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A voice I often hear in the back of my mind is that of Joyce Miller telling me to “Always be measuring”. It is a piece of advice that burrowed its way into my brain and set up long term accommodation.

It doesn’t matter what or whom you are working with, you must have an objective measure. “how is the pain?” and “how has the crying been?” are great questions but very subjective. The answers are prone to recency bias and can be more about how the last 5 minutes have been versus the last week.

But having an objective measure like a range of motion, cranial vault measurement, 3 month prone/supine test or Jan Hoeve’s vestibular scale give you more concrete findings off which to base your decision making.

A measurement I find myself relying on more and more with my oral dysfunction babies is tongue placement during sucking. For me this measurement is very much like Niel Davies’ cervical spine lateral flexion motion palpation (IYKYK)…it tells you something is wrong…but it doesn’t tell you what is wrong. And so, I like to use it as my baseline test for oral motor function.

The mechanics are simple. To be able to create a vacuum within the oral cavity during a latch, the tongue needs to be up and over the bottom gum. If it does this and can maintain this position with a relaxed mouth and flanged lips during sucking…generally your oral mechanics are looking positive. If, however, the tongue ducks down behind the lower gum line during sucking (aka snapback) we are in a bit of trouble. No vacuum can be formed and so the only option is…chomping. This leads to a tight mouth, nipple pain, slipping off during latching and poor milk transfer.

Of course, there are many reasons why this is happening and those will require further examination…but this test is my starting block, a go-to for me in practice. It’s a great visual to show parents (especially before and after – you can show real change in real time) and…it’s an objective measurement of tongue function and oral mechanics. It is a finding that can steady the ship when symptoms are flying all over the place and there is uncertainty.

If you aren’t using it already, add this to your assessment…let me know how it goes.

Chat soon

Mike

• 23 & 24 Aug 2025 - Paeds in Motion Part 1 (The Young Child) Boston, USA bookings with https://peak-potential-institute.mykajabi.com/peds-in-motion-1​
• 6 & 7 Sept 2025 - Paeds in Motion Part 1 (The Young Child) Wales, UK (bookings with michellebushell3@hotmail.com)
• 31 Oct 2025 - Student Paediatric Chiropractic Evening, Newcastle, UK​
• 1 & 2 Nov 2025 - Management of the Neonate, Newcastle, UK​
• 15 & 16 November - Amsterdam - Watch this space

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Connected Paediatrics – Dr Mike Marinus is a registered paediatric chiropractor treating babies and children and helping chiropractors learn effective paediatric techniques that they can use in their practice

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