As a lactation consultant and craniosacral therapist working at the intersection of anatomical integrity and neurodevelopment, I often encounter families seeking answers to their infant’s feeding difficulties—problems that often reflect deeper disruptions in oral function and craniofacial development. While therapeutic interventions in later childhood may help, the most powerful and foundational opportunity for shaping oral function occurs in infancy. And that opportunity is breastfeeding.
When anatomy is intact, breastfeeding is not only the optimal mode of nutrition but also the original, most complete functional stimulus for correct tongue posture and orofacial development.
Let’s explore what contemporary science now confirms.
Until recently, it was widely believed that the infant tongue used a wave-like peristaltic motion to compress the nipple and extract milk. However, advances in ultrasound imaging and intraoral pressure measurements have led to a clearer, more accurate understanding of breastfeeding mechanics.
Today we know that:
- Milk transfer is driven primarily by the generation of intraoral vacuum, not by tongue compression.
- The tongue lowers to allow breast tissue to expand inside the infant’s oral cavity, creating negative pressure that draws milk.
- The mid and posterior tongue elevate rhythmically in a piston-like motion rather than rolling in waves.
- Effective feeding depends on the infant’s ability to maintain a sealed oral cavity, coordinate suck-swallow-breathe rhythms, and generate suction pressure (Geddes et al., 2008; Elad et al., 2014; Morton et al., 2019).
This refined understanding makes the case even stronger for breastfeeding as the foundational mechanism for developing proper oral posture and function.
During effective breastfeeding:
- Milk transfer is driven primarily by the generation of intraoral vacuum, not by tongue compression.
- The tongue lowers to allow breast tissue to expand inside the infant’s oral cavity, creating negative pressure that draws milk.
- The mid and posterior tongue elevate rhythmically in a piston-like motion rather than rolling in waves.
- Effective feeding depends on the infant’s ability to maintain a sealed oral cavity, coordinate suck-swallow-breathe rhythms, and generate suction pressure (Geddes et al., 2008; Elad et al., 2014; Morton et al., 2019).
This refined understanding makes the case even stronger for breastfeeding as the foundational mechanism for developing proper oral posture and function.
During effective breastfeeding:
- The tongue must elevate and maintain a wide, cupped posture under the breast.
- The jaw stabilizes and supports rhythmic, efficient movement without overexertion.
- The palate receives consistent shaping pressure from the tongue and breast tissue.
- Nasal breathing is facilitated, influencing craniofacial and airway development.
- The infant’s nervous system receives regulating feedback via the vagus nerve, enhancing physiological regulation.
But all of this depends on one essential prerequisite: anatomical freedom. If oral restrictions such as ankyloglossia (commonly referred to as tongue-tie) are present, or if there is fascial tension in the cranial base or floor of the mouth, the tongue cannot elevate or maintain suction effectively. This impairs latch, milk transfer, and suck-swallow-breathe coordination. In turn, it may lead to maternal nipple pain, poor infant weight gain, fatigue at the breast, reflux-like symptoms, and disrupted bonding.
Studies have shown that early release of restrictive oral tissues can significantly improve breastfeeding outcomes, including increased milk transfer, deeper latch, and maternal comfort (Buryk et al., 2011; Pransky et al., 2015). Moreover, fascial restrictions from in utero constraint or birth trauma may require gentle bodywork approaches such as Biodynamic Craniosacral Therapy to restore oral and cranial mobility.
In my integrative practice, I approach each breastfeeding dyad with the understanding that:
- Function must be assessed in real-time feeding, not just by appearance of the tongue.
- Structural barriers cannot be overcome by will, technique, or positioning alone.
- Bodywork that addresses the fascial and nervous system layers enhances feeding biomechanics.
- A collaborative plan that respects the baby’s physiology and the mother’s experience is essential for successful outcomes.
Breastfeeding is not simply a maternal task. It is a biologically programmed architectural process that shapes the tongue, jaw, palate, and airway during the most plastic stage of human development.
If we miss this window in infancy, we may spend years attempting to undo patterns that could have been gently guided into health through optimal early feeding.
Let us respect the science, listen to the symptoms, and return to the wisdom of nature’s design. When anatomy is supported and restrictions addressed, breastfeeding becomes the architect of lifelong oral function.
References:
- Geddes, D. T., et al. (2008). Tongue movement and intra-oral vacuum in breastfeeding infants. Early Human Development, 84(7), 471–477.
- Elad, D., Kozlovsky, P., Blum, O., Laine, A. F., Po, M. J., Botzer, E., & Zelicovich, M. (2014). Biomechanics of milk extraction during breastfeeding. Proceedings of the National Academy of Sciences, 111(14), 5230–5235.
- Morton, C. H., et al. (2019). Integrative physiology of SSB coordination in infant feeding. Journal of Human Lactation, 35(1), 43–52.
- Buryk, M., Bloom, D., & Shope, T. (2011). Efficacy of neonatal release of ankyloglossia: A randomized trial. Pediatrics, 128(2), 280–288.
- Pransky, S. M., Lago, D., & Hong, P. (2015). Breastfeeding difficulties and oral cavity anomalies: The influence of posterior ankyloglossia and upper-lip ties. International Journal of Pediatric Otorhinolaryngology, 79(10), 1714–1717.
