Is your baby’s tongue tie a tetherberg or a tether floe?

There are two kinds of ice in the ocean: icebergs and ice floes. Both can look identical on the surface, but are completely distinct below the water. Icebergs have a portion of ice seen above the surface, and huge, extensive mountains of ice below the surface, anchoring what you can see above to the masses below. Ice floes are seen from above and are basically a sheet of floating ice.

Tongue ties can also be classified into two types: tetherbergs and tether floes.

Tetherbergs are tongue ties that look tied on the surface, but the breastfeeding issues and symptoms are connected to so much more than just the tongue. Baby usually has lots of tension in the body. There may be a sensitive nervous system. A traumatic birth. Baby may live in a state of fight or flight. There may be other asymmetries or structural differences in the body. There’s so much more below the surface than meets the eye. For these babies, doing a revision of the tie is literally only the tip of the ice berg. They usually need lots of pre and post release manual therapy such as chiropractic or craniosacral therapy, occupational therapy, and suck training. It may be weeks to months before what is below the surface is fully addressed.

Tether floes are the babies I dream of in my practice. The tongue tie is the root cause of the breastfeeding problems and symptoms. A simple release is an overnight, miracle cure to nipple pain and damage, weight gain, milk supply or reflux. These babies usually need minimal additional interventions to restore the breastfeeding relationship and have all of their symptoms melt away.

Being aware of the tetherbergs vs the tether floes is the beginning to understanding your journey with a tied baby. Many families have their baby’s tie revised only to find they still have persistent symptoms. For them, the mass of ice below the surface must still be addressed before relief is gained. If you’re in the middle of your journey, keep going. Keep asking questions. Keep finding the highly trained health care providers who specialize in ties who can help.

For more information, see the original post by Michele Chatham

https://www.michalechatham.com/blog/tether-berg-or-tether-floe?fbclid=IwAR0q5o8NP_iwFkA5XijLMymDPyxcsLwvTq3cS8V4kxyRZ1jOjk3x8g5sdZE

My baby won’t breastfeed I think there’s a tongue tie

As an SLP/IBCLC, I look at three things when doing an assessment on infants: what does the tongue look like, what can the tongue do, what symptoms is it causing. The tongue needs full range of motion (in and out, side to side, and up and down ) for feeding, dental hygiene and to some extent speech. You can have a frenulum can still have good range of motion. A frenulum is considered tied when the tongue can’t move in all directions and it’s causing symptoms because it’s not functioning correctly.

Symptoms to watch out for are:

👅Can not grasp and hold a nipple for breast or bottle feeding

👅Pops on and off the breast/unable to latch or maintain the latch

👅Leaks milk from breast or bottle

👅Fatigues easily from tension on the tongue and jaw/“sleepy” at the breast

👅Wants to feed all the time and never seems satisfied

👅Causes nipple pain and damage when latched

👅Pinches the nipple when feeding causing recurrent plugged ducts and mastitis

👅Doesn’t empty the breast well causing low milk supply

👅Tongue constantly in a “stimulation” mode instead of efficient sucking at the breast, causing an over supply of milk with fast let down

👅Cannot create the vacuum needed to draw breast milk and makes a clicking or loss of suction sound at the breast

👅Poor weight gain

👅Chokes and gags during feeding

👅Fussy at the breast

👅Swallows air while feeding causing reflux, gassiness or colic

When range of motion is restricted, or is causing symptoms, I will refer to a pediatric dentist who also looks at how the frenulum is impacting structure: is it pulling on the structures of the floor of the mouth and the jaw? Is it putting tension on the bone? In those cases, when function is restricted and it is currently causing symptoms, a revision is warranted. I never recommend revision to avoid symptoms down the road. It’s not ethical.