The osteopathic approach

to the treatment of babies

with tethered oral tissue

Osteopathy

Anatomy

& Biodynamics

Physiology Neurology Embryology

Musculoskeletal & fascial

Nervous & circulatory system Organ & endokrine system

The Oral Ankyloglossia Syndrome a group of signs and symptoms that occur together

Compensation patterns affecting

•Oral Function

(Sucking, Chewing, Swallowing, Speech)

•Musculoskeletal & Fascial

(Posture, Torticollis, Spinal)

•Airway

(Breathing, Choking, Coughing, Apnea)

• Digestion

(Reflux, Nutritional Deficiencies, Elimination)

• Sensory

(Overwhelm, Anxiety, Hyper or Hypo

Sensitivity)

• Immunity

(Frequent Colds, Cough, Throat infections

(Effath Yasmin - GOLD LECTURE SYMPOSIUM ON TONGUE TIE )

CASE •Oral Function

Visible frenulum, trouble maintaining vacuum, clicking and

applying pressure on the lips

•Musculoskeletal & Fascial

Palate, TMJ, Masticatory mm, hyoid, supra & infra hyoid mm,

cervical fascial system, head position & cervical spine, sub occipital mm,

thorax, shoulders, low rib flaring, diaphragm, pelvis, abdominal & paravertebral mm

•Airway

High costal breathing & breathing frequency, coughing, dysphagia

• Digestion

Silent reflux, stool pattern, bloating

• Sensory

Cold & damp hands and feet, reacts strongly on stimulation, moves constantly,

sleep affected

• Immunity

2 virus infections with cough & stuffed nose

TREATMENT 1. Gentle manual adjustments of blocks*, mobilization or cranial techniques

on the findings in the area of :Spine, Pelvis, Ribs. TMJ, Hyoid bone, Palate, Skull & Skull base with extra focus on

Compression at the Jugular foramen because of the affect on venous return that can cause stasis affecting 3

important cranial nerves:

N.VAGUS influencing larynx, heart, lungs, trachea, liver, gastrointestinal tract and digestive functions, has been

linked with colic and reflux, is responsible for the coordination of sucking with breathing. N. ASSESORIUS

For the SCM and trapezius muscles. Important for movement of the neck & maintaining open airways in the suck-

swallow-breathe rhythm

N. GLOSSOPHARYNGEALElevation of pharynx, irritation of the nerve can cause reflexive guarding of the airway & initiate the gag reflex this

makes breastfeeding difficult

Compression at the condylar part of the occiput where N. HYPOGLOSSUS exits with possible effect on the movement of the tongue.

2. Soft tissue release, muscle energy techniques (if possible) & mobilization of hypertone or "tight" muscles-

Activation of hypotone muscles.

3. Fascial unwinding & stretching techniques also in relation to the organs

4. Massage to reduce hypertone muscles, improve lymphatic drainage & circulation to stimulate the metabolic balance within the muscle

5. Instructing the parents on breastfeeding postions to decrease MER, massage & reflux advice.

*blocks is used to refer to a joint whose movement is limited in one or multiple planes of motion.

It has a neurologic, vascular & lymphatic effect on the join & on the surrounding tissues and organs

THE EFFECT 1. An increased excursion of the mandible so the baby was able to open the mouth

widely

2. Decreased tension in & around the mandible, mouth & cervical spine to make the baby feed with correct technique

3. Improved latch via more effective lip or tongue movement by better cirkulation,

innervation, muscle & fascia tension

4. Increased cervical range of motion, so the baby could stabilize & have optimal position at the breast also important for the suck-swallow breathe rhythm

5. Improved posture through the change in muscle & fascial chains

6. Improved - the mechanical part of - respiration and digestion ( via optimal

thoracic mobility and diaphragmatic action)

7. Decreased stress affecting the breathing, digestion, sleep, mood and tone of the muscles

Imagine for a moment, a relaxed, mobile baby growing up with good posture, optimal movement and motor skills, a solid nervous system that can take on the world, the ability to

chew, swallow breathe freely without any difficulty.

Let’s share this new knowledge & help each other help the littleones

Thank you for your time !

Photo : Mette Lyck