Pennsylvania Tongue-Tie Center

01/19/2026

Great insights from our CST expert, Moriah Cockley, LMT, MS

01/19/2026

It’s wonderful to receive this kind of heartwarming feedback from our patients. Rehabilitating an infant with oral ties is a process that can often take weeks and we are focused on carefully planning the treatment before and after the release procedure so that we can get the best results and a happy, thriving baby. 👶🏻

01/12/2026

We have enjoyed getting to with this delightful family! These sisters have done a great job working with Tri-State Myo’s therapists Diane and Dianne! We are proud of their accomplishment!

01/12/2026

In-Office Lactation Consultation

What to Expect and How to Prepare for Your In-Office Visit 📋

I'm looking forward to seeing you and your little one at my office!
First of all, great job prioritizing your feeding goals by scheduling an appointment. I am so proud of you for seeking support, and I can’t wait to help you and your baby thrive!

To help you prepare, here is a breakdown of what to expect and how to maximize our time together at the office:

💖 How to Prepare for Your Visit

Optimize Feeding Time: The most important prep is ensuring your baby will be ready to feed soon after your scheduled appointment time. A small, "snack" feeding about an hour beforehand can curb their hunger without filling them up completely.

Plan Your Travel: Give yourself plenty of time for parking and getting settled in our space so you can arrive relaxed.

Complete my intake online: I will email intake paperwork at scheduling. Please fill it out prior to our appointment so I can review it and prepare to address all your concerns.

Weight History: Have your baby’s birth weight, discharge weight, and most recent weight available.

Pump Prep: If you are requesting help with pumping or a fl**ge fitting, please bring your clean pump and parts with you.

Feeding Accessories: If you are using a ni**le shield or bottle, please bring those to the appointment along with some breastmilk or formula.

✨ What to Expect During Your Office Visit

I will be ready to welcome you on arrival, prepared with all the necessary tools and knowledge in a comfortable, private setting.

Warm Welcome: l will get you settled into a cozy, private consultation room.

Weighted Feed: I will have a scale ready to weigh your baby before and after feeding to accurately measure milk transfer.

Observation & Guidance: I will observe a feeding, offer gentle suggestions for latch or positioning improvement, and highlight all the positive things you and your baby are doing!

Oral Exam: I will perform an oral exam on your baby to evaluate tongue function and give any needed exercises to help improve their feeding skills.

Support: I will address your concerns, answer your questions, and provide guidance on pumping and bottle feeding, if needed.

Care Plan: I will prepare a Care Plan that will address your concerns and things we need to work on for optimal feeding. This will be emailed to you, and we will discuss plans for follow-up.

I can’t wait to welcome you! Until then, hang in there and happy feeding! ❤️

01/12/2026

👅 Why Does My Baby Have a White Tongue?

Reason 1: Milk Residue

The white coating on the center of the tongue is most likely residual milk left on the tongue seen right after or between feedings. The "milk tongue" is typically only found on the center portion of the tongue and not on the perimeter of the tongue.

What it is: When your baby drinks milk (whether breast milk or formula), some of the proteins can stick to the surface of the tongue. This can occur because the tongue cannot fully elevate against the roof of the mouth and "self-cleanse" against the palate.

How to tell if it is milk residue:
It usually looks like a thin, light coating that might be patchy.
It easily scrapes off with a clean finger or a gentle rub from a soft, wet cloth.
It doesn't usually bother your baby; they feed happily.

The fix: For many babies, no intervention is needed! Regular feeding usually washes it away eventually, and it's harmless. However...if you ALWAYS see a white tongue, this is one reason to suspect or further investigate a potential tongue-tie, which may not be allowing ideal movement and elevation of the tongue.

Reason 2: Oral Thrush
This is a fungal infection caused by an overgrowth of Candida albicans.

How to tell:
It often looks like thick, white, curd-like patches on the tongue, gums, cheeks, and roof of the mouth.
The patches DO NOT easily scrape off—if you try, you might see small, red, spots underneath.
It can sometimes cause discomfort or pain during feeding, leading to fussiness or refusing the breast/bottle.

⚠️ Important: If your ni**les are suddenly pink, shiny, burning, or painful between feeds, you may have a coinciding yeast infection that needs treatment, too.

The fix: Thrush usually requires an antifungal medication prescribed by your pediatrician. Mom and baby may need to be treated simultaneously (if breastfeeding) to prevent passing it back and forth but there is no contraindication to continue breastfeeding or pumping.

Anything that comes in contact with baby's mouth or mother's breast should be cleaned in hot/soapy water or run through the dishwasher.

If you are concerned about a persistent white tongue and baby's tongue function- 👉 Schedule a Consult with Me! 717-739-6566
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01/12/2026

💡 Debunking a Myth:
A babies' ability to stick out their👅DOESN'T Rule Out a Tie!

Parents are often told by well-meaning providers, "If the baby can stick their tongue out, they don't have a tongue-tie".

As an IBCLC, I want to clarify: This is a major myth! The ability to stick the tongue out (protrude) is only one small piece of the complex puzzle 🧩 of oral function.

❌ Why: Protrusion Isn't the Whole Story

A tongue-tie is not just about how far the tongue can stick out; it's about how the tongue can lift, cup, and move side-to-side.

Here's why protrusion alone is a poor indicator of a functional restriction-
1. The Focus is on Function-for effective feeding, the tongue needs to:

-Lift to create the suction vacuum.

-Cup the breast or bottle ni**le to maintain the seal.

-Wave (peristalsis) to actively extract milk. A baby with a restrictive tie may be able to stick the tongue out, but the body of the tongue may still be tethered to the floor of the mouth, preventing the necessary lift and cupping action.

2. “Posterior Ties” are Often Missed: Many highly restrictive ties are classified as “posterior” (hidden under the mucous membrane). These ties might allow the tip of the tongue to protrude, but they severely limit the elevation of the mid-tongue. These are often the most missed and most problematic ties when it comes to milk transfer.

3. Compensatory Movements: Babies are resourceful! They will often use tremendous effort and recruit other facial or jaw muscles to force the tongue tip out. This can look like normal protrusion, but it hides an inefficient and tiring suck.

Instead of just looking at protrusion, a thorough assessment by an IBCLC focuses on clinical symptoms and observation.

🤱 Trust Your Instincts & Seek Specialized Help

If your baby is feeding poorly, losing their latch, "clicking", or you are in pain, the issue is functional, regardless of how far their tongue can stick out. Don't settle for a quick look! A trained IBCLC can assess the function and structure of your baby's entire mouth. I use specific functional assessments to see how your baby uses their tongue. If you suspect a tie based on symptoms, please reach out to me for a full, comprehensive feeding assessment!

01/12/2026

Moriah Cockley, LMT, MS
Bond and Bloom Lactation
Pennsylvania Tongue-Tie Center

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✨ Why do you see so many babies at East Berlin Smiles? ✨
Because tiny miracles like this 3-day-old sweetheart come to see Dr. Cockley, Moriah, Amber and Brandi who help our littlest patients thrive! 💗

On Monday and Wednesday mornings, our office fills with babies, including newborns who need help with tongue ties and lip ties—and we are honored to be part of their very first days on earth. Amber is not only an EFDA (Expanded Function Dental Assistant) but also an IBCLC (International Board Certified Lactation Consultant)—the only one in the entire country with both credentials! 🌟 Her expertise helps these little ones feed better and rehabilitate after their surgeries.

Yesterday alone we cared for a 3-day-old (this precious angel!) and a 5-day-old, among others. Being trusted with these early moments is truly a joy and a privilege.

Do we love what we do?
Just look at these smiles. 💕👶✨

01/12/2026

01/02/2026

07/04/2025

We love recommending O Balls to our patients.

07/01/2025

We are thrilled to announce and congratulate Amber on achieving her IBCLC (International Board Certified Lactation Consultant) designation! This prestigious credential represents the highest standard in lactation consulting worldwide, requiring over 1,000 hours of clinical experience and the successful completion of a rigorous board exam. Amber has been a dedicated member of our Tongue Tie team since earning her certified lactation consultant designation in 2018, and this milestone is a testament to her years of hard work, passion, and commitment to excellence in patient care. Less than 3% of lactation consultants globally hold the IBCLC, making this an extraordinary achievement—well done, Amber!