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Ketchum is a pediatric occupational therapist practicing in the neonatal intensive care unit and pediatric out-patient at Central Pennsylvania Rehab Services (CPRS) at the Heart of Lancaster Hospital. Also certified in newborn massage and instructing yoga to children with special needs, Ketchum is the owner/operator of Aimee’s Babies LLC, a child development company. Through Aimee’s Babies, Ketchum has published 3 DVDs and 9 apps which have been featured on the Rachael Ray Show and Iphone Essentials Magazine. Ketchum is one of the five finalists in the National Word Gap Challenge through the U.S. Department of Health and Human Services. She will compete against 4 other large organizations and Universities in March 2017 in the finals of the Word Gap Challenge.
Ketchum has been working in pediatrics for 18 years and is currently pursuing her doctorate at Philadelphia University. Ketchum lives in Lititz, PA with her husband and two daughters and enjoys running marathons and half-marathons and directing elementary school musicals in her spare time.
Ankyloglossia, or “tongue-tie” is a condition when the tiny piece of skin called the frenulum that connects the baby’s tongue to the bottom of their mouth is shorter than usual and the baby does not have full motion of their tongue. This is sometimes identified by the pediatrician during an early well-baby check, but it can be hard to see and it may not become apparent until your baby has difficulty with feeding. Some babies are more tongue-tied than others if the frenulum is longer and extends closer to the tip of the tongue. You can actually notice that the baby’s tongue may look heart-shaped as the frenulum pulls the tip of the tongue back.
Approximately 2-4% of all babies are tongue-tied and some studies indicate that it runs in families. As the newborn baby grows, it is possible that tongue-tie can get better on its own as the baby’s mouth grows, and the frenulum recedes.
What are the potential issues with tongue-tie?
Tongue-tie could interfere with feeding. It makes it difficult for the baby to flatten the tongue under the nipple to suck adequately and move her tongue in the wave-like motion to suck and swallow. Tongue-tie could also cause problems down the road with speech and eating solid foods.
How do I know if my baby’s feeding issues are related to tongue-tie?
If you suspect tongue-tie, listen closely while feeding for a clicking sound with each swallow. Your baby may also break suction often and have difficult time latching on to the bottle nipple or breast. Pay attention to if she is sucking or “chomping”. If she is chomping, she may not have a coordinated suck that is needed to flatten the tongue and press the nipple against the roof of the mouth to express milk and you can ask your pediatrician to check for tongue-tie.
Treatment for tongue-tie.
If the tongue-tie is severe and doesn’t rectify itself within the first year, a simple procedure of snipping the frenulum called a “frenectomy” can be performed. This is typically done in the doctor’s office and it requires no anesthesia. Because it is such a thin piece of skin, it barely even bleeds and the baby usually is able to breast feed immediately with much greater ease. Of course, you could also make an appointment with an oral surgeon or ENT specialist for the frenectomy procedure.
Sometimes it is helpful to seek out occupational therapy or physical therapy after a frenectomy because the baby might have tight neck muscles in association with the tongue-tie because the range of motion of the tongue was limited and all the musculature in the mouth and neck are connected. Usually a few sessions of stretching will have her as good as new.
If you have any suspicion that your baby may be tongue-tied, just ask your pediatrician and they can check her with a simple visual inspection.