What is Bodywork and Does my Baby Need it?
Have you heard the buzzword “bodywork?” This phrase has been a hot topic in the pediatric world and is starting to make its way around social media and online parenting groups, so I thought I’d answer some commonly asked questions on this subject.
What is Bodywork?
Bodywork is a term used to describe a method of treatment with the goal to improve the patient’s mobility. It can come in the form of soft tissue release, massage therapy, stretching, acupuncture, and joint mobility/adjustments. The method to improve mobility will likely depend on the type of provider who is doing the treatment. Bodywork can be done by a physical therapist, chiropractor, acupuncturist, massage therapist, or a craniosacral therapist. When it comes to finding a provider for your child, finding a provider who is specifically trained in infant mobility is more important than finding a provider with specific initials after their name.
As a pediatric physical therapist, I would clinically replace the word “body work” for “manual therapy.” Manual therapy is a category of techniques that physical therapists use to improve movement of the patient’s skin, fascia, muscles, and joints (extremities and spine). Manual therapy can be facilitated through joint mobilizations, myofascial release techniques, soft tissue massage, and targeted stretching techniques.
How does bodywork relate to a baby who has a tongue tie?
A type of tissue called “fascia” surrounds the muscles, organs, nerves, and blood vessels inside the human body and holds these structures in the proper place. When there is a restriction in the fascia in one area of the body, it has a cascading effect to another area of the body because the fascia is all connected throughout the body. Think about having a knot in a stretchy piece of fabric.
Since the tongue is a muscle, it is surrounded by fascia. If the tongue is restricted (tongue tie), so is the fascia that surrounds it. Humans (and babies in particular) do not move naturally against any type of restriction or tension within the body (unless the person is wanting to perform a purposeful stretch).
For example, if you are flexible enough to bend forwards and touch your toes, you generally have good mobility of your hamstrings, however you are overcoming some type of body tension to reach forward and touch your toes. Now, if you were to drop a pen on the floor, do you pick it up via bending forwards with straightened knees? Highly unlikely. You would likely bend your knees and give into your body tension while picking up your pen. Even though you have the mobility to pick up the pen with straightened knees, to do so, you would have to work against body/fascial tension to do so. You will likely not attempt to challenge your body tension in a functional movement. The same goes with babies and their tongue and body movement. They will not purposely be able to overcome this body tension they feel during functional movements- feeding, tummy time, rolling, etc.
The restrictions in the fascia surrounding the tongue lead to poor movement patterns throughout the body, including the tongue. Bodywork relieves this tension in a baby’s body which will then positively impact the baby’s function of the muscles of the mouth and body.
How does the increased tension affect feeding?
The increased tension found in babies with a tongue tie affects feeding by not allowing all the important structures involved in feeding to work effortlessly. When a tongue is tied, it cannot properly elevate and cup to provide the negative pressure needed to transfer the milk during breast or bottle feeding. In order to feed efficiently, a baby needs to move their tongue independently from their jaw to create that negative pressure. In a baby who has excessive body tension, the tongue and jaw do not have the mobility or coordination to work independently from one another, therefore compensatory patterns develop and lead to inefficient feedings. These inefficient feeding patterns can lead to excessive reflux, constipation, gas issues, failure to thrive and gain weight, and short and frequent feeds due to fatigue just to name a few.
What are the signs of body tension?
-difficulty with breast and/or bottle feeding
-pain with breastfeeding, nipple damage
-difficulty with positions during feeding, appears uncomfortable
-difficulty opening mouth wide enough to latch onto bottle or breast
-clicking noise while feeding
-gulping or wet coughing sounds during or after feeds
-gagging at breast or bottle
-open mouth posture during wake and sleep cycle
-snorting/snorning sounds and/or mouth breathing during sleep
-constipation or excessive reflux
-elevated shoulders (appears to have a short neck)
-red creases in the skin of the neck
-dislikes tummy time
-appearance of furrowed brow
-appearance of tight chin with crease
-appearance of recessed chin
-has a preference for looking to one side
-has a consistent head tilt to one side
If my baby gets his tongue tie released, doesn’t this fix the problem?
Frenectomy or tongue tie release (via laser or scissors) fixes the anatomy but it does not fix the function of the tongue. Now, some babies will get their tongue tie released and be able to feed more efficiently with no issues, however most babies need some type of therapy before and/or after the release. Providers that can help with aftercare include IBCLC, occupational therapists, speech and language pathologists, physical therapists, chiropractors, and cranial sacral therapists. These providers must be trained in oral motor function and have the skills and knowledge to give specific exercises for the parents to practice at home.
A team approach for aftercare is ideal to see the best results. An example of a skilled team would include an IBCLC, oral motor therapist, and a bodyworker (physical therapist, chiropractor, or craniosacral therapist). These providers will work together to help the baby gain optimal function throughout the body in order to foster ideal development and to feed safely and efficiently.
What does a typical consultation and treatment look like?
-Observation of breast and/or bottle feeding
-Assessment of strength and coordination of suck: therapists using a gloved finger to have the baby suck on the finger. A pacifier may be used for this as well.
-Assessment of oral abilities to move tongue in different areas of the mouth
-Assessment of mobility of the spine, arms, and legs to determine if there is increased tension or less mobility in the body relating to tongue restriction. This will look like gentle movements in multiple planes of movement with your baby lying on his back and/or while being held in the therapist’s lap.
-Recommendations for future sessions and teaching of home programs if necessary. Home program is key and always emphasized as parents will be asked to carry over home program suggestions prior to the next therapy session.
If you have concerns regardng your baby's feeding abilities or feel that your baby exhibits the signs and symptoms listed above, contact a local pediatric feeding specialist and bodyworker. The earlier your baby recieves treatment, the faster the results!
→Special thanks to Karyn Johnson-Fernandez MS, OTR/L, SWC for her contributions to this post. To find more about her services, plase click here.
