09/06/2026
Treating patterns, not parts.
Here’s some of the oral restrictions identified in a 6-week-old baby I saw today.
From the very beginning, feeding had been challenging. Mum described his tongue as “really lazy” and said he struggled to properly latch and “grab the boob.” He was taking in a lot of air, couldn’t tolerate lying on his back without distress, and his sleep was frequently disrupted by obvious discomfort and passing wind.
Mum had repeatedly raised concerns with multiple health professionals. She had spoken with the paediatrician in hospital, the child health nurse, and her midwife. Each time she was reassured that everything was fine and advised to wait.
It was only after seeing a chiropractor for other concerns that she was encouraged to explore oral ties further and connect with an IBCLC virtually (they are regional). Up to five oral restrictions were flagged through photos, videos, and functional assessment, which we confirmed today.
One of the questions I am increasingly asked when multiple restrictions are identified is whether they can be released in stages. For example, should we release the tongue and upper lip first, then wait and see what happens before considering anything else?
These days, I’ve largely adopted an all-or-nothing approach.
The reason is that I can no longer ignore the facial and perioral tension associated with lip and cheek restrictions. In many cases, I suspect these restrictions are an overlooked contributor to shallow latch, poor seal, and compensatory feeding patterns.
If the lips and cheeks remain restricted, the tongue may gain mobility following a tongue-tie release, but the baby may still rely on overuse of the lips, cheeks, and facial muscles. In my experience, optimal suction requires the whole system to function well, not just the tongue.
Now that I’ve been releasing oral ties in infants for more than a decade, I have had the opportunity to follow many of these children over time. Increasingly, I see children presenting years later for orthodontic treatment with facial tension patterns and restrictions that I simply wasn’t paying enough attention to earlier in my career.
I’ve also observed recurring associations between these restrictions and particular patterns of dental and jaw development. Many of the restrictions I now identify in infancy are the same restrictions I often find myself addressing years later alongside orthodontic treatment to help address ongoing oral dysfunction and support stability of results.
This is one of the reasons I have become more proactive.
I increasingly view optimal latch, whether at the breast or bottle, as one of the earliest foundations for good oral function. I want to encourage colleagues and parents to look beyond reduced pain, adequate weight gain, and reduced air intake. Optimising depth of latch, seal, and tongue suction are worthy goals.
I increasingly view shallow latch as more than a feeding challenge. It may be one of the earliest clues that the developing oral and facial system is functioning under tension and compensation.
Today, after releasing the clinically significant restrictions identified in this baby’s assessment, mum reported a good feed post-release.
She described a wider mouth opening, less chomping, a more comfortable latch, and a noticeably more relaxed face with less downturn of the lips.
One feed doesn’t tell the whole story.
But observations like these continue to reinforce my belief that we need to treat the pattern, not just a part.
Disclaimer: Any surgical or invasive procedure carries risks. Before proceeding, seek a second opinion from an appropriately qualified health practitioner.
