Tongue Ties and Breastfeeding

 Perspectives and Strategies from a Lactation Savvy Therapist

This 6.5 hour, self-paced continuing education course provides an in-depth look at the dysfunction displayed during breastfeeding as a result of tongue ties, lip ties, buccal ties


IBLCE Long-Term Provider

6.5 L-CERPs

What's included?

  • Deep dive into available research to guide evidence-based practice
  • Determining realistic timelines to yield the most benefits from a frenectomy
  • How to mitigate risks of oral aversion and breast refusal after frenectomy
  • The necessary components of a function based oral assessment
  • The importance of collaborative care
  • Navigating misinformation
  • Defining the difference between bodywork and therapy
  • and so much more!

The IBCLC's role in supporting dyads through tongue ties and breastfeeding is crucial


This course is packed with case studies, videos at every stage of the frenectomy process (tongue function of client journey before frenectomy, same-day as a procedure, and post-op as well as information on oral rest posture, standardized and non-standardized assessment tools, limitations of the suck assessment, compensations, red flags related to infant development, supplementation, and wound management expectations).


Tongue Tie Learning Objectives


  • Identify how tongue and/or lip ties impact breastfeeding
  • Understand normal vs. abnormal oral function and mobility to help determine when tethered oral tissues may require treatment
  • Understand treatment options for tethered oral tissues
  • Understand the role of the IBCLC on the TOTS team and what professionals may play a role in the treatment of TOTs
  • Understand how bottle/breastfeeding differ
  • Understand the interplay of oral structures and oral function
  • Identify practical strategies to help families achieve breastfeeding goals
  • Appreciate why helping families to achieve their breastfeeding goals is so important
  • Identify the current research on ties and some of the limitations of¬†research on this topic
  • Identify other factors that may impact breastfeeding and understand the importance of a comprehensive approach/assessment when
    determining the role of TOTS
  • Identify common myths and misconceptions about breastfeeding and TOTS that families may encounter

Here's the timed agenda so that you know exactly what you'll be learning in this course.


Don't feel rushed! As a self-paced course, you can pause, replay, and watch the videos as many times as you'd like!


55 minutes

  • General Overview
  • Unique and Critical Role of IBCLC
  • Teamwork and Collaboration

Research on Tongue Tie

44 minutes

  • Literature Review¬†
  • Impact of Ties on Breastfeeding

Tongue Tie Assessment

1 hr 31 minutes

  • Clinical Observation and the Oral Assessment
  • Infant and Maternal Symptoms
  • Impact on the GI System
  • Breastfeeding Assessment

Breastfeeding Management

1 hr 23 minutes

  • Lactation Management
  • Additional Factors Impacting Feeding


1 hours 8 minutes

  • Overview of Treatment Options
  • Pre-Release Management
  • Surgical Release and Active Wound Management
  • Managing Expectations for Families

Case Studies

56 minutes

  • Case study A
  • Case study B
  • Case study C
  • Examples with no frenectomy completed

Meet the Instructor

Jeanne Pichoff, LOTR, IBCLC

Jeanne has 17 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 has pursued the additional credentials of Certified Lactation Counselor (CLC) and she sat for the International Board Certified Lactation Consultant (IBCLC) exam in September 2020. 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.

Frequently Asked Questions

What makes this TOTs course different?

This is a 6.5-hour course from the perspective of an experienced OT and IBCLC. She offers a comprehensive perspective specific to infant feeding complications when considering tethered oral tissues.


Who is this course for?

IBCLC and other health care providers such as NPs, PAs, or RDs. Therapists are required to take this version of the course.


Are there prerequisites for this course?

There are no required prerequisites. 


Can I count this course towards my 90 hours of lactation-specific education?

Absolutely! This course is approved for 6.5 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.


How long will I have access to the course?

6 months from the purchase date. 

OPTIONAL Paid Extension:

A course extension can be purchased for $30 and will provide additional 30-day access to the course. There is a limit of 3 paid extensions per person. This means that a course is only available up to 90 days past the course expiration date. Courses that have expired for more than one month are NOT ELIGIBLE for a paid course extension.


Information about AOTA CEUs

This version of the course is NOT approved for AOTA CEUs. Participants interested in AOTA CEUs should take this version.


Information about ASHA CEUs

This version of the course is NOT available for ASHA CEUs. Participants interested in ASHA CEUs should check out this version.


Information for Physical Therapists

This version of the course is NOT intended for therapists. PTs should check out this version.


What is your refund/cancellation policy?

Refunds can be requested by emailing¬†[email protected]¬†within¬†14 days¬†of purchase, a full refund is available if no modules have been started.

Once ANY portion of the course has been viewed, only a partial refund is available if:

(1) request is sent within 14 days and

(2) no more than one module has been completed.

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 the one module limit has been exceeded. If a certificate of completion has been issued there is no refund available.

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 provider 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.


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