Feeding Difficulties in Newborns, Tongue Tie Division and The Role of Osteopathy

As Principal Osteopath at The Waterside Practice, supporting babies with feeding difficulties is something I do every week in clinic. Over the years, I have worked closely with lactation consultants, tongue tie practitioners and families across Cambridgeshire, helping babies who continue to struggle with feeding even after a tongue tie division.

We are a recommended provider within the private healthcare sector throughout Cambridgeshire for babies following tongue tie division, receiving referrals from lactation consultants and tongue tie practitioners who recognise that some babies benefit from additional support after the procedure. Whilst the tongue may have been successfully released, it is common for babies to retain tension around the jaw, head and neck that can continue to affect feeding. Our role is to gently assess and address these restrictions, helping babies develop the movement and coordination needed for more comfortable and effective feeding.

Many parents arrive feeling frustrated and exhausted. They have often been through weeks of painful breastfeeding, lengthy feeding sessions, excessive winding, poor weight gain, milk leaking from the mouth, or a baby who simply seems uncomfortable whilst feeding. In many cases, they have already taken the important step of having a tongue tie assessed and released, yet feeding still does not feel as easy as they expected.

This can be frustrating for parents. If the tongue tie has been divided, why is feeding still difficult?

The answer is often that feeding involves far more than the tongue alone.

Whilst tongue tie division can improve tongue mobility, babies may still have tension through the jaw, neck and surrounding tissues that developed before birth, during labour, or in the weeks following delivery. These compensatory patterns can continue to affect how a baby opens their mouth, positions their tongue and coordinates feeding. I see the same pattern in clinic each week, and the good news is that these issues are often helped greatly by gentle hands on therapy such as osteopathy.

The Newborn Jaw Is Not a Miniature Adult Jaw

One of the most important things for parents to understand is that a newborn baby's jaw is very different from an adult's. You may have heard of the comment with newborns; “They look like little old men”.. lacking jaw depth and definition - in the older generation this is linked to muscle wastage and absence of teeth which, contribute to the healthy depth of an adult jaw.

At birth, the lower jaw is naturally smaller and sits slightly further back than the upper jaw. This position is entirely normal and forms part of the baby's natural feeding design. The jaw bones are still developing, the joints are immature and the surrounding tissues are highly adaptable.

During the first few months of life, feeding itself helps stimulate growth and development of the jaw and facial structures. Every feed acts as a form of exercise, encouraging the muscles of the tongue, cheeks, lips and jaw to work together.

Unlike adults, babies cannot simply bite or chew. Successful feeding requires a carefully coordinated interaction between the tongue, jaw, lips, palate, swallowing muscles and breathing pattern. If one part of this system is not functioning optimally, feeding can become challenging.

What We Commonly Find Following Tongue Tie Division

One of the most frequent findings during assessment is tension around the jaw and upper neck.

Many babies struggle to open their mouths widely enough to achieve an effective latch. Others appear to have a strong preference for turning their head to one side whilst avoiding movement in the opposite direction.

Parents often tell us that their baby seems to fight positioning on one breast, leaks milk from the corners of the mouth, clicks during feeding, swallows excessive air or struggles to maintain a seal around the breast or bottle teat.

These patterns can develop before birth due to positioning within the womb, during labour and delivery, or as a result of compensatory patterns associated with a tongue tie.

Although the tongue may have been released, the surrounding muscles and tissues may still be holding on to the movement patterns that developed before the procedure.

How Effective Breastfeeding Works

Many people think breastfeeding is simply about the nipple entering the baby's mouth, but the process is actually far more sophisticated.

For effective feeding, a baby needs to achieve a deep latch. Ideally, the nipple should reach well back into the mouth towards the junction between the hard palate and soft palate. This allows feeding to occur comfortably and efficiently whilst reducing unnecessary pressure on the nipple.

A successful latch involves the baby taking a generous amount of breast tissue into their mouth, not just the nipple itself.

The tongue should extend forwards over the lower gum ridge and cup the lower portion of the breast tissue. As the tongue moves rhythmically, it helps create the pressure changes necessary for effective milk transfer.

At the same time, the jaw opens and closes in a coordinated pattern whilst the lips maintain a secure seal around the breast.

When this happens effectively, milk is transferred efficiently and the breast receives the stimulation needed to maintain milk production. Good drainage of the breast sends signals to continue producing milk, making effective feeding important for both baby and mother.

Why Mouth Opening Is So Important

A baby who cannot open their mouth widely enough may struggle to achieve this deep latch.

Instead of taking a large amount of breast tissue into the mouth, they may attach more superficially to the nipple. This can reduce the tongue's ability to cup the breast effectively and may lead to:

• Painful breastfeeding

• Shallow latch, often clamping on the nipple

• Reduced milk transfer

• Prolonged feeding sessions

• Clicking sounds during feeding

• Milk leaking from the mouth

• Increased air intake

• Frequent winding and discomfort

The same principles apply to bottle feeding. Whilst the mechanics differ slightly, babies still require adequate jaw opening, tongue mobility and a secure seal around the teat. Without this, milk may leak from the mouth and feeding can become inefficient.

Additional Factors

Whilst tongue movement is important, feeding also relies heavily on the mobility of the jaw, neck and head.

Many of the babies we assess show restricted movement through the upper cervical spine and the base of the skull. Some strongly favour looking to one side, making positioning during feeding more difficult.

These restrictions can influence how comfortably a baby positions themselves at the breast or bottle and how effectively they coordinate feeding movements.

This is why our assessment extends well beyond the tongue itself. We look at the baby's overall posture, behaviour, movement patterns, head positioning and jaw function to gain a complete picture of what may be contributing to feeding difficulties.

The Role of Osteopathy

Babies are treated very differently from adults, the techniques you may associate with an osteopath are applied very different to an infant. Their tissues are delicate, highly responsive and still developing. Osteopathic treatment for babies uses extremely gentle techniques designed to encourage healthy movement and reduce areas of tension.

During treatment, we commonly work around the jaw, cheeks, upper neck and base of the skull. The aim is to improve comfort, encourage natural movement and support the feeding mechanics that babies rely upon every day.

Many babies relax and look like they are enjoying treatment (yes, really!) and parents often notice improvements in comfort, feeding efficiency, head movement and overall settling as treatment progresses. From my own perspective as an osteopath treating this age group since i qualified in 2011, they are often the most rewarding age group to work with. And as a fellow parent, a pleasure to help a family find a calm rhythm and see a happier baby.

Working Alongside Your Feeding Team

The best outcomes are often achieved when healthcare professionals work together.

Osteopathy is not a replacement for skilled breastfeeding support, lactation consultancy or tongue tie assessment. Instead, it forms part of a multidisciplinary approach that can help support babies after tongue tie division. Our local professionals whether, that be NHS or private understand that a combined approach works best for baby’s journey.

By addressing tension and movement restrictions around the jaw, head and neck, osteopathy may help babies make the most of the increased tongue mobility gained from their procedure.

At The Waterside Practice, we are proud to work closely with lactation consultants and tongue tie practitioners throughout Cambridgeshire, supporting families as part of their wider feeding journey.

If your baby continues to struggle with feeding after tongue tie division, an osteopathic assessment may help identify factors that are preventing them from feeding as comfortably and effectively as possible. Book a free consultation call with one of our qualified Paediatric osteopaths to explore further here before making an in person appointment here: https://thewatersidepractice.janeapp.co.uk/#/staff_member/1/treatment/96

The Waterside Practice, 10a Mill Green, Warboys PE28 2SA

01487 209 084

Reception@TheWatersidePractice.co.uk