Tongue Ties, Breastfeeding, and the Lactation Savvy Therapist

 Comprehensive. Evidence-based. Infant specific. 


Dive into the myths, controversies, and research around the diagnosis and treatment of oral ties so you’re informed and able to advocate and improve outcomes.


This 8 hour, self-paced continuing education course provides an in-depth look at lactation, oral dysfunction, and specifically tethered oral tissues (TOTs). 

Providing CEUs & L-CERPs for Healthcare Professionals

IBLCE Long-Term Provider

8.0 L-CERPs

There are a lot of opinions about tongue ties… how can you be sure you’re providing the best recommendations and interventions for the infants on your caseload? 


By being equipped with the most up-to-date research and improving your assessment, observation, and treatment skills. 


That can look like learning:

  • The therapist’s role and the variety of healthcare professionals involved in the treatment of oral ties
  • Myths & controversies regarding the identification and treatment of oral ties
  • The most up-to-date research regarding infants and ties
  • Oral assessment, fine-tuning observation skills, and understanding the impact of oral dysfunction on breastfeeding
  • How to effectively educate and guide families to achieve their goals and optimize outcomes


Exactly what you need to gain the confidence and skills to work with breastfeeding infants and TOTs.


Want to see what other therapists have to say?

“This course was excellent. I love how comprehensive it was for the basics and more. It was well organized and helped me to frame my own assessments. It also helps to give me confidence in what I am already doing with clients, knowing that I am on the right track. The videos and talking through each video and picture (and replaying videos when needed) helped so much. The case studies were great."
“Detailed description of assessment! I took thorough notes and used them in an evaluation immediately following. I felt confident I was completing a comprehensive functional evaluation of the baby's needs."
“This course was extremely thorough. Jeanne was a pleasure to listen to and gave excellent examples that made me feel prepared to take my knowledge to practice!"
“Excellent comprehensive information provided! Exciting to dive in even deeper! Excellent presenter, can see Jeanne's knowledge and compassion for helping families."

Tongue Tie Learning Objectives


  • Identify how tongue and/or lip ties impact breastfeeding
  • Identify the differences in mechanics of breastfeeding that might be different from bottle-feeding
  • Identify normal versus abnormal oral function and mobility to help determine when tethered oral tissues may require treatment
  • Identify common myths and misconceptions about breastfeeding and TOTs that families may encounter
  • Identify the role of the therapist (OT, ST) on the TOTs team and what professionals may play a role in the treatment of TOTs
  • Identify other factors that may impact breastfeeding and understand the importance of a comprehensive approach/assessment when determining the role of TOTs
  • Identify treatment options for tethered oral tissues
  • Identify practical strategies to help families achieve breastfeeding goals
  • Identify crucial benefits of breastfeeding (milk and non-milk benefits)
  • Identify the limitations of available research on tethered oral tissues.

Timed Agenda

Tongue ties, lip ties, buccal ties — there's a lot to learn. As a self-paced, online course, you can take as much time as you need to absorb the material and apply it to your caseload. See below for a full breakdown of the topics and the amount of time spent in each module.


39 minutes

  • Introduction
  • Collaboration & Controversy

TOTs Background & Assessment

2 hr 25 minutes

  • Literature Review
  • Definitions and the Role of the Therapist
  • Oral Assessment
  • Impact of Oral Ties on Breastfeeding


Breastfeeding & TOTs

1 hr 52 minutes

  • Milk Production & Storage 
  • Breastfeeding Assessment
  • Low Milk Supply & Supplementation
  • Oversupply & Overactive Letdown 


Function & Feeding

1 hr 12 minutes

  • Latch at the Breast vs Bottle
  • Case Video: Clicking During Breastfeeding, Shallow Latch, and Fatigue & 3 days old, Clicking, Noisy Sucking, and Nipple Shield 
  • Bottle feeding and Alternative Feeding Strategies 
  • Importance of Differential Assessment: Additional Infant Factors Impacting Feeding 

Release & Therapy’s Role

1 hr 26  minutes

  • Pre-Release Therapy
  • Surgical Release to Prevent Future Issues? (with case examples) 
  • Surgical Release and Active Wound Management
  • Post-Operative Therapy and Recovery

Tongue Tie Case Studies

33 minutes

  • Case Studies

CE Wrap-up


  • Post-assessment
  • Feedback survey


Jeanne Pichoff, LOTR, IBCLC

Jeanne Pichoff has over sixteen years of experience as a pediatric occupational therapist. She has worked in a variety of pediatric settings including the NICU, outpatient clinic, and the state early intervention system.

Jeanne owns and operates a private practice in Louisiana, Flourish Pediatric Therapy and Lactation LLC, which is focused on the niche areas of infant feeding, lactation support, and early intervention services.

Jeanne pursued the additional credentials of Certified Lactation Counselor (CLC), Certified Lymphedema Therapist (CLT), and International Board Certified Lactation Consultant (IBCLC). She continually strives to offer the highest quality service to families in her care.

In addition to her clinical work, Jeanne serves her community as a member of the Acadiana Breastfeeding Coalition, where she promotes breastfeeding advocacy in her region.

AOTA Approved Provider, ASHA CE Approved Provider, IBLCE Long-Term Provider

Frequently Asked Questions

Who is this course intended for?

This tongue ties course is designed for Occupational Therapy practitioners (OT and COTA), Speech-Language Pathologists (SLP), and Physical Therapy practitioners (PT and PTA). Therapists that are interested in a comprehensive, lactation-informed course would benefit most from this course. Professionals that are not licensed therapists should enroll in this version of the course.


What makes this course different from other TOTs courses?

Most CEU courses about tethered oral tissues (TOTs) focus on the entire lifespan or general pediatrics. Many of the pediatric CEU TOTs courses do not focus on babies, let alone breastfeeding babies.

This is a comprehensive 8-hour course taught by an experienced Occupational Therapist (OT) and International Board Certified Lactation Consultant (IBCLC).

This CEU course is unique in that lactation education is weaved throughout the course in order to highlight that both parts of the dyad contribute to functional feeding. To our knowledge, there is no other on-demand CEU course for therapists that provides this level of education and demonstration on functional TOTs assessment and intervention fully within the context of breastfeeding.


Are there prerequisites for this course?

There is no required coursework needed prior to enrolling in this course.


Does this course provide a TOTs certification?

Because certifications are widely unregulated and don't provide you with any extra skill or knowledge, we don't provide a TOTs certification with this course. 

We do offer course bundle discounts where you can earn badges for completing course groupings. These badges indicate you've completed multiple, inter-related courses that help you provide more comprehensive treatment to your clients. 

Please see the bottom of this page for the course bundle options.

You can earn CEUs and L-CERPs for completing this course as well which can be used for your therapy license renewal as well as lactation certification renewal for a CLC, CBS, etc.


As a therapist, can I count this course toward my 90 hours of lactation-specific education?

Absolutely! This course is approved for 8 L-CERPs. To receive credit for completion, the course must be completed with 100% watch time and each participant will need to complete a post-assessment with a passing score of at least 80% to ensure all learning objectives are met.


Information about AOTA CEUs

This course is approved for 0.8 AOTA CEUs. Participants will be required to:

  • Complete the course in its entirety (100% of the course watched)
  • Complete a multiple-choice post-assessment with a passing score of at least 80% (untimed test)

Information about ASHA CEUs

This course is approved for 0.8 ASHA CEUs. To receive ASHA CEUs, participants will be required to:

  •  Ensure you are eligible to receive ASHA CEUs! Click here for more information
  • Complete the course in its entirety (watch time is tracked by the learning management system) 
  • Complete the multiple-choice post-assessment with a passing score of at least 80% (untimed test, 3 retakes)
  • There is no option for partial credit

CE Information for Physical Therapists

APTA does not approve individual companies and you will need to check with your individual state for online course requirements. To best prepare you can save the following:

  • The certificate of completion that will be provided
  • List of references
  • A copy of the assessment questions

How long will I have access to the course?

6 months from the purchase date. This allows you time to learn about tongue ties, apply it to your caseload, and circle back to the course to absorb even more information and refine your clinical reasoning skills.


What is your refund/cancellation policy?

Refunds must be requested within 14 days of purchase by emailing [email protected]. A full refund is available if no modules have been started. A partial refund is available once ANY portion of the course has been viewed. The amount refunded is at the sole discretion of The Lactation OT LLC. There is no refund available after 14 days of purchase OR if module one has been completed. Recipients will receive acknowledgment of refund requests within 3 business days. If the request is valid per the terms listed above, the refund will be processed within 7 business days. If for any reason the course is canceled by The Lactation OT before the course is started, a full refund will be provided. 


How do I request special accommodation?

Please send us an email at [email protected] at least 14 days before starting the course with further details of your request.

Expand your understanding of TOTs from a whole-body perspective and in relation to breastfeeding.


Deepen your knowledge and help families navigate TOTs for optimal breastfeeding and developmental outcomes. 



Bundle, Save, and Earn a Badge

Tethered Oral Tissues Badge (15 hours)

  • Supporting Oral Motor Skills in the Infant: Assessment, Adaptation, and Remediation
  • Tongue Ties, Breastfeeding, and the Lactation Savvy Therapist

Bundle + Save 5% Now  ➝

The Lactation OT is proud to provide lactation-specific continuing education and resources to OT, SLP, PTs, IBCLCs, and healthcare professionals. We’re here to support you as you provide the most effective, evidence-based care possible to your clients. 
Thanks for joining us.
Together we can continue to raise the level of care in lactation and infant feeding.

Looking for more information? Have a comment or complaint?

Send an email to [email protected]. View complaint policy here.