiring a team approach over time (about 10 appointments total) to ensure successful feeding.TIMELINE OF CAREThe ideal would be to see an IBCLC to rule out any other issues related to nipple pain or low supply or a gassy baby.
THEN...
If deemed necessary by the IBCLC see a skilled bodyworker to evaluate the form and function of the baby’s body.
If deemed necessary by the IBCLC see a skilled qualified provider for a tongue tie diagnosis and release of the tethered oral tissue.
Return to the bodyworker. Return to the IBCLC. Return to the release provider. Return to the bodyworker. Return to the IBCLC. Continue until all function is normalised and feeding is established.
Aftercare at home is a CRITICAL part of the wound management. Tongue ties can readhere quickly because babies are always growing. In order to keep the wound open while it heals, you must hook your fingers in the floor of the baby’s mouth while stretching the tongue up and away to visualize a diamond shape in the wound. This must be done every 4 hours around the clock for at least a month to guarantee best results.
