Effective Infant Feeding: The Role of Tongue Movement

Effective infant feeding, whether through breastfeeding or bottle-feeding, relies heavily on the intricate movements of the baby’s tongue. These movements are not limited to simple in-and-out motions but require a coordinated combination of up-and-down and out-and-in actions to create the wave-like motion known as peristalsis. This peristaltic action is essential for efficient milk extraction and overall feeding success. Without proper coordination of these movements, infants may struggle with milk transfer, leading to feeding difficulties and beyond.

Understanding Tongue Peristalsis in Infant Feeding

During breastfeeding, the infant’s tongue exhibits a peristaltic movement—a sequential wave-like motion from the front to the back—that compresses the breast tissue against the hard palate, effectively expressing milk into the mouth. This action helps maintain the intra-oral vacuum pressure, facilitating milk flow. Research has shown that this peristaltic motion is crucial for efficient milk removal during breastfeeding. Similarly, during bottle-feeding, the tongue attempts to replicate this natural peristaltic motion.

Debunking the Myth: Tongue Protrusion and Tongue-Tie

A common misconception is that if an infant can stick their tongue out, they are not tongue-tied. This oversimplification overlooks the complexity of tongue movements required for effective feeding. Tongue-tie, or ankyloglossia, is characterized by a restrictive lingual frenulum that can impair not only tongue protrusion but also elevation, lateralization, and the ability to perform the peristaltic wave necessary for milk extraction. The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) is just one of the many assessment tools providers can use to evaluate both the appearance and function of the tongue. A comprehensive evaluation with this tool considers various tongue movements—such as elevation, lateralization, and extension—not just the ability to protrude the tongue. This assessment tool is the one our lactation consultants use as part of their functional assessment at Wisconsin Tongue Tie Institute.

Implications of Impaired Tongue Mobility

When an infant’s tongue mobility is restricted due to tongue-tie, the peristaltic movement essential for effective feeding can be compromised. This restriction may lead to difficulties in latching, inadequate milk transfer, and prolonged feeding times. For breastfeeding mothers, this can result in nipple pain and potential damage, further hindering the breastfeeding process. However, if these issues are not addressed during infancy, the struggles related to impaired tongue movement can snowball and affect a child’s development in various ways.

Proper tongue mobility is not just essential for feeding; it plays a critical role in overall oral development and health. During infancy, the tongue’s ability to move freely is crucial for establishing proper tongue posture. The tongue naturally rests on the roof of the mouth, which is important for the formation of the palate. A restricted tongue may not be able to maintain this ideal resting position, potentially leading to a narrow or high palate. This misalignment of the palate can impact the alignment of teeth and facial structure, contributing to orthodontic issues later in life.

In addition to affecting oral development, impaired tongue mobility can also influence a child’s breathing patterns. The tongue is a key player in keeping the airway open, and if it cannot rest properly on the roof of the mouth, it can contribute to sleep-disordered breathing (SDB), including issues like mouth breathing and snoring. These conditions, if not addressed, can lead to more serious health problems, such as chronic fatigue, behavioral issues, and even developmental delays.

Speech development is another area where tongue function is critical. The tongue is essential for articulating sounds, and restrictions in its movement can lead to speech delays or difficulties. Children with tongue-tie may struggle with certain consonant sounds and have trouble pronouncing words clearly, which can impact communication and self-esteem.

Addressing tongue-tie early on can help prevent these cascading issues from developing. By ensuring that infants have full tongue mobility, out and in AND up and down, parents and caregivers are setting the foundation for better oral, respiratory, and speech health throughout childhood and beyond. Prompt intervention can help a child thrive in their feeding, speech, and overall development.

Conclusion

The dynamics of infant feeding are intricately linked to the tongue’s ability to perform complex movements, particularly the peristaltic wave essential for milk extraction. Relying solely on tongue protrusion as an indicator of normal tongue function is insufficient. A thorough assessment of all tongue movements is crucial to identify potential restrictions, such as tongue-tie, that could impede effective feeding. Recognizing and addressing these issues promptly ensures successful feeding journey, and sets them up for success for the future.

Resources

• Geddes, D. T., et al. “Tongue movement and intraoral vacuum in breastfeeding infants.” Early Human Development, 2008. aomtinfo.org

• “Tongue-Tie: What It Is and What It Means.” Tongue-Tie UK. tongue-tie.org.uk

• “Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF).” NCBI. ncbi.nlm.nih.gov

• “Breastfeeding and Tongue-Tie.” The Women’s Health Institute. thewomens.org.au