Tongue and Lip Tie – A Quick Guide for Breastfeeding Challenges

If breastfeeding hurts more than you expected, or your baby seems to struggle with latching, feeding, or gaining weight, you’re not alone—and you’re not doing anything wrong. One possible reason could be something called a tongue or lip tie. This quick, clear guide will help you understand what it is, what to look out for, and what you can do next.

What Are Tongue & Lip Ties?

A lip tie is when the top lip is tightly attached to the upper gum by a piece of skin called the frenulum. If this frenulum is too tight or placed too low, it can stop the lip from flaring out the way it needs to during breastfeeding. This can make it harder for your baby to get a deep, effective latch on the breast.

A tongue tie, or ankyloglossia, is when the band of tissue under the tongue (also a frenulum) is too short, thick, or tight, limiting the tongue’s movement. Tongue ties are present at birth and may run in families. While lip ties are less common and often less severe, they can still affect feeding—especially if they’re combined with a tongue tie.

Studies suggest that some lip ties improve on their own as a baby grows, especially once the permanent teeth begin to come in. But when breastfeeding is painful or difficult, it’s important to look at what’s happening now, not just wait for your baby to grow out of it.

How Tongue & Lip Ties Affect Breastfeeding

Feeding your baby shouldn’t feel like a battle. When a tongue or lip tie interferes with movement, it can make latching shallow or painful.

Signs You Might Notice

• Nipple pain that doesn’t improve with latch adjustments
• Cracked, creased, or blistered nipples
• A pale or white stripe at the end of the nipple after feeding
• Plugged ducts, mastitis, or thrush
• Feeds that feel incomplete—like your breasts aren’t fully drained
• Lip tucked inward while nursing
• Frequent latching and unlatching
• Chewing at the nipple
• Gulping, coughing, choking during feeds
• Clicking sounds while sucking
• Excessive gassiness or reflux symptoms
• Very slow or no weight gain
• Long, frequent feeds that leave your baby unsettled
• Fussiness, back-arching, or early fatigue during feeding
• Difficulty maintaining suction
• Trying to take in too much breast at once to compensate
• Messy feeding or drooling
• Biting (if baby already has teeth)

Some babies with ties may breastfeed well at first, then begin struggling as their feeding demands increase. Lip and tongue ties don’t just impact feeding—they can also affect jaw development, chewing, swallowing, and digestion as your child grows.

Signs To Watch For & When To Ask For Help

Here’s when it’s a good idea to reach out to a lactation consultant or feeding specialist:

• You’re in pain, and it’s not improving with latch adjustments
• Feeds are stressful, extra long, or don’t seem satisfying
• Your baby’s weight gain is slower than expected
• You notice clicking, gulping, or milk dripping from the sides of their mouth
• Your baby falls asleep quickly at the breast, but wakes up still hungry

Even if you’re not sure it’s a tongue or lip tie, getting support early can make a big difference. Don’t wait for things to get worse—getting an expert’s eyes on a feed can help you spot whether your baby’s tongue and lip movements are working well enough.

Diagnosis & Assessment of Tongue & Lip Tie

Diagnosing a tongue or lip tie shouldn’t be about just peeking inside your baby’s mouth. It’s about how they use their mouth.

Some ties look dramatic but cause zero trouble. Others are nearly invisible (especially “posterior” tongue ties, which hide further back) but cause major latch issues. That’s why a proper assessment looks at both anatomy and function.

What A Good Tongue & Lip Tie Assessment Includes

• Watching a full feed (not just checking the mouth)
• Looking at tongue lift, range of motion, and cupping
• Checking how the baby transfers milk and manages suction

Unfortunately, not every doctor will do this. Some may glance in the mouth and dismiss your concerns. That’s why finding a practitioner who understands both breastfeeding and oral function is essential. Ideally, an International Board-Certified Lactation Consultant (IBCLC) will observe a full feeding and refer you to a pediatric dentist, ENT, or speech therapist if needed.

It’s okay to seek a second opinion—especially if you feel like something’s not right, but you’re not being heard.

Treatment Options – What You Can Try

Let’s be real: not every baby with a tie needs surgery. There are options, and you deserve to know them.

Non-Surgical Options (Often The First Step)

• Expert breastfeeding support from an IBCLC
• Trying new positions that improve latch and comfort
• Breast compressions during feeds
• Tongue exercises or stretches
• Bodywork (like craniosacral therapy or chiropractic care)

Some babies do just fine with a few adjustments and extra support. Growth can also change things over time.

Surgical Treatment

If feeding is still a struggle, your doctor might suggest a procedure to release the tongue or lip tie. This is called a frenotomy or frenectomy—a quick snip or laser release of the frenulum. It’s usually done in-office and only takes a few seconds.

Many moms report:

• Less nipple pain within days
• Faster, more effective feeds
• Happier, less gassy babies
• Better sleep and weight gain

Still, the procedure isn’t magic. Follow-up care is key—like latch work, gentle stretches, and feeding support.

What To Expect After A Frenotomy

If you go ahead with a release, here’s what to know:

• Healing is usually quick. Most babies feed right after the procedure.
• Feeding may feel different right away—or take a few days.
• You’ll likely get stretching exercises to prevent reattachment. They’re quick but important.
• Ongoing support helps. Keep working with your IBCLC to adjust latch and monitor progress.

Some moms feel instant relief. Others notice gradual changes over a few weeks. Both are normal.

Final Thoughts

The goal is to make feeding your baby feel better—for both of you. With the right support, you can get there.

You’ve got this, mama.

FAQs – Quick Answers For Worried Moms

Resources

• Find a breastfeeding support group near you.
• Milkology Breastfeeding Class – Affordable, video-based online course to help you master breastfeeding at your own pace.

References

• Breastfeeding Improvement Following Tongue‐Tie and Lip‐Tie Release: A Prospective Cohort Study — The Laryngoscope (2017-05)
• Tongue Tie in Babies: How Ankyloglossia Affects Breastfeeding — HealthyChildren.org, American Academy of Pediatrics (2024-07-29)
• The Effect of Tongue‐Tie and Lip‐Tie on Breastfeeding — Journal of the American Academy of Pediatrics (2019)
• Lip‐Tie and Breastfeeding — Breastfeeding support (2025-04-10)