By Dr. Barry Gillespie and Jennifer Tow
A mom caught me by surprise recently. She told me that I had worked on her six-week-old baby, and now, at four years of age, he is still having oral issues. The dentist wants to do a revision of his ties. I immediately reviewed his record.
Because he had early breastfeeding issues, this dentist did tongue and lip tie frenectomies. Since there still were feeding problems, mom came to me. The baby also had gas, indigestion, and reflux, which told me his fascial web was probably pulling into his oral tissues.
After the first visit, he opened to a great 100-second brain cycle. She never returned to complete care, probably because he was doing better.
It is important to understand that the release itself will not resolve the functional issues. Babies will need approximately six weeks of follow-up with both the IBCLC in functional rehabilitation and the Gillespie Approach therapist to optimize the potential for functional feeding that directs proper oral growth and development.
My suggestions for an optimal treatment plan: If there are breastfeeding issues at birth (and ties will always cause some feeding dysfunction, even if baby is gaining weight and mom has no pain), mom needs to consult a skilled IBCLC and a Gillespie Approach therapist prior to release of ties. Both the baby and mom need to be adequately prepared for the release.
There are many infant bodywork modalities dealing with oral ties, but the real issue is addressing the fascial strain in the entire web. Not only will there be oral strains but probably lower-body strains pulling into the oral tissues. Most providers miss these two concepts.
The skilled IBCLC determines if surgery is needed. Neither the dentist nor therapist makes that decision. After surgery, therapy needs to be done since any surgical procedure creates a scar that can bind down the fascial web and cause later problems.
My suggestions for his current situation: I see him until he is strain-free. At the same time, he sees a myofunctional therapist who does therapy and determines if the revisions are needed. If needed, he returns to me to work out the surgical strain patterns. He may also need speech therapy, orthodontics, and other services. It gets complicated and expensive.
My ultimate suggestion: Do the work at birth by freeing the fascial web for an easier journey. Gillespie Approach Training is a must for all neonatal providers.
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