Introduction

The recent increase in breastfeeding has brought an increased awareness of potential causes for breastfeeding difficulties. Many parents are choosing frenectomy or laser revision for their infants with tongue-tie (ankyloglossia). This study aims to identify somatic dysfunctions commonly found in infants with tongue-tie as a first step in distinguishing infants with feeding issues caused by somatic dysfunction from infants with feeding issues directly related to tongue-tie. Since somatic dysfunction of the cranial base and occiput have direct implications for impacting the hypoglossal nerve, which provides motor control of intrinsic tongue musculature, it is our hypothesis that infants with tongue-tie and feeding issues will have a high incidence of cranial base dysfunction.

Methods

A retrospective chart review was performed on 48 charts of infants diagnosed with tongue-tie who had been seen from June 2012 to January 2017 at a multispecialty practice. Thirty-one charts were excluded and 17 charts are reviewed here.

Results

Of the 17 infants with tongue-tie whose charts were included in the review, 76.4% had difficulties with latching and 35.3% had difficulty with suck or coordination of suck. All of the infants (100%) had occipital condylar dysfunction, 94.1% had restriction of at least 1 cranial suture, 94.1% had atlantooccipital (OA) joint dysfunction, and 23.5% had dysfunction at the sphenobasilar synchondrosis.

Conclusions

All of the infants with tongue-tie had somatic dysfunction at the cranial base. This again raises the question of whether or not the feeding issues were directly related to the tongue-tie or to the somatic dysfunction or to a combination of both. This study was limited by sample size and limited diversity of patient sampling. Further studies are necessary.

IRB #2017-007