Optimized Growth, Development and Function
Age group: Newborn – 6 Months
Key Signs and Symptoms that You can Assess
If you have answered Yes to 1 or more items in the checklist below, this may indicate an opportunity to improve the growth, development and function of your loved one. We would encourage you to schedule a caring & comprehensive assessment at Little Bird Pediatric Dentistry by calling 905-876-2473 (BIRD) or through the “Schedule an Appointment” button on our website (www.littlebirddental.ca).
While Baby is Awake
Chronic running/congested nose
While Baby is Sleeping
Snoring or heavy noisy breathing (more than 3x/week)
Gasp/stop breathing while sleeping
Sweating heavily while sleeping (pajamas and/or sheets damp)
Only can sleep upright or when held (gets upset sleeping on back)
Any History of Breastfeeding Difficulties
*If currently breastfeeding see below
Difficulties Breastfeeding (If Applicable)
a) Baby’s Signs/Symptoms
Difficulty achieving or maintaining a good latch (aka. Poor latch)
Gumming or chewing of nipple when nursing
Milk leaks or spills out the side of the mouth while actively feeding
Poor weight gain and/or failure to thrive
b) Mom’s Signs/Symptoms
Creased, cracked, bruised, flattened or blanched nipples after nursing
Bleeding or cut nipples
Poor and/or incomplete breast drainage
Why: Prior to 6 months of age, baby has not yet developed the coordination involved in an adult breathing/swallowing pattern. Baby is however able to nose breath and feed simultaneously (either by breastfeeding or with spoutless open cups, syringe-finger feeding, etc.) because of the overlap between the epiglottis and soft palate.
Milk is able to pass this overlap through two channels, directed downwards towards their stomachs, and the upper passage to the middle ear known as the Eustachian tube is protected to allow for its opening and drainage with each swallow. This optimized feeding prevents or reduces the likelihood of baby developing an ear infection. (See Image 1: Optimized positioning for breastfeeding/nose breathing).
© Natalie Cormier with Little Bird
IF however, baby’s tongue or lip is restricted (tie), or tongue is pushed back from certain products, it may impede the ability for baby to latch and nurse, causing separation of the soft palate/epiglottis seal. Milk and saliva can therefore be directed downwards and upwards towards the Eustachian tube. As the Eustachian tube is unprotected, it can become irritated, inflamed, and develop an ear infection. (See Image 2: Compromised functioning).
If mouths are open (whether due to muscle memory, tongues trained to be down, tongue and/or lip tie, nose obstruction, etc.), it increases the likelihood of mouth breathing. Mouth breathing, snoring and/or heavy breathing are all possible audible signs of a compromised airway. In order to achieve optimized growth, development and sleep, the lips must be sealed at rest with the tongue up against the roof of the mouth (a.k.a. palate).
Why: A possible reason for frequent “clicking” could be that the baby has restricted/tethered oral tissues (tongue and/or lip tie). Clicking on the breast (or feeding mechanism) often occurs when baby cannot maintain suction or a good seal (latch) and with each “click”, they are swallowing air. Aerophagia is excessive swallowing of air. When excessive amounts of air reach the baby’s stomach, abdominal distension (expansion), burping, vomiting/regurgitation, and excessive gas may result. This can be very uncomfortable, resulting in baby’s upset and crying that worsens when laid on their backs. This is why clicking may be found in conjunction with colic.
Note: Although there are other possible reasons for “clicking” and colic, if observed, a caring & comprehensive assessment of the baby is recommended.
Why: In order to achieve an optimal latch/seal when nursing, the upper lip needs to be able to evert outwards, similar to “fish lips” allowing for maximal extension of breast tissue into baby’s mouth. If the upper lip is tethered (tied) and curls inward, it may prevent the extension of breast tissue as well as push the tongue backwards. If this occurs, there would be notable pain for mom on latch and while nursing, as the baby’s gum pad (instead of tongue against breast areola) would be compressing the nipple.
Why: Callous or blisters on upper lips may be signs of a restricted lip (tie). As instead of the upper lip being able to evert (fish lips) while nursing, it is curling inward and receiving extensive friction (rubbing).
Dry or cracked lips are a common sign that the baby is having their mouth open and/or mouth breathing. A restricted upper lip (tie) could prevent the baby from being able to close their mouth (lips sealed at rest), resulting in compromised mouth breathing.
Why: If dried milk residue on tongue is regularly noticed, it may be a sign of a restricted tongue (tie) causing altered tongue function. To which the portion of the tongue with the milk residue is unable to contact the roof of the mouth (palate) to be cleansed and cleared in an optimized swallowing pattern.
Why: Reflux symptoms may be caused by possible restricted/tethered oral tissues (tongue and/or lip tie). Tongue and/or lip ties may present with frequent clicking on the breast, difficulty achieving a good latch (seal) and swallowing air (aerophagia) to which during the day is coming out as gas or as vomit/ regurgitation. At night, you may see silent reflux, with the baby waking up in the morning congested. Congestion while sleeping is not always an allergy. Therefore, prior to Mom going on special diets and/or removing dairy (common allergens), it is encouraged to have baby assessed – as if a tie is present and treated appropriately allowing for baby to attain a good latch, symptoms may resolve.
Why: Optimized breastfeeding should be comfortable for both Mom and baby. Baby’s tongue should extend above and beyond their lower gum pad, forming a tongue to upper lip seal with Mom’s areola (breast). A possible reason for maternal nursing discomfort or difficulties can be from baby having restricted/tethered oral tissues (tongue and/or lip tie). If present, there is likely to be notable pain for Mom on latch and while nursing, as the baby’s gum pad (which is hard bone covered by a thin layer of soft gum) would be compressing against Mom’s nipple to hold breast in place and get milk to flow.