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Infant tongue-ties and other tethered oral tissues can have far-reaching effects on a child’s development and even their sleep quality. Orofacial myofunctional therapy (OMT) is a specialized therapy for the tongue and facial muscles, addressing issues with breathing, swallowing, and posture. When a baby is born with a tongue-tie (ankyloglossia) – a thick, tight band of tissue restricting the tongue’s movement – it can lead to immediate feeding challenges and long-term structural changes that contribute to chronic mouth breathing or even obstructive sleep apnea (OSA) later in life.

Understanding Tongue Ties, Lip Ties, and Tethered Oral Tissues

A tongue-tie is simply a restriction of the tongue’s range of motion due to unusually tight tissue, and it often occurs alongside a tight upper lip (lip-tie). These are collectively known as tethered oral tissues. Anterior tongue-ties (at or near the tip of the tongue) are relatively common, occurring in an estimated 4–10% of newborns. Posterior tongue-ties (submucosal ties hidden under the tongue) may be even more widespread; one recent clinical review found that as many as one in three infants has a significant tongue restriction. These tethered tissues may not look alarming, but their functional impact can be profound.

Even a mild tongue-tie can make breastfeeding difficult: it prevents the tongue from moving forward properly, causing pain for the mother and inefficient milk transfer for the baby. Left untreated, a tongue-tie can lead to a cascade of problems. Lingering tongue-ties commonly cause painful latching, prolonged feeding sessions, slow weight gain, reflux, and gas. Later on, as the child grows, unresolved ties can cause problems with speech development (sounds like R, S, L, TH, and Z may be hard), orthodontic issues like crowding or a narrow jaw, and even picky eating or digestion issues. In short, a tongue-tie that interferes with nursing, feeding, swallowing, or speech should be evaluated by a specialist.

For babies struggling at the breast, an infant tongue tie release (also called a frenotomy or frenectomy) is often a game-changer. This quick procedure snips the tight tissue and instantly restores the tongue’s mobility. Many parents notice that nursing becomes far easier immediately after release. With the tongue free, babies latch more deeply and feed more efficiently, and mothers experience relief from pain. Early release can also help the palate develop more normally as the infant continues to breastfeed, since a free tongue can begin to gently shape a broader palate.

How Tongue Position Shapes Airway Development

In utero and during infancy, a baby’s tongue naturally rests against the roof of the mouth. This constant, gentle pressure helps mold the palate into a broad, flat shape. However, if a tongue-tie or lip-tie keeps the tongue down and forward, the palate instead becomes high-arched or “narrow.” A high palate takes up space that would otherwise be available for the nasal passages. Over time, this results in a smaller nasal cavity and reduced space in the upper airway.

When the palate is narrow and the lower jaw is underdeveloped or set back, the tongue tends to sit lower in the mouth or even fall back toward the throat. In that case, the tongue essentially fills the airway, leaving less room for air to pass, especially during sleep when muscle tone naturally relaxes. These structural changes force the person to breathe through their mouth more often than through the nose, particularly at night. Mouth breathing disrupts the deepest phases of sleep, meaning that even if a child seems to sleep enough hours, he or she may still wake up feeling chronically tired.

Common consequences of untreated tongue-ties in infancy:

• Breastfeeding difficulties: Painful latching, long feedings, nipple pain, and poor milk transfer often lead to early weaning and slow weight gain.

• Reflux and gas: Inefficient feeding can lead to swallowing more air, causing spit-up and fussiness for baby and extra discomfort for mom.

• Oral development issues: High-arched palate, crowded teeth, or a narrow jaw can develop without normal tongue function.

• Future feeding challenges: As solid foods are introduced, a tied tongue can cause gagging, messy chewing, or picky eating habits.

• Speech delays: Misarticulation of certain sounds and slower speech progress are more common when ties remain unaddressed.

Many healthcare providers now recommend an infant frenectomy (tongue tie release) early when these problems appear. By cutting the restrictive band of tissue, the tongue can immediately move more freely. After a successful release, breastfeeding often becomes smoother and the tongue is able to begin the natural widening of the palate.

Recognizing Sleep-Disordered Breathing and Sleep Apnea

Sleep-disordered breathing (SDB) is an umbrella term ranging from simple snoring to full obstructive sleep apnea (OSA). In children, snoring is not normal and should always be evaluated. Tongue-ties and other orofacial issues often lead to mouth breathing and partial airway collapse, which manifest in sleep. Parents should watch for the following signs:

• Snoring or noisy breathing: Even occasional snoring, wet or hoarse breathing sounds, or snorting are red flags.

• Mouth breathing at rest or during sleep: An open mouth, drooling, or habitual mouth breathing can indicate poor nasal airflow.

• Restless sleep: Tossing and turning, frequent awakenings, or unusual sleep positions (such as arching the back) are common.

• Pauses or gasps: Pauses in breathing (apneas) or gasping/choking during sleep may be observed by a caregiver.

• Daytime effects: Difficulty concentrating, hyperactivity, irritability, or excessive sleepiness in a child can result from poor sleep quality.

• Physical signs: Dark circles under the eyes, mouth breathing during the day, or a high-pitched voice sometimes accompany chronic sleep issues.

• Failure to thrive: In severe cases, consistently low oxygen can subtly impact a child’s growth and immune function.

Adults with long-untreated tongue ties may also develop SDB symptoms. They might snore loudly, experience frequent nighttime awakenings, and have daytime fatigue or headaches. Untreated sleep apnea can have serious health consequences, so any sign of disordered breathing warrants a thorough evaluation.

The Link Between Frenectomy (Tongue Tie Release) and Improved Sleep

Releasing a tongue-tie often has immediate and long-term benefits for sleep and breathing. A frenectomy is a quick, minimally invasive procedure to snip or laser the tight tissue under the tongue (or lip). For infants, this release allows the tongue to move normally during nursing, usually resulting in more comfortable feeding and better weight gain for the baby. Parents and lactation consultants often find that once the tongue can latch deeply, the baby breastfeeds more efficiently and sleeps more soundly.

Longer term, early tongue tie release lets the tongue naturally rest on the palate and help widen the arch of the mouth as intended. This broadening effect can significantly enlarge the space of the nasal passages and upper airway. In practice, clinics like the Center for Facial Oral Myofunction (CFOM) in Boise, Idaho, report that many families see improvements in sleep almost immediately after a frenectomy. Children who previously snored often snore less or stop completely, awaken less frequently during the night, and sleep more deeply.

Why frenectomy can reduce sleep apnea risk:

• Immediate tongue mobility: As soon as the tie is released, the tongue can lift and press against the palate, helping it expand properly as the child grows.

• Wider airway: A free tongue means a flatter, broader palate and jaws, creating more room in the nasal passages and throat for breathing.

• Nasal breathing encouraged: With normal tongue posture, the child is more likely to breathe through the nose, which improves oxygenation and sleep quality.

• Corrected tongue posture: The tongue naturally moves away from the back of the throat, reducing airway obstruction during sleep.

• Jaw growth support: When infants suck and chew normally after a release, their jaws grow stronger and larger, further opening the airway.

The Role of Orofacial Myofunctional Therapy (OMT)

Orofacial myofunctional therapy is often the missing piece that makes a tongue tie release fully effective. OMT consists of specific exercises and techniques to retrain the muscles of the tongue, lips, cheeks, and face. The goals are to strengthen weak muscles, establish a proper resting posture (tongue on the palate, lips together, teeth lightly touching), and normalize the swallow and breathing pattern.

Even after a frenectomy, myofunctional therapy is highly recommended. Specialized exercises help keep the newly released tongue in the correct position and prevent the tissue from reattaching. They also teach the patient to swallow properly (using a tongue-tip swallow) and to close the lips at rest instead of breathing through the mouth. A typical OMT program might include:

• Tongue exercises: Lifting the tongue tip to the palate, sweeping from side to side, or pressing the tongue against a tool to build strength.

• Lip and cheek exercises: Practicing lip closure and pursing, and strengthening cheek muscles to improve suction and swallowing.

• Breathing drills: Exercises that encourage nasal breathing and proper inhalation/exhalation through the nose.

• Swallowing retraining: Guided practice of an infant-like (tongue-tip) swallow to replace a tongue-thrust or reverse swallow.

OMT is also beneficial on its own for sleep apnea. Research has shown that a consistent program of orofacial exercises can significantly reduce snoring and the severity of obstructive sleep apnea in both children and adults. By toning the muscles around the airway and encouraging nasal breathing, myofunctional therapy can decrease the frequency of breathing interruptions during sleep. For patients who struggle with continuous positive airway pressure (CPAP) machines, OMT provides a non-invasive way to help open the airway and improve sleep quality.

A Team Approach for Sleep and Feeding Issues

Effectively addressing sleep-disordered breathing and tongue-ties usually involves an interdisciplinary team. This might include:

• Myofunctional therapists or speech therapists: Evaluate tongue and facial muscle function, teach exercises, and monitor progress.

• Pediatric dentists or orthodontists: Check for tongue-ties, high palates, or jaw alignment issues, and perform frenectomies if needed.

• Ear-Nose-Throat (ENT) specialists: Assess airway anatomy, tonsils/adenoids, and nasal health.

• Lactation consultants: Help mothers with nursing technique and identify tongue-ties that may be causing feeding pain or poor milk transfer.

• Pediatricians: Screen for growth, development, and refer to specialists if sleep or feeding problems persist.

For example, a child who snores and also has speech or feeding issues should be examined by a practitioner trained to recognize subtle posterior tongue-ties. If a tie is found, many experts now recommend releasing it early and following up with therapy to solidify gains. After all, both research and clinical experience show that early intervention (often within the first weeks or months of life) can prevent a cascade of airway problems that would require more extensive treatment later. Even older children and adults typically benefit from a combined approach of release and therapy to address any remaining habits or structural issues.

Encouraging Healthy Mouth and Airway Habits Early

Nature designed breastfeeding to stimulate jaw and airway development. The action of the baby’s tongue during nursing helps expand the palate and encourages proper growth of the facial bones. Pediatric specialists often emphasize exclusive breastfeeding for at least the first 6 months as a way to promote a broad palate and nasal breathing. After that, gradually introducing solid foods—especially textured foods that require chewing—helps strengthen the jaws and encourage normal tongue movement.

“Baby-led weaning,” where infants self-feed with soft chunks of food under supervision, naturally exercises the tongue and jaws far more than pureed spoon-feeding does. Meanwhile, limiting prolonged bottle use and pacifiers can also prevent the palate from collapsing inward. The combination of natural breastfeeding movements, early solid foods, and, if needed, a tongue tie release, gives a child the best chance to develop large, functional airways. This can reduce or even eliminate the need for future orthodontic treatments, and minimize the risk of developing sleep apnea or other breathing disorders as the child grows.

Putting It All Together: Outcomes After Release and Therapy

Many pediatric patients experience noticeable improvements in sleep right after their tongue-tie release and the start of myofunctional therapy. Children who previously snored and woke frequently often begin sleeping through the night. Parents report that their kids move around less, breathe through their noses more, and wake up in better moods. Even daytime behavior can improve: better sleep often means better concentration, better impulse control, and less hyperactivity or irritability.

Older children and adults may take a few weeks of consistent therapy to see the full effect, but the trend is similar: improved sleep quality, less snoring, and higher energy during the day. Patients frequently say that friends and family notice the positive change in how well they sleep.

Benefits reported after tongue tie release and myofunctional therapy can include:

• Deeper, more restful sleep: Patients spend more time in deep (slow-wave) and REM sleep, which is critical for learning and growth.

• Significantly reduced snoring and apnea: Many stop snoring altogether or breathe much more quietly at night.

• Improved nasal breathing: With the tongue freed, sleeping and breathing through the nose becomes much easier.

• Easier breastfeeding and feeding: Babies nurse with less pain and frustration, and older children chew and swallow more effectively.

• Better growth and weight gain: Efficient feeding and restful sleep support healthy growth.

• Enhanced speech clarity and feeding habits: Untethered tongue motion helps correct lisping or articulation problems and allows a wider variety of foods in the diet.

• Improved concentration and behavior: With uninterrupted sleep, children tend to have better focus, more stable moods, and less hyperactivity during the day.

By combining tongue tie release (frenectomy) with targeted orofacial myofunctional therapy, families and clinicians tackle both the mechanical restriction and its functional consequences. The release removes the hidden “string” that tethers the tongue, and the therapy retrains the muscles to function correctly from that point on. This one-two approach can significantly reduce the chance that a child will develop chronic sleep-disordered breathing or obstructive sleep apnea as they grow.

A Future of Better Sleep and Health

Sleep is essential for cognitive development, growth, and overall health. For infants and children struggling with tongue ties and related issues, investing in early intervention can pay dividends for a lifetime. An infant tongue tie release, coupled with proper myofunctional therapy, can restore normal tongue movement, encourage nasal breathing, and allow the airway to develop without constraint.

At the Center for Orofacial Myology in Boise, Idaho, we specialize in supporting families through infant tongue tie release, frenectomy, and orofacial myofunctional therapy to improve breathing, feeding, speech, and sleep.

If you notice signs of a tongue tie, persistent mouth breathing, or sleep-disordered breathing in your child, we invite you to take the next step. Call (208) 793-7006 today to schedule your free 15-minute consultation and learn how we can help your family breathe, sleep, and thrive.