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Tongue-tie and Breastfeeding

A tongue-tie (ankyloglossia) occurs when the connective tissue (frenum) under the tongue causes restriction in the tongue movement or function. It occurs in 2.8 – 10.7% babies, more often in boys and can be hereditary.

Anterior tongue-tie occurs when the frenum is attached at the front of the tongue, close to the tip. When the frenum is attached further back, or behind the mucosa, the term posterior tongue-tie is used. This term does not have consensus and the topic of posterior tongue tie (and lip tie) is a controversial one. Research is limited and opinions are divided.

Photo courtesy of Monica Hogan & David Todd

Signs & Symptoms

A baby with tongue-tie may not be able to poke the tongue out beyond the gum line / lips;  and /or may not be able to lift the tongue, or move it side to side. The tongue tip may look notched or heart shaped. This may interfere with correct attachment at the breast, leading to some of these problems:

Mother:

  • Nipple pain and damage
  • Low milk supply
  • Blocked ducts / mastitis
  • Early weaning
  • Frustration, disappointment and discouragement with breastfeeding

Infant:

  • Baby can’t latch or stay latched
  • Fussiness and frequent arching away from the breast
  • Clicking sound while feeding or spilling (poor suction)
  • Poor milk transfer – frequent small feeds or long inefficient feeds
  • Low weight gain
  • Chewing or chomping at the breast

How to treat:

Frenotomy is a minor surgical procedure performed using scissors. It is quick and the baby will often settle soon after. It can be performed without anaesthesia. Scissors are often used when the frenum is thin and anterior and unlikely to bleed much.

Laser frenectomy is an effective method for “posterior” tongue-tie / submucosal tongue-tie and lip tie that controls bleeding well. This is generally performed by a paediatric dentist or surgeon. Different lasers are used: water-lase is commonly used with infants.

Risks:

Infection is rare. Some babies may become fussy at the breast for a period of time afterwards. Bleeding is common – sucking/feeding straight after the procedure usually resolves this. There is a small risk of reattachment and scarring that may require a repeat procedure. Wound stretches and other oral exercises are often advised for this reason but may distress the baby and lead to oral aversion.

My approach as an IBCLC/bodyworker:

Sadly, I have seen many parents (and babies) whose breastfeeding journeys have been negatively affected due to missed tongue-ties. Babies with feeding challenges need to have an individualised, comprehensive feeding and oral function assessment. An IBCLC can rule out nipple infections and positioning and attachment issues which may potentially avoid surgery. Since becoming a craniosacral therapist, I further understand how cranial nerve compression and tension in the body can also cause similar symptoms to tongue tie. The tongue may be restricted, but not specifically due to the presence of a tight frenum. A couple of sessions of cranio/bodywork beforehand may address these issues and have a positive impact on breastfeeding. A procedure may be avoided or it may become clearer that a release is necessary. Cranio after the procedure can help to resolve any stress and to optimise function.

There is so much controversy, and limited research, around tongue ties, that it can be difficult for parents to know whether to go ahead with a procedure to release a tie – especially with posterior tongue-ties and lip ties. Where there is doubt about the presence of a tongue-tie, cranio is a gentle, less invasive approach than laser frenectomy. But ultimately, treating the tongue-tie can make all the difference to breastfeeding success.

Contact me for a lactation consultation, tongue-tie assessment or cranio pre or post tongue-tie release.

Four reasons why cranio supports infant sleep

I spent 4 years in the midst of sleep deprivation when my kids were babies.

My first son had difficulty with transitioning in and out of sleep. In hindsight I know this was related to our difficult birth and an activated nervous system. I didn’t know about cranio at the time. I took him to a chiro, a couple of times, and he slept well for the night of the treatments, but that was it.

My second son had food sensitivities. Safe co-sleeping was our survival strategy.

Both my kids didn’t sleep through the night until they were over two.

Image courtsey of Verity Worthington (Baby Sleep Information Source)

I understand the desperation parents feel when sleep deprived, the brain does not work well and life can feel overwhelming. Mainstream advice seems to consist of various ways of leaving the baby to cry, which goes against babies biological expectations to be comforted by, and to be in close proximity to caregivers.

I’m not here to say your baby should be sleeping through the night or self-settling. But if they are hard to settle to sleep, or cannot be put down at all, then cranio may help resolve any underlying issues. Babies tend to sleep better after cranio, not just the night of the session, but better sleep in general.

Here are some quotes from parents I have worked with recently:

“he is sleeping longer stretches in his bassinet”

“he slept 5 hours in a row last night”

“she is calmer and easier to settle”

“he is going down for more sleeps and they are longer”

“she will now fall asleep on the breast”

How does cranio help?

1. Babies nervous system may be stuck in a fight or flight state.

Birth, or events afterwards, may trigger a survival response in the nervous system. An activated nervous system is not a recipe for good sleep. Cranio works with the nervous system, the listening touch helps the body to switch out of a “fight or flight” state into “rest and repair”.

2. Compression of the vagus nerve.

The vagus nerve is an important nerve that regulates the autonomic nervous system. It winds its way from the brainstem, between the cranial bones down to the heart, lungs and digestive organs. If, after birth, the cranial bones are not optimally aligned the functioning of this nerve may be impacted. Cranio helps the body to self-shift these bones into a position that maximises function – breathing and heart rate is more regulated and feeding, digestion and sleep improves.

3. Musculo-skeletal issues

I have treated babies who have had back and neck injuries from inutero positioning or the birth process. If babies are uncomfortable or in pain they will not sleep well. Cranio helps the body to let go of any constrictions – to soften and relax – and this has a ripple effect on sleep and feeding.

4. Birth imprints

The experience of birth leaves an imprint on our bodies, especially when there have been strong emotions involved e.g. fear, stress or sadness. If baby has a story that is unresolved or cycling in their system, then they will be driven to try to tell this story through their behaviour, this can impact sleep and feeding. When babies bodies are listened to during a cranio treatment, then the baby feels heard and at peace. They often sleep (and feed) better when they have gotten the story off their chest.

Disclaimer!

Cranio is not necessarily the panacea. Some babies I have worked with do not improve with sleep, often for the following reasons:

  • Developmental leaps – cranio will often trigger a developmental leap and when babies are practicing rolling or crawling they are more likely to wake more frequently for a while.
  • Food sensitivities – babies who are uncomfortable due to cows milk protein intolerance (CMPI) or other food sensitivities will continue to be uncomfortable until the offending food is removed from their diet.
  • Temperament – some babies do tend to wake frequently even after emotional, physical and nervous system issues are ruled out or resolved. This may just be part of their temperament.

Sleep is not a learned behaviour but the result of a settled nervous system and a body free from physical restrictions and difficult emotions. Cranio is a gentle and often effective way to resolve the underlying issues that get in the way of sleep.  

Get in touch if you would like to try cranio for your little one.

Laryngomalacia and breastfeeding

Laryngomalacia, also known as “floppy larynx”, is a congenital condition where tissues are softer around the voice box and collapse in, partially blocking the airway. These babies tend to present first with feeding difficulties, struggling to transfer milk, and as such, lactation consultants are among the first health professionals to notice it. It may not be until around 2 months that the characteristic squeaky breathing becomes a noticable pattern. I have seen this condition quite a bit in the last few years (and most likely missed this in my first few years of being an LC), I write this article to share my experience as I have found it difficult to find information on the internet that specifically pertains to how breastfeeding looks in these babies.

What to look for:

  • Squeaky noise when breathing in.
  • Noisy when feeding or during sleep or when lying on their backs.
  • Low weight gain.
  • Poor milk transfer (breast and/or bottle); lots of pauses when feeding; long inefficient feeds.
  • Spilling or choking or coming off the breast to breathe.
  • Mouth breathing (babies should breathe through their nose).
  • Pale skin.
  • Weakness eg. floppy arms.
  • Chest retractions – skin sucking in around ribcage eg tracheal tug – when the skin sucks in at the bottom of the neck, between the collar bones.
  • Reflux is common


Breastfeeding can be challenging for these babies, as they understandably prioritise breathing over feeding. They may seem stressed when breastfeeding, stop feeding before taking a full feed and struggle to gain weight. Some babies do better when feeding from a bottle, though others struggle with bottlefeeding too; taking a long time to feed and needing to pause often. Mothers benefit from support from an IBCLC experienced in this area. We have tools to assess milk transfer and can support you with a feeding plan. It can be helpful to do a 24 milk production assessment; weighing the baby before and after feeds for a day, to work out how much extra milk baby needs. Some mothers end up predominantly pumping their milk for their baby. Though, some babies will gain enough weight with smaller, very frequent feeds. Upright positioning or any position that ensures the babies neck is extended (to open the airway) is often better in these babies.

It is important to see a doctor for diagnosis. A GP will likely refer to an ENT (ear, nose, throat) doctor. Most babies improve with time, the condition is usually outgrown during the first year of life. For babies with mild to moderate laryngomalacia, treatment is usually to wait and watch, weighing baby regularly to ensure the baby is taking enough milk to thrive, though I have worked with a few babies with severe laryngomalacia who needed to be hospitalised or have surgery.

Have you breastfed a baby with laryngomalacia? Please feel free to leave a comment below to share your breastfeeding journey so that other mothers may benefit from your experience.

Availability during the holiday season

Often I am away during Christmas and New Year and unavailable for clients. This year I am staying in Perth. I will be away late January instead.

Breastfeeding mothers often find it difficult to access support at this time of year, so don’t hesitate to book a lactation appt if you are struggling.

It is also a good time to book the kids in for a cranio session during the school holidays.

Whatever you are doing during the holiday season, I hope you find time to relax and enjoy time with friends and family and to switch off from work and responsibilities.

Falling asleep during a session

Its quite common for babies to fall asleep during a cranio session. Occasionally an exhausted adult will also drop into sleep. Recently, I had a couple of kids fall asleep during the treatment – which is pretty special.

Cranio helps the body to shift out of a “fight or flight” state into “rest and repair”, sometimes this looks like sleep. Both my boys ask for cranio when they have difficulty getting to sleep and I have occasionally helped my friend’s kids get to sleep at night, while I am at their place. Once, my skeptical partner (who still doesn’t understand cranio) allowed me to do cranio while he lay on the beach as he drifted off into a blissful sleep (he put it down to the gentle lapping of the waves, not the touch!).

It really is a privilege to support any body to shift out of a busy state; to find a sense of stillness and calm (that continues beyond the confines of the treatment room).

Perhaps you need this at the end of a difficult year? Would you like to find a calm centre during the silly season?

Contact me to make an appt – your body will thank you!

Top six reasons your baby would benefit from cranio.

Cranio is a holistic, gentle treatment that supports the nervous system to down-regulate, which triggers the body’s own self-healing mechanism.  Because it is so gentle, it is perfect to use with babies. Plus babies systems are so potent and ready to shift easily back to balance – some just need a little cranio support.

Because cranio is not well known, parents may not know the kinds of things that cranio is good at addressing. Here are the top six issues I see in my cranio/lactation practice:

1. Your baby had significant bruising around their head after birth

Some babies complete their birth journey looking pretty beat up!

Check out the squashed nose and facial asymmetry on this little bub, I had the pleasure to treat. He was not able to latch onto the breast without a shield and had issues transferring milk (before cranio).

And this little one had obviously been assisted to birth with a vacuum!

If after birth, your baby had significant bruising, forceps marks, chignon from vacuum extraction, a cephalohematoma or other abnormal head shape, it is a sign that baby has undergone some difficulty during birth and would benefit from cranio. Hospital staff are used to these kinds of injuries and often dismiss it, knowing that superficially these marks do disappear over the following weeks to months. But there can still be underlying physical and emotional tensions that are not yet integrated. These stress imprints remain in the tissues in obvious and less obvious ways. Babies may be very sensitive to touch on their head and may react strongly to clothes being pulled over their head. Other infant interventions like suctioning or fetal scalp monitors may also impact the tissues, in less obvious ways but may still be held in the system.

Cranio can find these holding patterns in the body and facilitate their system to gently release, leaving a sense of peace in the baby’s system.

2. Labour was very long or very fast

Babies have their own experience of birth, often linked to their mothers, but with their own unique pressures and stresses. If they have felt stuck for any reason or under a lot of pressure for a long amount of time this can influence their bodies, in particular the nervous system and the neck. They may have felt scared or panicked. If a prolonged labour ended up in emergency c-section then the baby may also feel disoriented, this can show as arching at the breast or pushing with the feet, the baby can feel stuck in the birth sequence of pushing from the uterine walls.

On the flip side, a fast birth may be a shock to the baby and can show up as activation in their nervous system.

Cranio acknowledges the birth experience and allows these physical and emotional tensions to release leading to happier well-adjusted babies.

3. You have been told your baby has a tongue tie

There is much controversy around tongue tie recently. Research is lacking around posterior tongue ties and lip ties, but that doesn’t mean they don’t exist. It helps to have bodywork before undergoing a tongue tie release. Cranio is a form of bodywork that can address other issues that may mimic the symptoms of tongue tie such as, cranial nerve dysfunction, tight fascia or general nervous system activation. If a couple of cranio treatments improves breastfeeding then the tongue tie procedure may be avoided; if it doesn’t, then the parent can feel confident that the procedure is necessary. It is also recommended to schedule a cranio treatment within a week of the tongue tie release, to optimise function and to reset the nervous system.

4. Your newborn has difficulty latching to the breast

Newborn babies have natural instincts to latch themselves to the breast after birth, if they can’t then there is usually a good reason for it. Often the mum feels like she is doing something wrong, but it is actually because the baby is in pain, tense, stressed or medicated from birth. Perhaps there is a tongue tie or tight jaw muscles? Cranial nerve function can be impeded due to compression of cranial bones which can affect tongue function and sensation. The earlier cranio treatment is given the better in these circumstances.

5. Your baby cries a lot

Babies cry to communicate and once that need is met usually stop crying. If your baby cries inconsolably or with a high pitch then they may need some cranio support. Some babies have musculoskeletal pain or discomfort from birth. Others have a strong need to tell their birth story through memory crying. I have successfully treated babies who have cried excessively since birth. Cranio provides deep listening as well as addressing any physical tensions and may help get to the root cause of their suffering.

6. Baby has a head preference/torticollis or breastfeeding is painful on one side

This gorgeous little guy needed a few cranio sessions for torticollis that was affecting latch at the breast and also causing him discomfort.

Babies with a stiff neck tend to have trouble with positioning and latch. Tight inutero environments and/or asynclitic positions during birth may impact the neck/shoulders and jaw and other parts of the body. This can cause breastfeeding difficulties which tend to be slow to resolve on their own. Cranio helps the body let go of these restrictions and then breastfeeding often becomes easier.

Birth is a formative experience. Its impact is imprinted in the tissues of the body and can influence the health and wellbeing of the person from infant to adulthood. Early cranio treatment can prevent future difficulties such as headaches, anxiety and more.

As the twig is bent, so grows the tree

Alexander Pope

Often an hour or so of skin to skin after birth helps the mum and baby to integrate the birth experience and let go of any held tensions; sometimes this doesn’t happen, sometimes it does – but bub needs more support.

Contact me to book your baby in for a treatment.

Photos used with parents permission*

Six issues that cranio works quickly to help in babies

Cranio is a gentle, holistic treatment that has the potential to facilitate profound changes in the body, which can make all the difference to an infant’s sense of wellbeing. Babies often find it to be very relaxing and parents often notice they feel a lot calmer too after their baby receives treatment. Babies tend to respond quickly to cranio, often only needing between 1-3 treatments. These six issues can be easily addressed in one session:

1. Your labour was induced

Induction via a Syntocinon drip can feel intense to mothers, often we overlook the experience of the baby. Babies play an active role in birth; pushing off the uterine walls with their feet, twisting and turning to find their way out. Induction overrides this natural pacing and sequence. During a cranio treatment I may palpate tones of urgency and fear. These stress imprints often resolve within one cranio treatment where they otherwise may be held in the body and impact on feeding, sleep and baby behaviour. Feeling of self-empowerment are often restored after a cranio treatment.

2. Your baby is restless when sleeping or difficult to settle to sleep

This may be related to a difficult birth experience, sometimes these babies are in shock from the birth or stuck in “fight or flight” mode with their nervous system is dialled up. Cranio helps to calm the nervous system. This isn’t just within a treatment, but often continues afterwards. Babies then feel safe enough to drop into a deep sleep. *Other reasons may include food sensitivities and may not be as easily addressed with cranio.

3. Your newborn baby falls asleep at the breast within 5 minutes

Medication or anaesthesia from birth may still be influencing baby. Or the baby may be in parasympathetic shock after birth. This is the freeze aspect of the nervous system survival mode – “fight, flight or freeze”. Cranio can clear this dissociative state so that baby is more alert to feed.

4. Your baby has poor eye contact

We underestimate babies. They have a strong capacity for connection and can make deep eye contact if they feel safe and are not holding on to difficult experiences. Babies often have improved capacity for eye contact after cranio treatment.

5. Your baby was exposed to medication (during pregnancy, birth or anytime afterwards)

Perhaps you had to take medication (including antidepressants, pethidine) during pregnancy or labour. Sometimes this is unavoidable and in the best interests of both mum and baby. Or maybe your baby had to have antibiotics for a health concern.

A baby may need a little support to help clear the side effects from their system, usually one session is all that is needed.

6. Baby vomits or hiccups excessively

There may be tensions in the diaphragm that cranio can help to release.


Ideally babies would have treatment in the weeks and months following birth, but it is never too late to book in. Please share with anyone you know who is pregnant or has a baby.

Please contact me to book an appt for your baby.

Price increase

As of 1st January 2021 I will be increasing my prices for new clients:

  • Lactation clinic consults: $180
  • Baby* /Child cranio: $70
  • Adult Cranio: $90
  • Mum and Bub cranio: $140

Home visiting in Perth area and surrounds.

  • $20 extra travel charge within the service area
  • $35 extra travel charge for areas outside of the service area

*I will continue to offer monthly, low-cost baby cranio clinics once, so babies can access this therapy despite parental financial restrictions.