Posterior tongue tie, osteopathy and relfux

[Millennial13]

DS is 15 days old and after first few days he started being sick after feeds and showing signs of discomfort in the evenings - bringing knees up to chest, arching back and screaming crying. He also sounds hoarse & wheezy and frequently hiccups. I am exclusively breastfeeding. It’s got to the point now where milk just spills or forcefully comes out of his mouth straight after some feeds (mostly morning and evening). He is then hungry afterwards and as a result, is on my boob quite a lot! Despite lots of cluster feeding, he has been slow to gain weight but midwives and HVs are not concerned because he is gaining and they say that the sickness is normal or it’s likely just reflux (there’s no just about it - it’s horrible for him and us!).

I saw a lactation consultant yesterday for a tongue tie assessment and she diagnosed a borderline posterior TT. She said it’s likely due to tension in his neck caused by a ventouse delivery. His latch was also quite shallow due to his chin not protruding as much as normal and I also have a fast let down. So a few things going on! She gave me the option for cutting but suggested he has some sessions of osteopathy first and if that doesn’t work, to come back for a division. We have already started seeing an osteopath so I decided to go down that route particularly as he is still so young.

Wondering if anybody else has experience with similar issues and whether osteopathy has made a difference to sickness/reflux symptoms or if you went for a TT division and found that worked?

Thanks!

Cranial osteopathy is pure quackery and babies have died from it, though thankfully all that usually happens is their parents waste time and money. I wouldn't see that "consultant" again.

I’m an IBCLC & training to be a tt practitioner & have seen babies benefit hugely from osteopathy/release of tension pre further assessment & yes often they don’t need frenulectomy as the tension was causing the tightness.

(for those calling quackery, hunch your shoulders & tip your chin to your chest & try to stick your tongue out, v’s relaxing shoulders tipping head back slightly (as if you were drinking) & see which feels easier).

it’s likely that your letdown flow isn’t any faster than others, but because baby is latch is so shallow they can’t compress the breast to control the flow as effectively as others can.

wishing you the best of luck going forward @Millennial13x

My DD was born via forceps delivery, and had significant tongue tie. Breast feeding was agony so we had to divide privately at 8 days old. Her latch was still super shallow, the osteopath helped release tension from her face and neck from delivery and her whole body basically from being squished up inside. She had torticollis and was lifting her head up as soon as she was born from the tension, it was awful I didn’t realise at the time! One session wasn’t enough either, it seemed that once we had finished with one issue or she had a growth spurt she would revert back.
From birth she had terrible reflux and was a really sicky baby, they prescribed gaviscon etc thought to be an allergy, when simply no it was her latch that was bothering her. As soon as she we started up right feeding it was a game changer at 3 months everything changed, the osteopath has definitely helped us, she is nearly 7 months now and we went to visit again just last month as I noticed my nipple was going a bit sore again as she had become shallow and after one visit back to normal again.
Highly recommend!

One of the issues is that while yes having a hunched.up shoulders makes drinking hard the evidence for osteo on babies fixing it is weak.

Is it cranial osteopathy where they do very light touches over the scalp? If so it's utter nonsense and its a shame vulnerable mothers are steered into it by health professionals.

Go to a proper pediatric physio if there are issues with the neck.

Also consider cmpa. It often goes hand in hand with tongue tie.

I had DD’s posterior tongue tie released and upper lip tie. She was still a very tricky refluxy baby. She was a natural birth with no intervention. Also tried the osteopathy. She had colic and just had to be kept upright most of the time to keep her happy.

It just all improved from 3 months and she was happy once she could sit.

I did think me not having dairy reduced her spills. It increased a great deal in volume when I consumed dairy. Could have been coincidence.

It’s really difficult and stressful to manage with a baby with ailments like these . It will get better with time regardless of which route you take. I think there are also dental and speech benefits for having some ties treated.

I hope it gets better soon.

Sometimes. Sometimes they do "manipulations" like chiropractic (also quackery) and these are not just useless as fixing problems but actively dangerous.

Please do not bring your helpless babies to these people.

My local hospital's maternity unit are working with an excellent cranial osteopath on a clinical study of the impact of cranial osteopathy on tongue ties and potential to avoid surgery. They also have a scheme where GPs and HVs can refer newborns for a no-cost check up with a cranial osteopath for digestive/sleep issues.

Are you sure you are sharing accurate information?

Yes. The evidence is very clear.

We used the Osteopathic Centre for Children (if you are London based). DD2 was breech and (we later found out also) had a 90% TT. Osteopathy (not just cranial osteopathy) is also recommended for breech babies and the NHS offers osteopathy now - https://www.nhs.uk/conditions/osteopathy/, so im not sure its still considered "quackery" . Anyway, DD2 had 4 sessions, was definitely chilled afterwards, always had a big sleep. So good from that perspective. TT still needed to be divided though and really that made the biggest different to feeds. We struggled on until around 10weeks i think? I lose track. But I'd say get the TT divided sooner rather than later as I think the ineffective feeding had impacted my supply by the time we got it sorted. Nothing sorted the reflux except time, but we used infant gaviscon to get it a bit more under control. If you get the gaviscon, the full dose often causes constipation. With a bit of trial and error, we found that about 1/4 - 1/2 dose was enough to reduce the reflux without causing problems at the nappy end.

Would you like to share your evidence then, @ArtTheClownIsNotAMime?

A friend used an osteopath in similar circumstances and found it helpful (although there was an element of baby just...growing anyway). She had a forceps delivery and poor thing was very tight.

We went to a pediatric physio as my son had a lot of tension on one side and ruined one of my nipples. She gave us exercises which I stuck with plus different breastfeeding positions. Again, I don't know if the exercises really helped or if it was just time.

At 8 weeks we also diagnosed a dairy allergy. I had to cut dairy and soy eventually and my baby really thrived after that.

The issue is that "cranial osteopath" and "osteopath" are two very different things. The former is about craniosacral energy sources and light touches of the head.

I used a cranial osteopath for DC1, one that had fantastic reviews, all the mums in our town were going etc. and it was an utter sham. I wish I'd looked more into it but I was desperate and vulnerable (which is how they gain their money!) I went 4 times. By the 3rd time I had seen no changes so I cut dairy from her diet and her behaviour changed over night. I went back for follow up with the cranial osteopath who claimed her behaviour as a result of his therapy. Utter bollocks!

With DC2 I used a properly qualified paediatric physio and the difference was huge. Proper knowledge of the actual body, rather than hokum. The physio spent a long time watching DC2 to see what the issues were and worked with me over several months to give me exercises to help DC2's movement. I'd recommend her a million times.

https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1452465/full
This paper concludes "CST demonstrated no significant effects in this meta-analysis, indicating a lack of usefulness in patient care for any of the studied indications"

And this one finds "Osteopathy and chiropractic treatment failed to reduce the crying time and increase sleeping time in babies with infantile colic, compared with no additional intervention"
https://onlinelibrary.wiley.com/doi/pdf/10.1111/apa.16807

But yet HVs and midwives seem captured by it all. I suspect it's because mums do report it helps (because time helps) and it's something only really accessible to middle class mums who can afford the time and money to pursue it so it's no cost to the NHS and feels like they are doing something. Because actually what is required is a proper breastfeeding support service with tongue tie diagnoses, breastfeeding support and guidance through allergies but midwives and HVs just can't offer that, sadly.