Oral Ties & Impact on Function: An OT Mom’s Perspective
- emma89766
- Apr 10
- 8 min read
Updated: 2 days ago
Hi! My name is Diana, I’m co-owner of Foundations Pediatric Therapy, an occupational therapist of many years, and a mom. You’d think that by having all of these “qualifications” I’d be an “expert” when it comes to my second son but I was quite humbled by the arrival of my second son, Jet! When it comes to supporting Jet’s needs, being present as his mom is the most important thing to me but if you know me, you know I can’t turn off my little therapist voice in thinking about all of the what ifs.
As an OT, I’ve heard and suspected unresolved oral ties in my young children and school aged clients from speech impediments, to poor sleep, and to delayed milestones which contribute to difficulties functioning well in the home, school, and community environments. I’ve made recommendations to families to get oral ties assessed and follow up with their providers for ongoing treatment.
As a mom, I’ve heard about the terrible exercises that are needed to comply with oral tie releases and how truly horrifying it sounds. Now after going through this transformative experience myself, I am now invested in pursuing more continuing education in oral ties to help support more families!
I’ve always said Jet is my ambitious baby boy. I’m including a few examples below:
He gave me early labor symptoms starting at 33 weeks but he held out until 37 weeks and 3 days.
My water broke at 1:15 AM and he was earth side by 3:15 AM after just 15 minutes of pushing.
Immediately after birth, Jet started suckling on his hands and the nurses said “Wow! He’s hungry! Let’s latch him!”
Jet could lift his head up while on my chest and turn from side to side. Many people mistaken this as strength but in reality, this is body tension and I couldn’t believe how much tension he had.
Baby experts say that newborns experience “second night syndrome” 24-48 hours after delivery. Our Jet graciously gave us “second night syndrome” just 18 hours after birth and would latch for 8 hours on/off throughout his first night as a newborn.
All these things contributed to why we picked the name Jet for our beautiful baby boy, it just seemed very fitting.
As soon as Jet latched, I distinctly remember getting chills and screaming out “ouch!” I nursed my first son for 9 months and Jet’s latch was very different and terribly painful. I chalked it up to him needing to practice as newborn mouths are so incredibly small. Later that evening I excitedly was looking forward to a long stretch of sleep as my husband was prepared to give Jet a bottle of formula so I could rest. As soon as it was feeding time all I heard was wailing from Jet and I looked over to see my husband struggling, milk was just flowing out of the nipple and onto Jet. And then it became a battle between trying the hospital bottle, bottles that I brought from home, trying formula, trying my reconstituted dehydrated breastmilk from my first born, and then atlas, Jet would only settle nursing directly from me while I suffered from the intense pain as he cluster fed through the night. I immediately suspected a tongue tie as this experience was just too painful. The next morning I asked the lactation consultant to check for oral ties and she didn’t have much else to add aside from “yeah, you’re probably right”. Let me start by saying IBCLCs are incredible human beings that truly try their best to support mothers and their babies but not all IBCLCs practice the same and this is where I started my journey in learning more on the difference it makes when picking preferred providers well versed in oral ties. When the pediatric surgeon checked on us in the hospital, I asked her about oral ties and she said if she saw anything she would come back and let me know and then we can make a decision to cut any ties. Well, I never saw her again after that visit and I was informed by my nurse that his tongue tie was clipped. Now that I know more, Jet likely had an anterior tongue tie that was cut with scissors. After this, nursing did seem better but it didn’t resolve everything that I was noticing. I’m all about function and Jet definitely had some non functional things going on -
Jet had torticollis as he preferred looking over his right shoulder.
He always had an open mouth posture with a tongue thrust.
He had difficulty with bottle feeding.
He coughed and made a clicking sound while nursing.
He was so incredibly tense, remember when I said earlier that he could lift his head up and look from side to side right after birth?
Shortly after discharge I started working with a tie-savvy IBCLC, an oral myofunctional speech therapist (shout out to Ms. Rose Tran at Foundations), a pediatric chiropractor, a myofascial release physical therapist and a pediatric physical therapist. I diligently attended appointments between all providers for about 3 months and although Jet was gaining weight well and I saw improvements in decreasing muscle tone, addressing body asymmetries, bottle feeding, and breastfeeding, one thing I could not overlook was he still had an open mouth posture with tongue thrust no matter how much I implemented the oral exercises and attempted to close his mouth during the day and while sleeping.
I learned more about a posterior tongue tie and its presentation. Despite getting his tongue clipped in the hospital, a posterior tongue tie is deeper than what can be cut with scissors and the best recommendation is to use a laser. Because of this restriction, Jet truly could not lift his tongue to rest at the roof of his mouth. You can’t outstretch a restriction because you don’t have the range to achieve a maximal stretch. With the support of my team, I scheduled an appointment with an airway specialist ENT, Dr. Christopher Tran at Airway Alliance. I continued to pray and hope things would miraculously improve as I was so terrified to do the oral stretches post release but in my heart I knew we’d need to clip all of Jet’s oral ties. Dr. Tran diagnosed Jet with a level 3 tongue tie (less than 50% of full range of motion of his tongue), a mod tie lip, and min-mod buccal ties on both right and left side. Let me just say, Dr. Tran is incredible. Sure, he made a recommendation to cut Jet’s oral ties but he took it a step further to explain the why and then left the decision up to me as he would support me either way – if we decided to cut or not cut. Instead of instilling fear or rushing through the appointment to force me to get Jet’s ties cut, he took the time to sit with me and listen and talk through my concerns. This is rare and truly special to find in a provider. Post release, he didn’t just give me Jet back and send me on my way, he took the time to sit there with me to guide me in his stretching technique and ensured I left feeling confident that I could do the stretches for the next 6 weeks. This is why I advocate so much for finding the right providers for your child because a terrifying experience can co-exist with an empowering experience as well. Also if a provider tells you, you don’t need to do stretches with a posterior tongue tie, this may not be the right provider for you and I say this because of what our recovery process looked like and how quickly reattachment can occur. Dr. Tran has a very strict stretching protocol and while it was hard, it was 100% worth it.
The recovery process:
It’s sort of incredible how fast I was able to see improvement. It’s like Jet’s tension melted away with these releases. For the past month (even with my support to guide his body how to roll), he kept doing this crazy body crunch in an attempt to roll off his stomach and then the morning after his release, he just rolled normally.
He also immediately started doing more closed mouth sounds the morning after.
I’m not going to sugarcoat the recovery because the first week was incredibly hard between waking up Jet through the night every 4 hours and continuing the stretches throughout the day to doing the stretches while he’s crying inconsolably to seeing some bleeding, I most definitely cried with him.
We had a 1 week post op appointment and I informed Dr. Tran that Jet has been congested this past week and it seems like he can’t nurse longer than 3-4 minutes at a time and then he told me the dreaded words “it sounds like reattachment” and my heart shattered. I asked Dr. Tran to rate it and he gave us a 6/10 for tongue range and again supported me either way if I wanted to break open the reattachment or if I wanted to preserve what range we did have. I said let’s break it open because I saw first hand the positive impact it had on Jet almost immediately and I knew he could continue to do so much more if he had full range. At this appointment, Dr. Tran again helped me with my stretching technique and did not leave the room until I felt confident I could keep up with it. Then bam, I nursed Jet immediately after the reattachment was broken and Jet nursed for longer than 10 minutes on each side even with his congestion. You can’t argue with the immediate results that I was seeing and although despite my best efforts in stretching and having reattachment, I knew this was the best decision for Jet.
At our 2 week post op appointment, Dr. Tran rated us an 8.5/10 for tongue range. He empowered me to lock in my technique with hand over hand demonstration. Looking back, I was so afraid to push down to give Jet a deep stretch because of how much he cried but by giving him a deep stretch I was allowing him to have more range of motion with his tongue and I just continued to focus on that to get us through the stretches.
At our 4 week post op appointment, WE DID IT! Dr. Tran rated us a 10/10 for tongue range. I nearly cried because I could just see all the difference in Jet’s body by achieving this full range. Jet started babbling (a skill that requires mouth closure), he was finally taking the bottle easily, he was nursing well, he had way less body tension, and he was achieving developmental milestones.
When I started this journey, I was in denial that Jet had a posterior tongue tie because I was terrified of the stretches. Then I had regret that I didn’t have his oral ties released earlier because at 4 months, he started sleeping longer stretches through the night but now I know, I was on the right timeline for Jet and myself. Had I done the release sooner, I may not have seen the direct impact it had on Jet’s body especially with babbling and rolling (developmental milestones that you don’t always see earlier than 4 months). As a clinician, I learned the fascia of the tongue runs deep throughout the body down to the toes and now having gone through this experience myself, I can confidently say I know for sure it does and Jet is the prime example of that. At the end of the day for us, Jet’s functional movement of his tongue post release has given him the best outcomes when it comes to feeding, communication, and physical development and this is only the beginning!
Comments