When a newborn struggles to latch, when feeding is painful for mom, when the baby seems colicky or fails to gain weight, the first thing many parents hear is: “It might be a tongue tie.”

And yes, oral ties—tongue-tie (ankyloglossia) and lip-tie—are real and can absolutely interfere with feeding. But here is what is often overlooked: the tongue tie is rarely the root problem. The palate deformity is.

As a manual osteopath specializing in newborns and infants, I see this pattern repeatedly. A baby is diagnosed with a tongue tie, the tie is released (often with great hope), and yet the feeding difficulties persist. The reason is simple: the tongue cannot function properly if it has nowhere to go.

Let me explain.

The roof of the mouth—the palate—is not just a passive structure. It is the platform against which the tongue must work to create the suction needed for breastfeeding or bottle-feeding.

During pregnancy and birth, the baby’s head and face undergo tremendous molding forces. These forces can shape the palate in ways that restrict the tongue’s natural range of motion.

• Wide and arched
• Tongue rests comfortably against the entire roof of the mouth
• Suction forms easily during feeding
• Baby can breathe while feeding

• High, narrow, or V-shaped
• Tongue cannot reach the roof of the mouth
• Tongue is “trapped” in a lower position
• Suction is weak or impossible
• Baby tires quickly during feeds

When the palate is narrow or high-arched, the tongue literally does not have enough space to elevate and create the vacuum needed for efficient feeding. The tongue tie is often a symptom of this underlying structural issue, not the cause.

There are several reasons a baby’s palate may become restricted:

Intrauterine Constraint

The baby’s position in the womb—whether due to crowding, a tilted uterus, or the baby’s own positioning—can create tension in the cranial bones. This tension affects the development of the palate before birth.

Birth Molding

The journey through the birth canal is intense. Even in an uncomplicated vaginal birth, the baby’s skull compresses and molds. This can create strain in the bones of the cranium and the palate. Forceps or vacuum-assisted deliveries increase this strain significantly.

C-Section Delivery

Babies born by cesarean section miss the compressive forces of vaginal birth. While this may sound beneficial, those forces actually help to open and expand the cranial bones and palate. C-section babies sometimes present with palates that are less expanded and more restricted.

I have worked with many families who have already had a tongue or lip tie released—sometimes more than once—only to continue struggling with:

• Poor latch
• Clicking sounds during feeding
• Milk dribbling from the mouth
• Gassiness and reflux
• Maternal nipple pain and damage
• Baby falling asleep at the breast before feeding adequately

The release addresses the soft tissue—the membrane tethering the tongue. But it does not address the bony structure—the palate—that the tongue must press against to function.

If the palate remains narrow or high-arched, the tongue is still working against an unfavorable structure. The release gives the tongue freedom, but not a functional home.

Osteopathy takes a different approach. Rather than focusing solely on the tie itself, we look at the whole structure: the cranium, the palate, the tongue, and the fascia that connects them.

What Happens in an Osteopathic Session

When I work with an infant with feeding difficulties, I assess:

• Cranial bone mobility: The bones of the skull are not fused at birth. They are designed to move. When they are restricted, the palate is affected.
• Palate shape and tension: I gently assess the width, arch, and mobility of the palate.
• Tongue mobility and attachment: I look at how the tongue moves and where it is restricted—not just the visible tie, but the deeper fascial connections.
• Fascial tension: The tongue is connected to the entire body through fascia. Tension in the neck, jaw, or even the diaphragm can affect feeding.

Gentle, Non-Invasive Techniques

Osteopathic treatment for infants is extremely gentle. I use light pressure—sometimes no more than the weight of a nickel—to release tension in the cranial bones, palate, and fascia.

The goals are:

• Expand the palate: Gentle intraoral techniques help to widen and mobilize the palate, creating more space for the tongue.
• Release cranial tension: Balancing the bones of the cranium allows the palate to expand naturally.
• Restore tongue function: With a more favorable palate, the tongue can now elevate and create effective suction.
• Address whole-body connections: Releasing tension in the neck, jaw, and diaphragm supports coordinated sucking, swallowing, and breathing.

When the palate is addressed alongside the oral tie, parents often report:

• A deeper, more comfortable latch
• Reduced or eliminated clicking sounds during feeding
• Longer, more efficient feeding sessions
• Baby gaining weight steadily
• Reduced reflux and gassiness
• Mom’s nipple pain resolving
• A calmer, more content baby

If your baby has been diagnosed with a tongue tie—or if feeding has been harder than you expected—know that there is more to the story. The palate matters. The cranium matters. The whole baby matters.

Osteopathy offers a gentle, effective way to address the structural foundations of feeding. By creating more space for the tongue, we help babies feed with ease and parents feed with confidence.

1. Lopez D. The Dynamic Motion of the Tongue and Craniofacial Development. Daniel Lopez, DO; 2020.
2. Gunge D, Chen A, Wolf KJ, et al. Osteopathic Manipulative Medicine to support the Breastfeeding Dyad: a Scoping Review. Presented at: Section on Osteopathic Pediatricians, American Academy of Pediatrics Experience; September 29, 2024; Orlando, FL.
3. Chowdhury R, Khoury S, Leroux J, et al. Alternative Therapies for Ankyloglossia-Associated Breastfeeding Challenges: A Systematic Review. Breastfeed Med. 2024;19(7):497-504.
4. Wedenig K. Middle Ear Pathologies and the Mobility of the Temporal Bone in Children with Cleft Lip and Palate – A Pilot Study. Osteopathic Research Web; 2019.
5. Palaska PK, Antonarakis GS, Suri S. A Retrospective Longitudinal Treatment Review of Multidisciplinary Interventions in Nonsyndromic Robin Sequence With Cleft Palate. Cleft Palate Craniofac J. 2022;59(7):882-890.

Disclaimer

The information provided in this article is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Osteopathy is a complementary manual therapy; it is not a substitute for professional medical care.