Assessing & Treating Oral Restrictions

Did you know, for babies, breastfeeding is a vital sign?  All babies should nurse within 1 hour of being born.  They should also be able to crawl up the mother’s abdomen when she is in a reclined position, and latch onto the breast all on their own.  They should be able to easily stay latched, transfer milk, swallow milk, and breathe during breastfeeding.  They should be able to do all of this without causing any discomfort for mom, besides maybe some after pains contractions.  It really is that simple.  Anything different than this is less than optimal and a reason to seek support.

Babies typically learn to compensate quickly to help them get milk, such as with altered tongue movements, clamping down, pausing, or sleeping often.  Likewise, mothers have culturally learned tricks to help their babies get the nourishment and developmental comfort they need, such as breast holds, positioning, formula, and pacifiers.  However, these compensations will affect the baby for life, and for many moms, will be the beginning of the end of the breastfeeding relationship.

The important thing to remember is that if baby is not nursing optimally, or mom is uncomfortable, help is available!  Don’t hesitate to ask for help while working to figure any difficulties out with breastfeeding.

While spontaneous unmedicated birth, latch,  and positioning are crucial to optimal breastfeeding, oral restrictions are often the main culprit of the need for compensating tricks.  A baby must be able to suck, swallow, and breathe in a rhythmic pattern to comfortably and efficiently transfer milk and swallow milk.  These actions complete the development of the baby’s ability to breathe and eat for life.  The rest of the baby’s whole-body development is determined by being able to suck-swallow-breathe in the first hours, days, weeks, months, and years of their life.

Oral restrictions include things such as tongue, lip, or buccal ties, high narrow palate, small jawbone, over or underbite, tense muscles, loose muscles, asymmetrical bone development or muscle tone, and various other restrictions only able to be assessed with a thorough evaluation.  Only in the past 10 years or so are we really beginning to understand how to fully assess oral restrictions, short and long-term symptoms, and how to properly revise and provide therapy for these restrictions and ties.  There is still a lot of misinformation about oral restrictions and how much they can affect the person for life.

In addition to breastfeeding complications, a baby with oral restrictions may have various forms of wellness ailments such as fussiness, reflux, “colic,” sleeping too much or too little, children with difficult speech patterns, swallowing solid foods, gagging or choking, breathing difficulties such as chronic congestion, snoring, apnea, as well as ADHD and learning disabilities, neck and back complications, and so much more.

Possible signs of restricted oral function:

  • Posterior baby regularly during pregnancy
  • Transverse or Face presentation at birth
  • Long or difficult labor or birth
  • Head moulding (yes, I know, this is what a baby's skull can do to help them fit through your pelvis, but it will for sure press on their cranial nerves that allow their suck-swallow-breathe to function)
  • Baby favors head to one side (torticollis) or favors one breast while nursing
  • Lip blisters or calluses
  • Dimpled cheeks between nursing or cheeks being sucked in while nursing
  • “Cup” shape to the tongue while crying or opening their mouth
  • White blanching on tethers (frenulums) between lips and jaw or tongue and gums when stretched
  • Baby falls asleep often at the breast
  • Baby wakes to nurse every hour, all day
  • Colic or fussiness
  • Reflux or excessive burping or gassiness
  • Baby rests or sleeps with their mouth open
  • Baby has difficulty latching, or staying latched, while breastfeeding (or with a bottle or pacifier, although bottles and pacifiers will worsen the issue)
  • Excessive drooling or milk coming out of baby’s mouth during or after nursing

Ideal options for treatment:

  • Craniosacral therapy within the first four days of birth, skin to skin, tummy time & stretches at home, & regularly thereafter
  • Revision with a laser by a qualified practitioner (ideally within 30 days of birth) if there are tongue, lip, or buccal ties
  • Stretches & exercises daily for 6 weeks after revision including craniosacral therapy or other soft tissue bodywork therapy


If you would like your baby assessed, this should be done by someone experienced in assessing oral restrictions, likely during a newborn exam after birth, but can be done at any time.  Get in touch at MOV Birth and let’s work to improve breastfeeding and optimal oral and whole-body function for life!