Tongue Tie in Babies: Signs, Feeding & Treatment | Parenting Hub
Tongue tie can affect breastfeeding, bottle feeding and weight gain. How to recognise it, what an IBCLC will assess, and when a frenotomy may help.
Painful feeding, clicking sounds or shallow latch? Tongue tie may — or may not — be the cause. Here's how it's properly assessed and when release helps.
What tongue tie is
The frenulum is the small piece of tissue under the tongue. In tongue tie (ankyloglossia) it's short, thick or attached too far forward, restricting how far the tongue can lift or extend. Around 4–10% of babies are born with some degree of tongue tie, but only a portion have feeding difficulties because of it.
Symptoms that may point to it
A combination of signs from both baby and parent is more telling than the look of the frenulum alone.
- Painful or pinched nipples that don't improve with latch correction
- Clicking or smacking sounds during feeds
- Shallow latch — baby slides off, fusses, takes long feeds
- Poor weight gain or low milk supply
- Bottle-fed: lots of leaking, gulping, long feeds, frequent windy unsettled periods
- Heart-shaped or notched tongue tip when baby cries
- Tongue can't reach the upper gum or lift to the roof of the mouth
Causes
Tongue tie is a normal variation in how the frenulum develops in pregnancy. It often runs in families. It's not caused by anything you did.
What helps before deciding on a procedure
A full feeding assessment by an IBCLC or experienced midwife usually comes first.
- Latch and positioning review (deep, asymmetric latch with baby's chin into the breast).
- Functional tongue assessment — not just the look, but how the tongue moves and seals.
- Trial of positioning changes (laid-back / koala hold), nipple shields if needed.
- Address other contributors: oversupply, fast let-down, jaw tension, bottle teat flow.
When release (frenotomy) may help
If feeding problems persist after expert support, and functional restriction is clearly present, a frenotomy (a quick clip of the frenulum) by a trained doctor or dentist may improve feeding. Outcomes are best when assessment is done by someone trained in infant feeding, not by appearance alone.
When to see a doctor
Always see your GP, midwife or maternal health nurse if feeding is painful, baby isn't gaining weight, or you're worried. Ask for a referral to an IBCLC for a feeding assessment.
When to seek help
- Baby is losing weight or hasn't regained birth weight by 2–3 weeks
- Fewer than 6 wet nappies in 24 hours after day 5
- Baby is very sleepy, jaundiced or hard to rouse for feeds
- Mother has cracked, bleeding nipples or signs of mastitis
Common questions
Will tongue tie cause speech problems later?
Most children with tongue tie develop speech normally. Speech-related release is occasionally needed in older children if specific sounds remain affected — a speech pathologist can advise.
Do all tongue ties need releasing?
No. If feeding is going well and weight gain is normal, no treatment is needed even if the frenulum looks tight.