Body Therapies for
Body-Therapies to Aid your Infant's Feeding Ability
(ask for your therapist to have experience with infant feeding related tensions)
For a directory of manual therapy providers with experience in treating babies with feeding issues and tongue-tie please visit www.bodywork.org.uk
Chiropractic therapy https://www.gcc-uk.org
Cranial-Sacral therapy https://www.craniosacral.co.uk
Myofunctional Therapy https://bsmft.org.uk
Should you choose to join my Facebook peer support group page, there is a thread where service-users have recommended therapists across the UK based on their treatment experience. To join the facebook page, please just click on the link:
Manual Therapy and Infant Feeding
What is the role of manual therapy for helping babies with feeding difficulties?
(Extracted from: https://www.tongue-tie.org.uk/manual-therapy-and-infant-feeding/).
There are several healthcare professions that use manual therapy as their modality for treating the human body. Manual therapy is the hands-on method of treating the body, rather than a drug-based approach. The therapist uses a variety of techniques to support the tissues and help return function to a normal level when there has been injury or changes to the areas involved.
The techniques used can have different names depending upon the profession using them, but in general they include:
Mobilising a joint: taking it through a range of motion to promote full use, to ease ligamentous, capsule or muscular restrictions to full movement.
Soft tissue techniques: massage, stretching, inhibition, cross-fibre.
Active tissue techniques: asking the patient to work against the therapist e.g. Muscle Energy Technique.
Nerve stretching: proprioceptive neuromuscular facilitation stretching.
High Velocity/Low Amplitude Thrust: the “clicking” or “popping” noise of a joint when it is adjusted to regain motion.
Cranio-Sacral Techniques and Sacro-Occipital Technique: these are generally very subtle, “quiet” and gentle techniques. This first was developed within Osteopathy and is an extension of osteopathic principles aimed at releasing adverse tension in the tissues of the skull: meninges and other connective tissue and can be applied to other joints in the body too. The latter is the extension of Chiropractic philosophies and looks at more subtle mechanical ways of dealing with chiropractic “subluxation” patterns. Both of these approaches are popular for use in treating babies and they involve very little strong force to be applied to the body.
Most osteopaths and chiropractors who treat babies have undertaken extensive post-graduate studies in order to gain an in-depth knowledge of the embryological development of the baby. This will include the anatomy of the nerves, vessels, bones, joints and muscles relating to the brain, head, face, neck, back and body and organs during development. They understand the stages of development during embryonic life, the process of birth and the interventions or traumas that may occur during birth, and the developmental stages during the early years of life.
The aim during treatment will be, for example:
to relieve the compressions that occur whilst the baby is growing within the womb (uterus), particularly in the later months when space becomes restricted.
to relieve stresses and traumas that might result from the birth process, for example awkward presentations that require interventions such as forceps or ventousse can create trauma in the neck and head areas.
to improve the motion of the thoracic cage which houses the heart and lungs so that breathing is easier.
to improve the movement of the upper neck area so that the nerves that facilitate feeding are not impinged and the baby can physically and comfortably get their head into the right position for feeding, on both right and left side.
For the mother, osteopaths and chiropractors can work on, for instance:
the pelvis to reduce the symptoms of pelvic girdle pain (symphysis pubic dysfunction) that can make walking and daily activities very painful and awkward.
the parts of the thoracic cage (ribs and spine) that relate to the nerves that supply the breast and in turn control the milk supply and milk ejection reflexes.
the mothers muscles and joints to improve their function can help ensure that mother can achieve comfortable positions for birthing, for feeding, for sleeping.
In the United Kingdom there is increasing legislation to protect the general public and to ensure that health practitioners are adequately trained (to B.Sc. degree level or above), insured and continuing their professional development (ongoing training; CPD). Certain professions have their own governing body that regulates the training courses and the individual practitioners on the register, for example, Osteopaths are regulated by the General Osteopathic Council, Chiropractors by the General Chiropractic Council, whilst other professionals, e.g. Physiotherapists, are required to register with the Health and Care Professions Council that regulates many other professions too.
In law, these professional titles are protected and it is a criminal offence to use them if the practitioner is not registered with the relevant governing body.
The protected titles include the following:
Physiotherapy (HCPC; https://www.hcpc-uk.org)
Osteopathy (GOsC; https://www.osteopathy.org.uk)
Chiropractic (GCC; https://www.gcc-uk.org)
However, there are several practitioners of manual therapy who do not enjoy the same legally protected status, but may well be trained to a high level or have a great deal of experience within their chosen field. It is the individual choice of the member of the public who chooses to use a non-regulated person to ensure the level training and experience is to their satisfaction and to be aware that whilst these practitioners may be a member of an association, it is not a governing body that has recourse within law to protect the public. For example, titles commonly seen include massage therapists, physical therapists, manual therapists, cranio-sacral therapists. Where nurses and midwives provide manual therapies they are still regulated by the Nursing and Midwifery Council in these roles.
Orofacial Myofunctional Therapy
Diana is an advanced practitioner trained in the discipline of orofacial myofunctional therapy and recognises the importance of strengthening the surrounding oral muscle structures and tissues, to support the tongue to regain its function post tongue-tie division (see 'About Me' for my career history!).
In infants, the tongue tie procedure (frenulotomy) is usually indicated when the lingual frenulum restricts the tongue's movement and compromises infant feeding. Correct posture and function of the tongue is crucial for milk transfer. Optimal tongue function requires the mobility of the full tongue to create a vaccuum which engages the nipple/teat to stimulate the sucking reflex to elicit the peristaltic action of the tongue through to a timely audible rhythmical swallow (not gulp!) and transfer of milk.
The styloglossus muscle of the tongue retracts and elevates the tongue. This muscle runs from the tongue tip to an area near the temporomandibular joint. A tongue tie makes movement of this muscle more difficult and therefore achieving a nice wide open gape in order to achieve efficient pain-free feeding is unable to be sustained or maintained and in some cases not at all. I frequently hear gestational parents recalling how when feeding their infant they latch with a wide gape, but then the infants mouth 'slips' to a shallow latch or unable to maintain it at all requiring frequent attempts at latching.
Orofacial Myofunctional Exercises are performed differently for infants, as babies are unable to do the exercises following a command.
Instead, babies respond to stimuli and reflex. So, in order to strengthen the muscles necessary for feeding, breathing and sleeping, suggested exercises for the adult caregiver to perform on the infant work well. These are gentle, and relaxing and can easily be incorporated into a busy lifestyle.
Feeding an infant stimulates the orofacial muscles and this promotes the growth of the face. In the same way, correct suction and chewing prevents dental alterations and difficulties when structures such as the lips and tongue are moving. An orofacial myofunctional practitioner is trained to, after conducting a thorough assessment, and working in an allied approach, may apply techniques to rebalance the muscles of the mouth, face and neck, and restore the functions of breathing, chewing and swallowing. Neurological re-education exercises are prescribed to assist the normalisation of the developping or developped crainiofacial structures and function. The concern is not the appearance of the lingual frenulum (tongue tie), it is how the oral function is affected and the long term consequences of decreased oral function.
Orofacial myofunctional therapy has 3 distinct roles that help improve the success of the frenulotomy (tongue-tie) procedure:
1) Prior to a frenulotomy procedure, orofacial myofunctional therapy builds strength coordination awareness and behaviour modification through the application of neuro-muscular re-education. Diana will provide you with an exercise sheet and program to support you through the stages of neuro-muscular re-education.
2) Orofacial myofunctional therapy aids the healing process by engaging tongue function and movement by encouraging strength to the previously weakened areas of the mouth allowing it to work towards improved innate feeding abilities.
3) Rehabilitation of the oral structures to restore and improve correct oral function. Similar to physical therapy following a surgical procedure, orofacial myofunctional treatment fills the same role to help improve the success of a frenulotomy.
Tongue Function/Tone Strengthening Exercises
These exercises are found in your aftercare paperwork I gave you at your consultation.
Although doing these is absolutely optional, my recommendation is not to delay, and to commence from day 2.
This will enable your baby to get the most benefit from the division and give him/her a 'head-start' in terms of learning ability on their feeding journey. Exercises are designed to be a playful, bonding and learning experience-If you are short on time or too busy we do not want to do these in a time-pressured situation. These exercises are designed to mimic the different aspects that the tongue uses to feed; the last thing we want to do is put your little one off feeding.
To be clear; I DO NOT advocate any form of exercise or practice that involves touching or interfering with an open wound for the reasons discussed at your consultation.
Resting Tongue Posture Exercises:
(Suitable from birth to pre-crawling age)
Here we have all of the benefits of a baby massage course, to be enjoyed without even leaving the house!
Baby massage is not a new concept, and has been practised in other countries for hundreds of years, with the belief that it helps with health, happiness, security and a feeling of being loved-for parent and baby. Baby Massage is tailored for all babies right from birth until pre-crawling age. It also addresses many of the symptoms a baby may be experiencing as a result of a restrictive frenulum such as colic, trapped wind, reflux and teething without the need for medication. It also has the added benefits for parents with bonding and confidence with their baby.
Baby Massage involves the parent/caregiver learning massage techniques, in order to promote physical and emotional well-being to the baby whilst also promoting bonding and attachment skills for the parent too. Baby massage is also a great introduction to infant Yoga.
Course benefits include:
Aids gross & fine motor skills
Sleep, increases duration & frequency
Aids digestions, relieves constipation and colic
Helps with reaching developmental milestones
Increases parent & baby bonding
Increased strength & flexibility