Your baby is unique, and rehabilitation is not a one-size-fits-all. A lactation & feeding specialist trained in TOTs (tethered oral tissues) is highly skilled at assessing the following:
Cranial nerve function & primitive reflexes
Nervous system regulation
Neck mobility & whole body tensions
Asymmetries
Airway & respiration
Resting mouth posture
Palate-shape
Frenulum
Tongue strength, coordination, cupping, extension, range of motion
Gape
Latch
Suck-swallow-breath coordination
Milk transfer
Can you see a feeding specialist one time, get your custom home program and be on your way?
Maybe. But we recommend follow-up and continuation of care until feeding goals are met. And the reason is, the plan will change. We will upgrade and modify the program as baby shows improvement. Likewise, sometimes baby won't be able to engage muscles for an exercise recommended, and we can modify the program to meet baby where they are, and advance as appropriate.
Your feeding therapist will also be able to determine what other members of a feeding team might need to be brought in based on initial findings or lack of progress. This may include a cranial sacral therapist, chiropractor, OT/PT, IBCLC, etc.
The initial evaluation is very comprehensive. Establishing a relationships with families and making sure they have a good interim feeding plan in place can be the focus of that first visit. Sometimes, a long list of exercises and things to be working on at home can be overwhelming. We want to avoid that. I've had parents ask me, "What's the most important thing to focus on right". And that's okay! We want to meet you and baby where you are. We acknowledge that your lives are full, and that a laundry list of home exercises just might not be practical. This is another reason for ongoing care. We can closely monitor progress, and make sure you're getting the biggest bang for your buck with a highly customized program that is meant to simplify your life, not complicate it!
Ultimately, feeding therapy is about giving baby skills for a functional task, in this case feeding! Every program will look different, but it should always consider the whole child. We are not just treating a mouth, we are caring for the mother-infant dyad.
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