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  • Writer's pictureMegan Dunn

It's a process

Our babies are delicate little people sensitive to the many sensory inputs they receive every moment.  They are born with reflexes – automatic responses – to help them survive and at least 20 of those aid in feeding. 

Those feeding reflexes are started by stimuli – a chin pressed into a breast, a nipple rubbing on a cheek – and the movement response is carried out using multiple muscles.  What happens though when baby has is still recovering from a challenging birth or was constrained in the womb causing some muscles to be tighter on one side or their chin to be pulled back a bit far?

The automatic reflexes have a progression A then B then C.  If A is the stimuli and C is the result, B must be functional to get to the result.  These reflexes are automatic and our babies do not at first know how to get to C if B is not working correctly.  They may develop a work around and perhaps hop down the alphabet to D or even F to try to work back to the result they need.  Those workarounds can be described as a compensation. 

A compensation which requires baby to skip around our metaphoric alphabet is not as efficient as the born-in reflex pattern – it’s not functional and it’s not efficient.

Let’s pretend the child in this example is also one of the 8ish% who is also born with a tight lingual frenulum (tongue tie) which is also impairing their feeding function.  What happens if we immediately release that tie without addressing the other bodily dysfunctions contributing to their feeding problems?  Baby still doesn’t know how to get their alphabet in order.  They may try the old method of A, G, C – but that doesn’t work either, so they are left to find a whole new order leaving them with a new feeding problem rather than correcting everything like one might have hoped.

What happens if instead, your infant feeding therapist helps your baby get as close to A, B, C prior to the surgery?  What if we address the head rotation, the receded chin, the discomfort baby is feeling first?  The most ideal scenario is that by removing all the other barriers to tongue function this baby with that tight frenulum now have normal function and can eat, breathe, and use their tongue within it’s full range of motion and endurance.  The other scenario, going back to our alphabet metaphor, is that perhaps this child is now singing a different and much closer alphabet so the leap toward A, B, C post-frenotomy is now a lot easier and faster.  In the latter scenario, baby will still likely need support through your feeding therapist (IBCLC) to reach full rehabilitation through gentle movements and oral exercises but these are a lot easier to achieve with a baby who is comfortable and as close to reciting their ABCs as possible.

This process should be addressed swiftly - often we can see improvement toward functionality in a week or less with very young babies.  Deciding when and if to release ties is crucial and requires a healthcare provider with advanced knowledge, skills, and keen assessment.

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