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Sleepy Baby



Dr. Tarnoff is trained using the Kotlow Classification System to assess and diagnose tethered oral tissues (TOTs).


Infant tongue-ties often go undetected, misdiagnosed, or are dismissed by some healthcare providers as the cause of infant distress or maternal discomfort during breastfeeding.


Tongue-ties can vary in appearance from very obvious attachments near the tip of the tongue to less obvious attachments that may be hidden under a membrane.


What is most important in diagnosing tongue-ties is not the outward appearance of the tongue, but its mobility and function. Full mobility of the tongue is essential to achieving a proper latch and efficient transfer of milk.

If detected, a referral will be made to a pediatric dentist or ENT specializing in tethered tie releases, who will discuss the release procedure, if it is medically indicated.


Often, you will have already been diagnosed with a tie and have been referred to our office for your baby to have CranioSacral Therapy (CST) body work done before and after release.


Dr. Tarnoff can perform CST  to assist in reducing tightness of the surrounding structures of the head and neck as this has been shown to help babies create new neural pathways that allows them to utilize their tongues optimally. 

Signs and symptoms your baby may have ties:



  • Painful breastfeeding

  • Damaged nipples


  • Difficulty latching

  • Clicking while nursing

  • Heart shaped tongue

  • Poor tongue elevation

  • Reflux

  • Gassiness

  • Poor weight gain

  • Poor milk transfer

  • Never satisfied at the breast

  • Falls asleep while nursing


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