Differential Diagnosis & Management Online Course(s) & Continuing Education
Access the latest clinical skills and research for Differential Diagnosis & Management for Tongue-tie, Lip Tie & Structure professional training. These Differential Diagnosis & Management online courses provide practice-changing skills and valuable perspectives from leading global experts. This Differential Diagnosis & Management education has been accredited for a variety of CEUs / CERPs and can be accessed on-demand, at your own pace.
A Sensory Motor Approach to Neuromuscular Re-Education Post Frenotomy
Lori L. Overland, M.S., CCC-SLP, C/NDT, CLC is a licensed speech and language pathologist with her neurodevelopmental certification and certificate as a lactation counselor. Lori is currently working on her IBCLC under the mentorship of Dr. Tina Smilie M.D., IBCLC, and Cathy Watson-Genna IBCLC. Lori’s private practice focuses on infants, toddlers and preschool children with oral sensory-motor/feeding disorders. Lori has co-authored two books: A sensory motor approach to feeding, and Functional assessment and treatment of tethered oral tissue. In addition to her private practice, Alphabet Soup, Lori is a member of the TalkTools® speakers’ bureau, and has lectured on sensory-motor/feeding disorders around the United States and internationally. Lori holds degrees from Hofstra University and Adelphi University.
This session will focus on functional assessment and treatment of tethered oral tissue in the breastfeeding infant. Participants will understand the importance of task analysis of the motor skills to support sucking, prior to referring an infant for a release. Post op treatment has focused on active wound management (Ghaheri, B. 2017) rather than neuromuscular re-education. This approach multidisciplinary approach encourages lactation consultants to partner with body works specialists and speech pathologists to develop the underlying motor skills to support sucking.
Aerophagia Induced Reflux Associated With Lip and Tongue Tie in Breastfeeding Infants
Dr. Siegel is a pioneering Tongue Tie surgeon, mentored through medical school, residency and in private by practice by the late Elizabeth Coryllos, MD. He is a dual degree MD, DDS Oral and Maxillofacial Surgeon, lectures internationally and publishes on the topic of Reflux associated with Lip and Tongue Ties.
This study aims to show a correlation between aerophagia in infants with tethered oral tissues (TOT’s) consisting of ankyloglossia and shortened maxillary labial frenula (tongue and lip-tie) and reflux. Currently there is little to no data on aerophagia as a possible cause of reflux in infants. Infants with tongue and possibly lip tie often have a poor latch in which there is often an inadequate seal around the breast and inefficient transfer of milk. As a result many of these infants swallow air during breastfeeding. Many of these infants suffer from symptoms of reflux. This study and results to demonstrate a correlation of ankyloglossia and shortened maxillary labial frenula with aerophagia and reflux.Treatment of these infants with a relatively simple frentomy procedure may reduce or eliminate reflux in this population.
Dr. Brandi is the pediatric chiropractor in a practice that provides chiropractic care for women and children. Her focus is on infants with feeding difficulties and children with neurodevelopmental delays. Dr. Brandi created a program at her practice which incorporates chiropractic, optimal nutrition, myofascial/cranial-sacral techniques, and neurofunctional exercises into one comprehensive program. Her ultimate goal is to naturally support the body (brain, gut, spine and immune system) to work together in balance and help children achieve their maximum life potential. Dr. Brandi attended Cleveland Chiropractic College after earning a bachelor’s degree from the University of Missouri- Kansas City. She is also certified by the Academy of Chiropractic Family Practice. In her free time, Dr. Brandi enjoys spending time outdoors with her husband and two sets of fraternal twins.
Oral ties are often diagnosed and released during infancy to improve the breastfeeding relationship between mother and baby. But what happens if ties go undiagnosed? This course will review tethered oral tissues and their relationship in a breastfeeding dyad and the neurodevelopment of an infant and beyond. We will explore the implications of oral restrictions on the myofascial system throughout the body. Movement patterns, posture, and primitive reflex integration can all be affected by oral ties. Signs, symptoms, assessment tools, and strategies for co-management between IBCLC and bodyworkers will be discussed. Attendees will also learn neuro-biomechanical implications of TOTs beyond breastfeeding. Several case studies will be discussed and how successful management can be achieved with a team approach.
Clinical Case Studies: Ankyloglossia in Babies With Marasmus and Kwashiorkor
Okky Nafiriana, MD is a member of Praborini Lactation Team, Indonesia.
She believes breastfeeding is the best way to feed and nurture baby.
But breastfeeding not always comes easy. Experienced breastfeeding her 2 daughters who were born with tongue and lip tie, made her realize the problems came with the ties and support frenotomy.
She currently works as a lactation counselor in Permata Depok Hospital and Puri Cinere Hospital, Indonesia, where she meets parents and educates the benefit of breastfeeding. She loves to study and currently pursued her dreams to deepen her knowledge in lactation.
Ratih Ayu Wulandari, MD, IBCLC is a
member of Praborini Lactation Team, Indonesia.
She believes breastfeeding is the best way to feed and nurture baby, therefore she became a breastfeeding counselor in 2012 and then IBCLC in 2014.
Experienced breastfeeding her three tongue-tied babies, she understand the pain and support early frenotomy.
She is practicing frenotomy for tongue-tie and lip-tie in Puri Cinere Hospital Depok Indonesia and a private practice. Her publications are including articles for international journal and books for mothers. Japan society of ADEL acknowledges her as Specialist of ADEL (Ankyloglossia with Deviation of Epiglottis and Larynx).
Successful breastfeeding depends on an infant’s latching onto the mother’s breast correctly. A poor latch will cause insufficient milk transfer that will cause poor growth. Each type of mammals produces different components of milk which make it species specific, which adjust to their needs, growth rate and breastfeeding habits. Human breast milk has many benefits for human babies because it contains various substances both as nutrition and as protection.
The authors present two infants who suffered ankyloglossia, which hindered the baby’s ability to breastfeed and eat solid food. These babies were diagnosed with marasmus and kwashiorkor (severe malnutrition). After revision of both the lip- and tongue-ties, supplementation with pasteurized human milk donor, and good complimentary feeding the babies finally reach an optimal growth and development. Learn more about how these two cases were managed to bring the babies back to health.
From Head to Toe It's All Connected: Pediatric TMJD, Tongue Tie, and Chiropractic Care
Dr. Jenna Davis is a Family Chiropractor and owns a highly successful family wellness multidisciplinary clinic, Acorn Family Health and Wellness Centre, in Oakville, Ontario. Dr. Davis has a focus on Preconception, Infertility, Pre- and Postnatal care, Pediatrics, Retained Primitive Reflexes, Infant TMJD and Women’s Health. Dr. Davis loves working with families in all stages and has a unique ability to educate her practice members so they feel heard, honoured and understand how chiropractic can improve their function and life. She has a passion for educating and is an avid lecturer both in and out of her office. Dr. Jenna Davis is a mother, author, entrepreneur, educator and is a sought after speaker internationally sharing information on many topics including the Power of Communication, Infertility, Pediatrics, Retained Primitive Reflexes, Infant TMJD, TOTs (Tethered Oral Tissues), Team Approach to Health and Wellness, and Women’s Health. Dr. Davis created a technique in 2016, the P.I.P.S. Technique (Pediatric Intraoral Palate Specific Technique) specifically to assist with Infant TMJD, Sphenoid Fault, Tongue-tie, Lip-tie, Dural Tension and Oral Motor and Oral Sensory Challenges. Dr. Davis has develooped a unique approach to combine sensory, motor, developmental and function into the care and approach to her practice members. Dr. Davis is also the creator of Baby Boom Creations, a company that develops and provides products to assist patients and practitioners in office and at home. Dr. Davis has been a featured speaker on many stages in Canada, the United States, Australia and the UK. She prides herself on her continual quest for the newest information and research and is a life long learner. Dr. Davis has done extensive postgraduate work and continues to expand and grow her knowledge base and resource team to give the best care possible to her practice members and the audiences she has the honour to present to.
Every day in practice Dr. Jenna Davis witnesses how TOTs and Pediatric TMJD, when not addressed, may lead to postural changes, mouth breathing, and may impact craniofacial growth, posture, spinal alignment, development and lead to overall compensation. Ankylofrenula and associated tension is rarely a solitary issue. In this session, we will discuss how these infants may present, the examination process, discuss intraoral work including the PIPS (Pediatric Intraoral Palate Specific) Technique, assessment protocols, and Chiropractic Bodywork. Dr. Jenna will demonstrate other incredibly important exercises parents can add at home to assist with the tension and lack of function often associated with ankylofrenula and TMJD. Learning to assess intraorally is critical for long term improvement at all ages. In this session Dr. Davis will discuss intraoral, palate, and cranial to sacrum assessments and chiropractic adjustments (chiropractic bodywork) that can be done to assist with changes related to Tongue Tie, Pediatric TMJD and associated dural tension. Finally strategies for communication about bodywork, your findings and recommended strategies will be shared to maximize and strengthen your relationship with patients/families, professionals you may co-manage this special population with and your community.
Gamechangers: New studies that will change the way we think about tongue-tie
Dr. Hazelbaker has been a therapist in private practice for over 30 years. She specializes in cross-disciplinary treatment and to that end has taken training in several modalities to best assist her clients. She is a certified Craniosacral Therapist, a Lymph Drainage Therapy practitioner, a Tummy Time™ Trainer, a Haller Method practitioner, A Pre and Perinatal Psychology Educator, a Lactation Therapist Diplomate, an International Board Certified Lactation Consultant and a fellow of the International Lactation Consultant Association.
She earned her Master’s Degree from Pacific Oaks College (Human Development specializing in Human Lactation) and her doctorate from The Union Institute and University (Psychology, specializing in Energetic and Transformational healing.)
People recognize her as an expert on infant sucking issues caused by various structural problems like torticollis, plagiocephaly, brachycephaly and tissue shock-trauma. She invented the Hazelbaker™ FingerFeeder and the Infant Breastfeeding CranioSacral Protocol™ to assist in the resolution of this type of infant sucking dysfunction.
Topic: Cranial Nerves: A Critical Component of the Process of Breastfeeding - [View Abstract]
Topic: Creating Flow: Using Lymphatic Drainage Therapy for Breastfeeding Issues - [View Abstract]
Topic: Finger Feeding: What Do We Know? What Should We Know? - [View Abstract]
Topic: Gamechangers: New studies that will change the way we think about tongue-tie - [View Abstract]
Topic: Infant Trauma: Impact on Breastfeeding - [View Abstract]
Topic: The Faux Tie: When is a "Tongue-tie" NOT a Tongue-tie? - [View Abstract]
Topic: The Impact of Bodywork on Infant Breastfeeding - [View Abstract]
Topic: What Does Torticollis Have to do with Breastfeeding? - [View Abstract]
This presentation examines several influential recent studies that will change the way we think about tongue-tie; the manner in which we examine, treat and perform therapy on babies. From the overall perspective of development, Dr. Hazelbaker looks at histology, speech development, posture, wound healing, lasers and airway integrity, citing the most exciting studies on these subjects, explaining how each will impact our philosophical, intellectual and clinical involvement with study findings. Further, Dr. Hazelbaker makes suggestions of how these various studies should guide our thinking about when and how to assess and treat tongue-tied infants.
Navigating the Challenges of Tongue-Tie: Counseling and Anticipatory Guidance
Adrienne Guirguis, a board certified lactation consultant has over 25 years experience in helping breastfeeding infants and their families. She began her journey into the world of lactation after struggling to breastfeed her oldest son. She became an accredited La Leche League leader and was able to help babies breastfeed. Her experience with La Leche League led Adrienne to become a International Board Certified Lactation Consultant (IBCLC). She has been board certified for 20 years and has experience with a wide range of problems that may be experienced by new families. Adrienne has worked in hospital for over 10 years and then worked in community health for many years. She is a clinical practitioner, working hands on with families to improve feeding outcomes.
Adrienne continues her lactation education, constantly attending conferences and courses to stay up-to-date on the information and skills needed to benefit those who most need breastfeeding help. In 2022 Adrienne completed the Holistic Integrative/Functional Lactation course, a year long program followed by a residency. This course has increased her skills to provide the best care for the families with whom she works.
Adrienne also is an educator, working within the community to teach others the skills necessary to become lactation counselors and eventually board certified lactation consultants.
Parents with infants who are having breastfeeding issues due to tongue tie, face a complicated journey of conflicting information and differing opinions, complicated care plans and challenging emotions. Providing anticipatory guidance about the education providers receive on tongue tie, the many faceted symptoms of tongue tie for both parent and infant, the functional assessment versus the appearance of tongue and compensatory behaviors are all important for the parents to be able to make informed decisions and successfully navigate their way back to successful breastfeeding. Learn more about how to provide necessary information in a compassionate and useful way to already overwhelmed parents.
The Bigger Picture Takes a Bigger Team – Our Journey From a Tongue-Tie Division Service to "Whole-istic" Care
Kate is a Chartered Physiotherapist who works with infants, children and adults with oral myofunctional disorders.
She is Co-Director of the National Tongue Tie Centre where herself and her husband Justin, Consultant Paediatrician, lead a Team offering specialist services in a dedicated family centred environment.
Having trained at the University of Liverpool, she worked in both Leeds and Southampton, where she led and delivered the regional neonatal service for pre-term and high-risk infants, before moving to Ireland. She is a member of the Irish Society of Chartered Physiotherapists and is an IBCLC.
Kate has travelled many times over the last few years, mainly to the USA, to undertake further training in Orofacial Myofunctional Therapy, Craniosacral Therapy and Autonomic Nervous System Therapeutics.
Justin is a Consultant Paediatrician and a Fellow of the Royal College of Paediatrics and Child Health (FRCPCH) and a Fellow of the Faculty of Paediatrics, Royal College of Physicians of Ireland and is registered with the Medical Council (Number 171584) under the Specialist Division for Paediatrics.
He has spent thousands of hours on continuing education having attended numerous conferences and courses on tongue-tie, predominantly in the States, in order to be at the forefront of care for infants, children, and adults. He is also a board member of the International Consortium of Ankyloglossia Professionals (ICAP).
Justin's interest in Tongue Tie dates back to 1999 when his first daughter was born. At 5 days old she had her tongue tie divided in Southampton. Six children and four tongue ties later, he returned to Southampton to start his training in how to divide tongue ties himself. He has been treating tongue ties since 2008 and running a dedicated tongue tie clinic since 2010 and established the National Tongue Tie Centre with his wife Kate, Physiotherapist in 2017. Currently, Justin, Kate and the Team would assess and manage Tethered Oral Tissues in over one thousand children and adults each year.
The management of Ankyloglossia has historically been controversial. To this day, the recognition of what makes a tongue frenulum restrictive such that it is ankyloglossia and how infants should be managed before, during and after surgery still generates debate between the professions involved in their care.
We will take you on our journey from awareness, through training and experience, always striving to optimise management of Ankyloglossia for infants and their families.
The Impact of Tongue-Tie on the Musculoskeletal and Nervous Systems
Dr. Sharon A. Vallone is a graduate of Rutgers University (AB Microbiology 1978) and New York Chiropractic College (1986). She completed her Diplomate in Clinical Chiropractic Pediatrics in 1996 through Palmer College and received her appointment as Fellow in Clinical Chiropractic Pediatrics in 2003. Dr. Vallone has a private practice limited to high risk pregnancies and challenged children in Connecticut and is currently the Chair of the Board of Kentuckiana Children’s Center in Louisville, KY and past Vice Chair of the International Chiropractic Association’s Council Pediatric Council. She is an international speaker, author, and editor of the Journal of Clinical Chiropractic Pediatrics. Sharon brings 33+ years of pediatric chiropractic experience with a primary interest in pregnancy, birth trauma, breastfeeding and problems with infant /toddler neurodevelopment.
Topic: Wondering about “The Wanderer?” The Vagus and Ankyloglossia - [View Abstract]
The impact of tethered oral tissues on the fascial system of the neonate can be the origin of both successful and unsuccessful compensatory biomechanical alterations in an attempt to breastfeed. These biomechanical alterations can manifest as asymmetries in appearance and function as well as in behavioral challenges ranging from sleep disturbance, colic like symptoms and inconsolable crying. It is important to understand these issues when looking at the whole picture so as to improve outcomes when surgical interventions are required. The goal of this lecture will be to support the attendees with understanding the relationship between structure and function and how this ties in with physical limitations like tongue and lip tie, the biomechanical assessment and discussion of manual therapies available to assist the breastfeeding dyad.
Tongue Tie and Orofacial Myofunctional Development
Dr Marjan Jones, a dental surgeon in Brisbane Australia pioneered a multi-disciplinary approach to the treatment of oral restrictions in Australia. With over 20 years’ experience with dental lasers and extensive knowledge of the comprehensive treatment of oral restrictions, her practice treats patients of all ages, offering a team-based approach to surgery incorporating in-house myofunctional therapy and orthodontics for treatment for children and adults. For infant patients, she collaborates with IBCLCs and cranial therapists for a comprehensive approach toward functional outcomes. She co-founded the Tongue Tie Institute designed to advance the education of health professionals in the treatment of oral restrictions. She now lectures to practitioners from Australia and around the world who have been introduced to a team approach to the management of oral restrictions. She has personal experience with the effect of tongue ties and their effect on herself and family (including breastfeeding challenges) and is determined to help others avoid or overcome their impact. She is a Fellow of the World Clinical Laser Institute, a member of the Academy of Laser Dentistry, the Academy of Breastfeeding Medicine and was the immediate past Chairperson of the Interim Board of the International Consortium of Ankylofrenula Professionals (ICAP). He passion for breastfeeding has resulted in studies toward IBCLC certification.
Michelangelo at work - Tongue Tie and Orofacial Myofunctional Development
Our oral and facial muscles are the master sculptors of our jaws and face. Research and clinical findings show that changing resting oral posture and functional habits of our oral and facial muscles not only influence structure but also affect function. The important functions of the orofacial region include breathing, eating/drinking (including breastfeeding) and speaking.
Breastfeeding is the premier and pivotal determinant of orofacial myofunctional habits. Beyond the many risks of not breastfeeding, malocclusion (poorly positioned jaws and teeth) is a very significant risk.
As such it is important that all health practitioners working with neonates rally to educate, accompany and support breastfeeding dyads toward functional and breastfeeding for as long as possible.
The tongue’s ability to move (particularly to elevate) affects breastfeeding biomechanics. As such, a tethered tongue’s range of motion and span of influence is a deviation from the physiologic norm. Teaching a dyad to compensate or simply manage through sub-optimal breastfeeding and its resulting symptoms can have consequences in functional outcomes later in life. Compensations have consequences that emerge well beyond breastfeeding years.
