Tongue ties and FAQs

Occupations are the activities that we all do throughout our day. Occupational therapy (OT) helps people engage in activities they are unable to do. Your baby's main occupations are to eat, sleep, and play, so OT By Mommy gives babies the skills they need to engage in these activities.

If your baby is having difficulty with tummy time, eating, colic, reaching milestones, sleeping, or any other daily activities, they would benefit from OT services.

While everyone has a frenulum or band of tissue on their tongue, we consider it a tongue-tie when that tissue is tight or thick, and impacting oral function. Along with a tongue tie, we may see lip ties or buccal (cheek) ties. Together they are often referred to as tethered oral tissues (TOTs). At OT By Mommy, we often use tongue tie, TOTs, and oral restriction interchangeably. We prefer the term oral restriction because it encompasses the structures (TOTs) and restricted function due to the muscles compensating.

Some physical signs of oral restriction include lip blistering or appearance of chapped lips, small or recessed jaw, low oral tone, facial asymmetries, high/narrow palate, dimpling, and more. Some functional signs of oral restriction can include bottle refusal, breast refusal, coughing, choking, sputtering, loud gulping, milk dribbling from the sides of the mouth, turning away from the breast or bottle, failure to thrive or weight gain issues, poor milk production, excessive milk production, clogged ducts or mastitis, difficulty falling or staying asleep, reflux, excessive gas, colic, and many more. We often see the whole body working hard to feed so baby may appear "strong," roll very early, and lift their head high due to the imbalance of tension in the nervous system.

If baby has signs of tethered oral tissues (TOTs), a functional evaluation is necessary to determine if the tie is the issue. Babies typically benefit from pre-release therapy for neuromuscular re-education (to learn to active the right muscles) from a qualified therapy provider like an OT, as a compliment to high-quality lactation care, even if a tie has already been identified. As OTs, we are uniquely qualified to work on whole-body function, sensory processing and regulation, motor milestones, oral skills, and wound care.

As occupational therapists, we address the functional difficulties like feeding, tummy time, symmetry, temperament, and milestones. We also provide a foundation for the longer-term functional impacts related to oral restriction that are often discussed, but less often addressed, like crossing midline, attention, sensory processing, vestibular difficulties, learning, and development of the growing child.

Bodywork is a blanket term for providers working hands-on with babies. We provide hands-on therapy. We even do manual therapies, like cranial sacral therapy, and forms of massage, but we provide more than just bodywork, we work on function and neuromuscular re-education.

Nope! While we often recommend releases when functionally necessary, the final decision is up to you and your family. We work to see functional changes before babies go for a release. We will provide you with education, resources, and recommendations, but some of our families opt out of going for a tongue tie release and are happy with the changes from therapy alone.

Nope! We find the best results happen when there is a team approach to oral restriction. We often collaborate with IBCLCs, chiropractors, osteopaths, speech and language pathologists, and more! If you need a recommendation for a trusted colleague in another profession, feel free to ask us!

Many of the issues we see are so common that they are dismissed by other medical professionals as "normal." If you feel your baby needs support or daily activities like feeding, sleep, and tummy time are harder than they should be, but your concerns have been dismissed by other providers; we are happy to help support you with an evaluation or by connecting you to relevant resources. Often times, even if the issue is common, there are ways to help give babies and parents more tools for more enjoyable experiences. OT by Mommy works to get to the root-cause to give baby a solid foundation for development.