Oral Tie Assessment.

There are a couple of different structures we want to look at when we think about oral restriction and its impact on a baby's feeding and development. This includes the tongue, the lips, the cheeks, and the roof of the mouth. TOTs or Tethered Oral Tissues’ is a generalised term that tells us there is connective tissue called frenula or frenulum that is restricted and could be preventing these structures from functioning the way that they need to for your little one to feed effectively and efficiently. For example, a tongue tie falls under the classification of TOTs.

During my visit, I will look for the appearance of any tethered tissue and assess its potential impact on oral motor function. This will include collecting a comprehensive symptom profile and information about pregnancy and labour, medical history, and feeding experience. I will also observe your baby while they are feeding and playing and have a quick feel of the inside of their mouth.

Some of the signs and symptoms I look for that suggest oral restriction could be affecting oral function include:

• Baby falling off the nipple or bottle teat
• Clicking sounds while feeding
• Milk spilling from the baby’s mouth while feeding
• Dry or blistered lips
• Baby coughing, gagging or choking while feeding
• ’Stridor-like noises’, which sound like high-pitched inhales
• Baby’s oxygen levels drop while feeding
• Slow growth
• History of reflux or silent reflux
• Frequent congestion
• Very long or very frequent feeds

If my assessment suggests that your little one has restricted tethered tissue affecting their oral function and development, I will work with you to identify an intervention plan that works for your family. This could include adapting new techniques or tools, therapy, and/or referral to an oral surgeon for a second opinion.