Welcoming a new baby is a joyful and life-changing experience—but it can also bring unexpected challenges. Breastfeeding should feel nurturing and rewarding, but for some new mothers, it can be frustrating or painful. If your baby struggles to latch, feedings seem inefficient, or you're suffering with sore, damaged nipples, a tongue-tie could be part of the reason. Understanding how a tongue-tie can affect tongue mobility, suction, and attachment can help you get the right support and make feedings more comfortable for both you and your baby. The good news is that with the right support and treatment, breastfeeding can become a more rewarding experience.

What is a Tongue-Tie?

Tongue-tie, or ankyloglossia, affects about 4-10% of newborns. It happens when the band of tissue, called the lingual frenulum, that connects the bottom of the tongue to the floor of the mouth is shorter or tighter than usual. The frenulum may attach near the tip of their tongue or further back. This restriction can make it difficult for your baby to lift, extend, or move the tongue properly—affecting attachment, suction, and overall feeding. Many babies show improved breastfeeding after treatment for tongue-tie, making feeds more comfortable and effective.

What is a Lip Tie?

In infants, the frenulum under the upper lip is often attached at—or just above—the gumline. The concern isn’t so much how it looks or exactly where it’s attached, but whether it is tight or inflexible. Like a tongue-tie, it can make it difficult for the top lip to flange correctly, which can impact the baby’s seal on the breast and sometimes cause them to suck in extra air. Research shows that treating lip ties can improve symptoms like reflux in over half of affected babies, helping feedings feel more comfortable for both mom and baby.

What is a Buccal Tie?

A buccal tie (pronounced like “buckle”) is when the tissue connecting the baby’s cheeks to the gums is tight or short. This frenulum is located near where the first molars will eventually emerge. There is less agreement among healthcare providers about how common these ties are, how they contribute to breastfeeding problems, and whether there is a benefit to treatment or not. 

Symptoms of Ties in Babies

Difficulty Latching

Does your baby fuss, pull off the breast, or seem frustrated during feeds?

Shallow Latch

Does your baby have trouble opening their mouth wide and maintaining a deep latch?

Sore Nipples

Are your nipples sore, cracked, or damaged?

Clicking

Does your baby make clicking noises while feeding?

Curling in the Top or Bottom Lips

Does your baby have trouble flanging their lips during feedings? 

Misshapen Tongue

Does your baby’s tongue look heart-shaped or like a taco shell when they cry?

Leaking from the Corners of the Mouth

Are breast or bottle feedings messy? Do you see milk escaping from the corners of the mouth?

Poor Milk Transfer

Does your baby feed more often than expected, fall asleep quickly during feeds, or seem unsatisfied after feedings?

Excessive Weight Loss or Slow Weight Gain

Are diaper output or weight gain a concern?

Symptoms for Mom

Nipple Pain

If you have severe nipple damage or soreness lasting beyond the first couple weeks, it might be because of a poor latch caused by tongue-tie.

Nipple Blanching

If your nipple turns white after feedings and hurts, it may be caused by nipple compression or creasing from tongue-tie.

Breast Pain

Engorgement, plugged ducts, and mastitis are often the result of ineffective milk removal when babies are not latched or draining the breast well.

Milk Production

If your baby is having trouble latching or not getting enough milk, without pumping, breast milk supply can decrease over time.

Pumping

Do you need to pump to relieve fullness or to offer your baby supplemental feedings?

What if Your Baby Has a Tongue-Tie?

Leading organizations like the American Academy of Pediatrics, American Academy of Pediatric Dentistry, and Academy of Breastfeeding Medicine recommend a team approach. They all recommend meeting with a lactation consultant who can observe a feeding, identify any underlying breastfeeding issues, and perform a thorough oral exam on the baby.

Sometimes, small adjustments like improving latch and positioning, healing sore nipples, or boosting milk supply can make a big difference. When additional support is needed, your consultant can guide you toward evaluation or treatment by a pediatrician, pediatric dentist, or ENT specialist.

Treatment Strategies

Lactation Support

Work with a lactation consultant to develop a plan to ensure your baby is getting plenty of milk and growing well. 

Perfecting the Latch

Gentle adjustments and positioning techniques can help achieve a deep, comfortable latch for both you and your baby.

Bodywork

Some families find infant massage, oral myofunctional therapy, or gentle chiropractic care helpful in easing tension and muscle tightness that can contribute to latch difficulty.

Wait and See

For some babies, a little time might be all that is needed. Many babies improve naturally within the first few weeks, especially once they regain birth weight and become more alert.

Surgical Release

If other strategies aren’t enough, a frenotomy or frenectomy may be recommended. While this procedure is not without risk, it is generally considered quite safe. Pediatricians, pediatric dentists, and ENT (Ear, Nose, and Throat) specialists can all perform this office procedure to release the tie. 

Options

Procedures are commonly done with sterile scissors (frenotomy) or laser (frenectomy). All major medical associations agree that there is no preferred method of tongue-tie release. 

Caring for Your Baby After Treatment

After treatment, your baby will need some extra care to ensure everything heals well and to make the most of the procedure:

Pain Management

Use of gentle pain relief (as recommended by your provider), skin-to-skin, babywearing, and frequent feedings can help comfort and support your baby. 

Gentle Stretches

While there is no universal agreement on “aftercare”, your provider might suggest specific tongue exercises to support mobility of the tongue and prevent reattachment.

Frequent Feedings

Watch and respond to feeding cues, practicing good latch techniques to maximize milk transfer.

Pumping & Supplementing

If needed, ensure your baby receives adequate supplementation until breastfeeding improves. Maintain your pumping routine, until you are confident breastfeeding is going well.

Regular Check-Ups

Follow-up with your baby’s healthcare provider and your lactation consultant to track healing and growth. 

Physical/Occupational Therapies

For lingering challenges, additional therapies can be used to improve tongue range of motion, coordination, and oral strength. Many of these infant feeding specialists offer services that are covered by insurance. Your baby’s pediatrician should be able to connect you with local resources for extra help.  

You're Doing a Great Job

Every baby is unique, and every breastfeeding journey has its own challenges and triumphs. With the right support, guidance, and care, most babies with tongue-tie go on to feed more comfortably and effectively. Remember, you are not alone—reaching out to your healthcare team and lactation consultant can make a big difference, and small improvements can have a lasting impact on your breastfeeding journey.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.