What are TOTS?

Tethered oral tissues (TOTs) can include ties of the tongue, lip, and even buccal tissues. This is when the frenulums are short and/or thick and limit movement of tongue, lips, or cheeks.

Oftentimes, these anomalies produce symptoms that are misdiagnosed as acid reflux, colic, and even failure to thrive—all of which have treatments that will not help with the true condition itself. Babies who have one or more of these oral anomalies show symptoms of poor, difficult latch or popping off frequently when breastfeeding; gumming or chewing while nursing; gasping for air or clicking or wheezy sounds while nursing; and excessive drooling. This leads to excessive air swallowing during feedings, causing hiccups and gassiness, which can in turn cause colic and reflux issues.

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