Was baby diagnosed with a "small tongue tie" but didn't require treatment to breastfeed? Or maybe a tongue tie was never diagnosed during infancy, but now you notice symptoms consistent with toddlerhood tongue ties. Sometimes maternal milk supply is so robust that a tongue tied baby requires very little effort to breastfeed. Or a bottle fed baby may have a tongue tie go undetected, because family found the right bottle that met baby's needs for compensation (like flat nipple bottles, or shallow latch bottles, nipples baby can bite on to express milk, etc). Either way, these are some of the common symptoms associated with an orofacial myofunctional disorder, or tongue tie, in toddlerhood:
History of breast or bottle feeding difficulties
Gags or chokes on solids
Picking eating, food refusal
Chronic open mouth
Drooling
Poor sleep quality
Obstructive sleep apnea
Snoring
Dark circles under the eyes
Chronic ear infections
Enlarged adenoids/tonsils
High palate and narrow upper dental arch (front teeth protrude)
Teeth grinding
Tooth decay
Tongue thrust with speech and swallow
ADHD like symptoms, behaviors, learning difficulties
Thumb/finger sucking
Biting or mouthing nonfood objects
Difficulty potty training
Who should you see for a tongue tied toddler?
Tongue tie management at any age requires a team approach. Members of your healthcare team will depend on symptoms, which providers in your community have advanced training in tethered oral tissues and myofunctional disorders, and child's age. If you don't know where to start, start with a reputable, airway-centric pediatric dentist. From there, the team may include:
ENT
Orthodontist
Myofunctional trained feeding therapist:
Speech-Language Pathologist
Occupational Therapist
Physical Therapist
Chiropractor
What does feeding therapy look like in toddlerhood? It's play-based, with a lot of parent coaching. The goal is optimal oral rest posture (mouth closed and tongue up), and appropriate muscle function for speech and feeding. While toddlers aren't old enough to actively participate in myofunctional therapy, we target oral function through play. The important thing at this age is that we can get the mouth closed to combat risk of dry mouth and tooth decay, support nasal breathing and proper airway growth, good oral/dental development, and protect against respiratory infections and inflammation of lymph tissue. Treatment may also address feeding challenges. What kind of feeding challenges might be associated with a tongue tie?
Picky eating, preference for snack foods or other easy-to-chew foods
Preference to graze over eating a meal
Coughing on food/liquid
Overstuffing the mouth
Pocketing food in the cheeks
If you are in the Spokane area and think your toddler has a tongue tie, we specialize in assessment and treatment of tongue ties and myofunctional disorders. Schedule a free phone consultation online!
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