2. Any modality of treatment using hands-on techniques that makes changes to structure in order to restore optimal function.

3. Light touch form of bodywork that makes changes to structure in order to restore optimal function by working via the fascial network.

7. Layers of connective tissue 22 cranial bones 34 articulations 60+ muscles Multiple physiological functions

10. MotilityMobility Stability Flexibility Inherent movement Organ movement Motility Ability to achieve optimal range of motion Ease in overcoming inertia Responisveness Mobility Strength Organized Ability to stay Stability Ease Elasticity Degree of Range of Motion Flexibility

17. Embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement.

18. Any structural compromise due to forces that overwhelm adaptive mechanisms of the tissue(s) can create tensional dynamics that mimic both anterior and posterior tongue- tie.

19. Tongue-tie Malformation Non-responsive Faux tongue-tie Deformation Responsive

20. Lingual frenulum and mouth floor tighten

22. Bodywork Responsive tissue Deformation Function improves Non- responsive tissue Malformation Function stays the same or worsens

25. Eyes Note asymmetries of face and eyes Note head shape Watch the baby breastfeed Hands Plapate neck Palpate hips and pelvis Palpate umbilicus Orodigital exam Tools Tummy time Finger- feeding Bodywork

26. Do body work first Continue lactation Therapy If you hit a wallFrenotomy Laser Frenectomy Do bodywork If you don’t hit a wall Continue bodywork Use other forms of therapy

29. Craniosacral Therapy Pre-surgery goal: Resource system Address trauma Address intrauterine issues Address childbirth issues Address postpartum issues Post-surgery goal: Resource system Address surgery trauma Address muscular imbalance Address tongue-tie specific restrictions Resolve global restrictions & restore global physiology Restore or rewire suck-swallow-breathe at brainstem and brain pathway levels Ignite the organism

30. As soon as the problem(s) is/are identified 1-2 days post surgery Continue until the problem is solved

35. All tongue-tied babies who have developed compensations All tongue-tied babies who have co-morbidities All tongue-tied babies who had birth interventions Skilled IBCLC Osteopath Craniosacral therapist Myofascial therapist Chiropractor

36. www.upledger.com www.iahp.com www.carolgray.com www.milneinstitute.com www.craniosacraltherapy.org www.upledger.com www.iahp.com www.carolgray.com www.milneinstitute.com www.craniosacraltherapy.org

37. Restoring optimal function via structural change using light touch What? Because tongue-tied babies have multiple functional deficits Why? Before and after surgery When? As much as it takes to restore function How much? Most tongue-tied babies Who?