This is in the ankyloglossia (tongue tie) presentation.  A high arched
palate is formed when the tongue does not press the breast against the
palate to expand its edges and bring down the dome.  A bottle nipple is
thin and short, and does not spread along the palate, but is pressed
against a small area.  The bottle nipple does not spread the palate, but
might even make it higher from deformation from the relatively
unyielding nipple pressing against the palate.
When a baby is tongue tied, he might not be able to press the breast
against the palate sufficiently to spread the palate, so the end result
- a high, narrow palate, is similar to that of bottle feeding.
If the palate is narrow, the nasal choanae (the bony entrance to the
nose) is narrow and close together, making it hard to pull in as much
air.  If the palate is spread by the breast, the choanae are farther
apart and wider, giving a better airway.
If the palate is high, the dome of the palate is at the expense of the
nasal air space (the space behind the nose and over the mouth).  This
also reduces the amount of air that can be exchanged.
This all might not matter as much during the day, but at night when
everything relaxes, the air space might not be enough, and snoring is a
sign of obstructed breathing.  If breathing is obstructed enough, short
periods of apnea, and disturbed sleep occurs.  This disturbed sleep is
what leads to the bedwetting, the person does not arouse to know they
have to go and so they can't get up and use the bathroom.  Perhaps there
is a brief moment of unconsciousness as well that might lead to loss of
bladder control.
Enlarging the airway by removing the tonsils for a "quick fix" then
doing a maxillary expansion to spread and lower the palate, helps to
reduce snoring and sleep apnea, normalize sleep cycles, reduce daytime
sleepiness, and stop bedwetting., not to mention make room for the teeth!
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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