A speech therapist working on articulation with a child

What Does a Speech Therapist Actually do?

How about a little background on how your speech therapist are trained and who they work with?  A Speech-Language Pathologist (SLPs) often called a speech therapist can work with newborn babies, children, adults, and seniors.  In other words, we can work with you across your lifespan. SLPs study in school human communication, development, and disorders. A Speech Therapist does 4 years of undergrad and 2 years of graduate school. Therapist work on 9 different areas:

  • Articulation
  • Language
  • Cognition
  • Feeding and Swallowing
  • Voice and resonance
  • Fluency
  • Hearing
  • Social Communication
  • Communication Modalities

Are you new here? I also have the following posts to help you with other breastfeeding information!

To Clip or Not to Clip? That is the questions.
Are Tongue Ties real?
Are Lip Ties real?

Warning Signs that your baby needs to visit a Speech Therapist

Below you will find signs and symptoms that your baby might have a tongue, lip or buccal-tie and needs to see a speech therapist. Or even better a Speech therapist that is also a lactation consultant, like me.

  • Poor latch
  • Popping off the breast frequently
  • Noticeable clicking noise while nursing
  • Needing to be burped more frequently
  • Colic
  • Not getting enough milk and feeding often
  • Slow weight gain, lack of weight gain, 1% on the weight chart

Do you feel your milk supply is low due to your improper latch, mastitis, clogged duct, bleeding nipples or thrush? Check out my new Ebook that you can download right away with lots of tips and tricks to help along with a lot of printables to help with daily trackers, pain trackers, breastfeeding planner and more. There is a special bonus that comes with a FREE call with me. Check out my Ebook: How to Deal with Pain while Breastfeeding.

Ebook Cover: How to deal with pain while  - How My Emotions Made Me Lose My Breastmilk Supply

Can a Speech Therapist help with Breastfeeding?

YES, we are well known for working in neonatal intensive care units (NICU) settings to work on helping with babies first feeding. An SLP and a Lactation consultant work closely together to help with the right strategies for each baby. Quite a few SLPs are also licensed lactation consultants.

A SLP will complete an oral motor evaluation to check for strength of the oral muscles and for tongue, lip, and buccal-ties. The SLP will have the baby suck on their gloved finger to see how well their suck, swallow, breathing is doing. 

Each parent needs to be given time to talk about their goals for their baby. One Mama may want to only breastfeed from her breast and another wants to pump and a third might say neither one of these options is best for my family. We will use formulas. We are here to support your goals, not the therapist’s goals or the goals of the Center for Disease Control and Prevention (CDC).

The CDC is currently recommending a Mama exclusively breastfed (which can also mean exclusively pumping) for the first 6 months, and then continues to introduce appropriate food. However, the American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend exclusively breastfeeding for about the first 6 months with continued breastfeeding and food for up to 2 years of age or longer. You should always do what is best for your family and mental health.

How does SLP help with feeding?

When an infant is showing signs of being ready to eat table food. A therapist can help in a variety of ways.  We will do a feeding assessment, swallow study (if needed) and/or an oral motor exam. During therapy, the SLP will work on oral exercises that include facial massage and various tongue, lip, and jaw exercises that will strengthen the muscles for eating, drinking and swallowing.

The therapist will work on different techniques to try new foods such as food chaining. You work with foods the child loves such as a chicken nugget and then work on adding to the chicken nugget. For example: try a chicken nugget in BBQ sauce, ranch, or ketchup to just name a few. If your child enjoys pasta, you would try plain pasta and then add red or white sauce and maybe a meatball.

What happens next if the Speech Therapist finds a Tongue-tie?

While the therapist is completing an oral motor exam,we might find that your baby has a tongue, lip, and/or buccal-tie. The restriction or tie is known as tethered oral tissue or TOTs. The TOTs will limit your baby’s range of motion (ROM) with the tongue, lips, jaw and/or cheeks which can make breastfeeding and/or bottle feeding difficult. In the future, if the TOT is not revised you might see feeding, speaking and sleeping issues, just to name a few.

Your SLP can refer you to a provider in your area to perform the release of the tongue, lip or buccal-tie of a pediatric dentist or ENT. However, even after the tie is released, this is not an overnight fix. Your baby will need to relearn how to use their tongue to eat and swallow.

Think your child may have a tongue-tie? Grab my freebie Do You Have Pain When Breastfeeding Your Baby? Where I share signs and symptoms of both Mama and Baby where your baby might have a tongue-tie.

What is the Importance of Therapy?

In a perfect world, every baby with a tie release will have pre and post-op care. However, this is not always possible due to insurance, weight issues, availability of a therapist in your area, or lack of knowledge. 

In my case, I was not aware there should be pre and post-op care because my pediatric dentist did not inform me. My son was evaluated, and his ties were released within a matter of minutes. We stayed in the dentist office for an hour and then released home with exercises on a sheet of paper. Later we found out, his tie was not released all the way and it needs to be done again.

Let’s look at a perfect world. First, you would see a trained TOT’s provider (a Speech therapist, lactation consultant or occupational therapist.)  The therapist will evaluate the FUNCTION of oral structures and help to determine if a release is needed. FUNCTION is the main component of any baby.  Are they able to eat, sleep, and breathe properly? The therapist will take down the baseline skills to compare it to their progress or lack of progress after the tie release.

Before surgery, the parent and baby need to be taught the exercises before the baby’s mouth hurts from the pain or they are too upset to work with the therapist.  After the release, the baby is used to the exercises and will let either parent or therapist into their mouth. This will be a huge win-win to not have a release done again.

Who would be on the Team with a Speech Therapist?

When your child is diagnosed with a tongue, lip or buccal-tie there should be a whole team approach. The list below is an all inclusive list but it does not have to always include every professional. Usually with babies you use a pediatric dentist and older kids or adults see an ENT that can put them to sleep for the revision. The ENT will sometimes use stitches too which is helpful if the person is asleep.

  • Lactation consultant: IBCLC/ CLC/ CBC
  • OT
  • Physical Therapist/Bodyworker, Massage Therapist
  • Cranial Osteopaths
  • Oral Sensory-Motor Therapist
  • Dental Professionals
  • Oral Surgeon/ENT

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How My Emotions Made Me Lose My Breastmilk Supply
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