Why Craniosacral Therapy is the Best Option for Tongue Tie in Children


Chances are you’ve likely heard the term tongue tie whether you’ve experienced it first-hand or not. You’ve also either seen a chiropractor for yourself or know someone who has received chiropractic care. Did you know these two can, and in many cases should go together. Chiropractic and Craniosacral Therapy (CST) can be a highly effective and non-invasive means to correcting an infant’s tongue tie and improving many of their early life experiences. Craniosacral Therapy for nursing mothers can also offer great benefit, including lactation benefits.


What is Craniosacral Therapy

Cranial sacral therapy (CST) is a hands-on bodywork system developed by Dr. John Upledger, that releases tightness and compression in the tissues of the tongue, jaw, mouth, head, upper neck, spine, pelvis and other structures. It is noninvasive, your chiropractor uses gentle pressure on the neck, head, jaw, mouth and other areas on the body to bring about a change in the elasticity of the tight tissues. Rigidity of oral tissue do correlate to tissues on the outside of the body.


The foundation of CST’s efficacy is the stimulation and enhancement of your bodies fluid flow, called Cerebro Spinal Fluid (CSF). The movement of fluid into the tongue, jaw, mouth, lips, etc. facilitates a softening, lengthening and release of tight, constricted muscles and tissue. 


Over time, this muscular and tissue rebalance allows for major changes within the Central Nervous System (CNS), and many positive noticeable developmental changes can start to take place.  


CSF is colorless fluid that is produced in the Choroid Plexus of the Brain, with the system known as the Craniosacral Mechanism and it is the lubricating, hydraulic, energetic part of the CNS that controls your tissue and muscle tone and your bodies functions. It is encased with the head and spine and moves within the brain, spinal cord and all cells of the body. It also cushions and keeps soft the organs, collects needed supplies from your blood, and gets rid of waste by-products from the body.


Recently it has been found that the flow of CSF is directly correlated to the flow of lymphatic fluid and overlaps the whole excretory waste production-excretion lymphatic system.


CSF has also been found in every organ, tissue and cell in the body.


CST can be performed by many practitioners including massage therapists, physical therapists, osteopaths, and chiropractors once they become trained in the methods via hands-on continuing education seminars with the Upledger Institute.


Depending on the patient’s individual needs CST may require a few sessions for certain issues to many months of care to resolve. 


What is Tongue Tie

Tongue-tie, or ankyloglossia, is a condition present at birth which restricts the tongue’s range of motion. The condition describes an unusually short, tight or thick band of tissue tethered to the bottom of the tip of the tongue attached to the floor of the mouth. This can interfere with breastfeeding, eating, speaking, swallowing and may possibly be a contributory factor in childhood developmental delays.


In some cases a tongue-tie may not be noticeable or cause problems, while others require surgery or alternative therapies for treatment. 


If you believe your child is experiencing a tongue-tie there are certain signs and symptoms you’ll want to take notice of. Trouble lifting their tongue up or to their upper teeth or moving it from side to side. Difficulty sticking their tongue past their lower front teeth or a tongue that appears heart shaped if/when it is stuck out. 


Non-anatomical side effects of tongue-tie are related to poor sucking during nursing or bottle feeds. These side effects include: reflux, colic, gassiness, poor weight gain, clicking noise while sucking, choking on milk, or excessive drooling. Often including the painful experience for the mother.


In most cases the lingual frenulum, portion of skin responsible for tongue-tie, separates before birth. This separation does not occur in those with a tongue-tie and the reasoning is largely unknown, though genetics are an assumed association. Tongue-tie is also more common among girls.


The Link – CST and Tongue Tie

Tethered oral tissues, tongue-ties in babies often unbeknownst point to muscle and tissue restrictions elsewhere in the body, like the upper neck, jaw, sacrum or head. By applying gentle hands-on treatment and doing tissue work, with these potential points of origin there can result a positive effect on the intra-oral tissues of the tongue tie.


Effects of CSF flow can cause restrictions

Restrictions within the musculoskeletal system may exist in any tissue of the body, especially where the head meets the neck, the occipital cervical muscular area can experience tightness through the neck resulting in tongue tie. Everything is the body is connected.


Other effects of Tongue-Tie and restricted CSF flow 


  • Experience trouble breathing
  • Stiffness and tension in the rest of the body
  • Restriction of mobility in the cranial bones
  • Cranial misalignment
  • Torticollis (tightness greater on one side of the neck)
  • Facial asymmetry
  • Plagiocephaly (flat spots on the head) 


Medical Treatments for Tongue Tie

Diagnosis for tongue-tie typically occurs during a physical exam. A screening tool may be necessary for infants. Pediatricians will score numerous aspects of the tongue’s appearance and movement ability.


Medical treatment for tongue-tie can be quite controversial. Some professionals in the field, doctors and lactation consultants, may recommend immediate correction prior to hospital discharge at birth. This correction is done through surgical means. 


On the other end of the spectrum is the wait-and-see approach. Hoping the tongue-tie will resolve itself by loosening over time. Those who may benefit from this approach are babies and small children who do not experience complications as a result of their tongue-tie. Many practitioners can / are consulted in determining the best approach for each individuals particular needs. 


To help parents determine if surgical treatment is needed a team of professionals is commonly consulted with. Surgical procedures include a frenotomy or frenuloplasty.

Frenotomy – This surgery to treat tongue-tie can be done with or without anesthesia in the hospital or doctor’s office. The professional performing the surgery will examine the lingual frenulum and uses sterile scissors to snip the frenulum free. 

The procedure is quick and thought to have minimal discomfort because there are few nerve endings or blood vessels in the lingual frenulum. Very little bleeding occurs, just a few drops if any. The baby can potentially immediately begin breastfeeding. 

Complications are thought to be rare, but may include infection, bleeding, as well as tongue or salivary gland damage. Uncontrolable excessive crying is also veru common among babies. In some instances the frenulum may also reattach to the base of the tongue, negating the surgery’s purpose. 

Frenuloplasty – This option is more extensive and recommended if/when a repair is needed from a reattached frenulum post-frenotomy. In some cases the frenulum can be too thick for a frenotomy, in which case a frenuloplasty may be warranted.

This surgery requires general anesthesia and necessitates sutures to close the wound. The sutures absorb on their own making follow-up removal unnecessary. Similar complications can arise from frenuloplasty as with frenotomy; bleeding, infection, and tongue and salivary gland damage. Scarring may occur because the wound is larger and the patient may also experience reactions to anesthesia. 

Patients who undergo frenuloplasty will need to perform specific prescribed exercises that increase tongue movement and reduce scarring potential. These exercises however can be very painful and the baby/child often cries. 

Craniosacral Therapy for Tongue Tie

The most common form of alternative treatment for tongue-tie is Craniosacral Therapy (CST), which can improve the following: 


  • Breast / Bottle Feeding – Baby’s oral structures are important regardless of how they are fed; breast or bottle. When the 22 bones in a baby’s skull are not completely in line it can interfere with the way the tongue and facial muscles work. This may irritate the nerves in the face, all of which affect suckling, swallowing and breathing associated with breast and bottle feeding.



  • Speech – Complications of speech caused by tongue-tie are not clearly understood, but it is known the tongue needs to make contact with the roof of the mouth to pronounce lingual sounds; t, d, z, s, th, n, and l. Severe restrictions from a tongue-tie that hasn’t been corrected early in life can cause problems in a child’s articulation. 


  • Eating – Beyond infant eating, breast or bottle feeding, children with a non-corrected tongue-tie may begin experiencing issues when they are introduced to solids. The tongue-tied baby will develop methods of overcompensation like opening mouth widely. 


Issues that arise with eating in particular include: 

    • Preferring specific foods only
    • Failure to chew age appropriate solid foods
    • Gagging, choking or vomiting food
    • Poor dental hygiene 
    • Drooling or dribbling food
    • Dental problems 


  • Emotional Side Effects – A cumulative effect of these issues can occur and result in negative repercussion. Self-esteem and confidence are two significant side effects of a non-corrected tongue-tie. As we age we become more verbal as a means of communicating our wants, needs, and desires as well as connecting with those around us. For those with significant, uncorrected tongue-ties this means of communication can be interrupted leading to poor self-confidence and isolation.  


  • Other Benefits – Lip and tongue ties can impact more than just infancy, but also lead to lifelong issues like retracted jaw, sleep apnea, breathing difficulties, trouble with food manipulation, ADD/ADHD, speech difficulties, and is also associated with ties to allergies, migraines, neck pain, and more. 


Why CST is Best  

Craniosacral Therapy may be the longer journey to correction than surgery, but it is non-invasive and doesn’t carry with it the risk of complications that frenotomy and frenuloplasty do. Unlike having a tongue-tie revised through surgery, CST sessions are actually quite relaxing for babies. 


Most babies fall asleep or become markedly relaxed during the session. Moms can even opt to breastfeed during a CST session in many cases. Older babies may be able to play with toys and possibly move around the room as part of the session. 


While it is thought that frenotomy causes minimal pain, this is not specifically known. Craniosacral Therapy is gentle and effective in treating tongue-ties. Surgery, especially the commonly used frenotomy, can lead to regrowth and tissue reatachment. 


A practitioner of craniosacral therapy can facilitate improvement in CSF fluid flow, thereby positively effecting a softening and relaxation of tongue tie issues.


A major benefit of CST as a treatment for tongue-tie is the benefits the patient also experiences in other areas of the body and improvement in other health issues.


Results to Expect

Though each mother and baby are different, some common effects from as little as one CST session for tongue-tie children include: 

  • Baby latches and stays latched longer 
  • Mom experiences a more comfortable latch
  • Baby has a noticeably more effective suck, gets more milk 
  • Baby, and mommy, sleep better as a result of more efficient feeding and fullness
  • Baby grunts less
  • Nursing is more balanced on both sides
  • A noticeable decline in tension in the baby’s body
  • Baby has a generally more peaceful mood


What to Expect 

After initial evaluations have been conducted typical CST sessions will begin. Many practitioners will facilitate flow at the sacrum and work their way up to the mid-body, then neck and finally head area, stimulating fluid flow.


The baby’s comfort during the session should be the highest priority for parents and practitioner, alike. It is not uncommon for tongue-tied babies to be fussy, which should begin to fade even throughout the session as tension is released. 


The number of sessions necessary for effective tongue-tie treatment varies from person to person. In most cases only 4 to 10 sessions are needed to address and release the underlying tension. 


Depending on how dire the situation is, weight loss or failure to thrive from poor nursing, sessions can be spread out between days to weeks. For more severe cases practitioners recommend more frequent sessions early on, twice a week is very common. Although three times per week is sometimes recommended.


Less severe ties typically spread their sessions out to once a week. After a few sessions the practitioner can determine if more or less frequency is necessary. 


It is best to have a consultation if you suspect a tongue-tie, but haven’t had it revised. CST is also useful post-revision to offer the same as before revision and to also improve mobility and aid in exercises. The release of fluid flow from CST can make revisions more successful and less likely to reattach. This approach may require most weekly sessions than those with non-revised tongue-ties. 


Final Thoughts 

Parents and caregivers want the best experiences for their infants and children, starting at a very young age. The earliest experiences we have involve the mouth through sucking to eat. If this is interrupted it can lead to frustration for parents and baby, making early days of life challenging and intense.  


Undergoing surgery is yet another potentially negative experience for any infant to face, for those that can be avoided, CST may be the best approach as it leads to relaxation and comfort. The gentle approach of CST will not only help to correct a tongue-tie, but encourage feelings of ease which improves the infant’s overall mood and temperament. 


Tongue-ties are a seemingly small condition that can create significant issues in the life of the mom and child. CST can help give these children the best start to life through a gentle, non-invasive approach to correction. 


Dr. Alex Kaminsky is a Chiropractor offering Craniosacral Therapy to his patients.