For over 25 years, Dr. Wohl has dedicated his expertise to treating mothers and babies with medical issues related to breastfeeding. Common complaints include maternal pain, “chomping”, “shallow latch”, air in-trailing, and low milk production. There may be other clinically related infant airway and head & neck problems, but the good news is that with the proper diagnosis, treatment, and guidance, the majority of these issues can be quickly resolved, and breastfeeding can proceed safely, comfortably and successfully.

Coordinating breathing, nursing, and swallowing is a finely tuned neurological function. There are many impactful diagnoses to consider and some of the most common include:

(Ankyloglossia) is a condition in which an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue to the floor-of-mouth, preventing a good nipple seal.

 The piece of tissue behind your upper lip is called the maxillary frenulum. When thick and restrictive, it can keep the upper lip from moving freely to seal around the nipple.

Laryngomalacia (LM) is best described as floppy tissue above the vocal folds that obstructs into the airway when breathing in. It is the most frequent cause of noisy breathing (stridor) in infants and can disrupt feeding.

 The esophagus is the tube that carries food from the mouth to the stomach. If your baby has reflux, their stomach contents may back up into the throat, disrupting feeding. Another name for this is laryngopharyngeal reflux.

The lingual frenulum is a residual band of tissue between the floor-of-mouth and the undersurface of tongue. If it is prominent, and if there is sufficient tongue movement restriction, there may be nursing and feeding challenges. All infants have some tissue in that space and there is a wide range of presentation, but when there is a short, tight or thick frenulum, with tongue movement restriction, this is called a tongue tie. The incidence of impactful tongue tie is approximately 5-10% of newborn babies.

There is no one unified classification system for ankyloglossia. You are encouraged to speak with your resource team, including a physician specialist, to explain their approach to understanding restrictive ankyloglossia. 

Laryngomalacia is a common cause of noisy breathing in infants. It happens when a baby's larynx (voice box) is soft and floppy. When the baby takes a breath, the part of the larynx above the vocal folds falls inward and temporarily blocks the baby's airway. There are several variations and the diagnosis can be determined by office endoscopy.

Babies with laryngomalacia make a harsh, squeaky “chirp” sound when breathing in. This sound, called inspiratory stridor, can start as soon as the baby is born or, more often, within the first few weeks after birth. Almost all infants with laryngomalacia will improve over 6-18 months, but symptoms typically worsen over several months as the effort to breathe becomes increasingly difficult. The infant larynx will mature and it is important to monitor feeding as well as their height & weight percentile growth.