The Neurological Approach to Lip and Tongue Ties: Beyond the Surface
Lip and tongue ties are often viewed through a mechanical lens—a simple physical restriction of movement due to tight connective tissue. However, from a neurological perspective, they are far more complex. These ties are not just structural issues but signs of underlying nervous system imbalances that can impact a child’s development well beyond feeding difficulties.
What Are Lip and Tongue Ties?
Lip and tongue ties occur when the frenulum (the thin piece of tissue under the tongue or upper lip) is unusually tight, thick, or restrictive. This can cause:
Breastfeeding challenges (poor latch, nipple pain, inadequate milk transfer)
Speech difficulties
Digestive issues (swallowing air, reflux, gas)
Sleep disturbances
Oral development concerns (narrow palate, dental issues)
But what causes these ties to form in the first place? To answer that, we need to explore their neurological origins.
The Neurological Roots: Midline Development & the Neural Tube
Lip and tongue ties are part of a broader developmental process tied to the midline of the body. The midline is established during early embryonic development when the neural tube forms—the precursor to the brain and spinal cord. This structure is critical because it:
Directs the development of the central nervous system (CNS)
Establishes the body’s bilateral symmetry
Guides the formation of midline structures (including the frenulum, palate, spine, and brainstem)
The midline fuses between the 4th and 6th weeks of gestation, a critical period when the neural tube closes and essential structures like the brain, spinal cord, and craniofacial features begin to develop.
When stressors disrupt this early development, we often see signs like:
Lip and tongue ties
Torticollis (tight neck muscles)
Asymmetrical head shapes (plagiocephaly)
Midline birthmarks or sacral dimples
What Disrupts Midline Fusion?
Several factors can interfere with the proper closure of the midline during this critical window:
Genetic Factors: While not always the primary cause, certain genetic predispositions can affect tissue formation and neural development.
Environmental Toxins: Exposure to harmful substances (e.g., heavy metals, pesticides, endocrine disruptors) during pregnancy can interfere with fetal development.
Maternal Stress: High levels of cortisol and stress hormones can impact cell signaling and neural tube closure.
Nutritional Deficiencies: Inadequate folate, essential for neural tube development, can increase the risk of midline defects.
Medications or Infections: Certain medications or maternal infections can alter embryonic development, influencing neural and craniofacial formation.
These are not isolated issues but neurological markers indicating that the body’s developmental blueprint has been affected.
What Causes Disruptions in Midline Development?
Several factors can influence the development of the neural tube and midline structures:
Prenatal Stress
Maternal stress, poor nutrition, or toxin exposure can affect fetal nervous system development.
Inflammation and stress hormones cross the placenta, impacting the baby’s growth.
Birth Trauma
Difficult deliveries (forceps, vacuum, C-sections, prolonged or rapid labor, Pitocin use) can create tension in the cranial and cervical regions, affecting nerve function and tissue development.
Nervous System Stress
Early subluxations or stress to the vagus nerve can influence muscle tone and coordination, contributing to issues like poor latch, digestive dysfunction, and oral motor challenges.
The Hidden Impact of Frenectomy (Surgical Release)
Many healthcare providers recommend a frenectomy (cutting the frenulum) to address lip or tongue ties. While this can offer immediate relief, it often fails to address the root neurological cause.
Potential Downsides of Frenectomy Without Neurological Support:
Persistent Feeding Issues: The structural release doesn’t improve muscle coordination if the nervous system remains dysregulated.
Compensatory Tension: The body may develop new tension patterns elsewhere, leading to ongoing issues with the jaw, neck, or spine.
Emotional Dysregulation: The procedure can be stressful for infants, especially if the nervous system is already in a heightened state of stress (sympathetic overdrive).
The Neurological Approach: Addressing the Root Cause
At Purpose Driven Chiropractic, we focus on the nervous system’s role in oral motor function. Rather than just addressing the physical restriction, we look at how the brain and body communicate.
Key Components of Our Neurological Approach:
Assessing Nervous System Function: Using advanced neurological scans, we identify areas of stress and interference in the brainstem, vagus nerve, and cranial nerves.
Chiropractic Adjustments: Gentle, specific adjustments help reduce subluxations, restore proper nerve communication, and improve muscle tone.
Coordinating with Therapists: We often work alongside lactation consultants, myofunctional therapists, and bodyworkers to create a comprehensive care plan.
The Role of the Vagus Nerve
The vagus nerve is a key player in this conversation. As the longest cranial nerve, it controls:
Swallowing and digestion
Breathing and heart rate regulation
Speech and oral motor coordination
When the vagus nerve is under stress (due to birth trauma, subluxation, or nervous system dysregulation), it can affect:
Latch and suck-swallow-breathe coordination
Digestive issues like reflux or colic
Sleep disturbances
When Is Surgical Intervention Necessary?
There are cases where a frenectomy is necessary, but it should be approached as part of a comprehensive neurological care plan. Pre- and post-frenectomy chiropractic care can:
Reduce nervous system stress
Improve oral motor function before surgery
Support faster, more complete recovery afterward
Final Thoughts: A Holistic, Neurological Perspective
Lip and tongue ties are more than just physical restrictions. They are often symptoms of deeper neurological imbalances related to midline development and nervous system function.
If your child has been diagnosed with a lip or tongue tie—or if you’re considering a frenectomy—let’s have a conversation. We’ll help you understand the full picture, address the root causes, and support your child’s health from the inside out.
