This content is reviewed and approved by our midwife Lydia Schorah.

If you’re struggling with breastfeeding pain, poor latch, or a fussy baby who seems frustrated at the breast or bottle, you may have heard about tongue tie. It’s a term that gets thrown around in parenting groups and lactation discussions, but what exactly is it? More importantly, how do you know if your baby has it, and what can you do about it? Let’s break it down.

What is tongue tie?

Tongue tie, or ankyloglossia, is a condition where the strip of tissue (the frenulum) under the tongue is too tight, thick, or short, restricting the tongue’s movement. This limitation can affect a baby’s ability to latch onto the breast or bottle, leading to feeding difficulties, maternal pain, and sometimes even speech or dental issues later in life.

Some babies with tongue tie nurse without issues, while others struggle to feed effectively, leading to poor weight gain, frustration at the breast, or excessive gas and reflux from swallowing air.

How to diagnose tongue tie

Diagnosing tongue tie isn’t always straightforward, as not all healthcare providers are trained to recognise it. However, here are some common signs to look for:

In babies:

• Difficulty latching onto the breast or bottle
• Clicking sounds while feeding
• Short, frequent feeds or excessively long feeds
• Poor weight gain despite frequent feeding
• Excessive gas, reflux, or colic-like symptoms
• Frustration or pulling away from the breast/bottle

In mothers (for breastfeeding babies):

• Painful, cracked, or damaged nipples
• Engorgement or recurrent clogged ducts due to ineffective milk removal
• Low milk supply from baby’s poor milk transfer

To confirm a tongue tie diagnosis, an evaluation by a pediatric dentist, lactation consultant (IBCLC) or GP is recommended. A functional assessment—looking at how the baby moves their tongue rather than just its appearance—is key in proper diagnosis. For more information on who can refer and how to be referred visit: https://www.tongue-tie.org.uk.   

Where to seek help for tongue tie

If you suspect tongue tie, there are several professionals who can assess and guide you:

• Lactation Consultants (IBCLC): Often the first point of contact, they can assess latch issues and refer you to a specialist if needed.
• Your GP: While GPs do not specialise in tongue tie, they can diagnose and refer you to the right provider.
• Pediatric Dentists : These professionals often perform tongue tie releases and can provide a thorough evaluation.

If your healthcare provider dismisses your concerns but feeding difficulties persist, seeking a second opinion from a tongue tie specialist may be beneficial.

Treatment for tongue tie: what to expect

If tongue tie is causing feeding difficulties, a procedure called a frenotomy or frenectomy may be recommended. This is a quick, relatively simple procedure where the restrictive frenulum is clipped (using scissors) or released with a laser.

What happens during the procedure?

• The baby is usually swaddled for comfort.
• A numbing agent may be applied, but the procedure itself takes only a few seconds.
• If using scissors, the provider snips the frenulum. If using a laser, the tissue is gently released with minimal bleeding.
• Babies are often encouraged to nurse or take a bottle immediately after to soothe them and assess improvement in latch.

Post-procedure care

• Stretching exercises: Some providers recommend stretches or gentle massages under the tongue to prevent reattachment.
• Increased feeding sessions: The baby may need time to adjust to their new tongue mobility.
• Possible temporary discomfort: Some babies are fussy for a day or two post-procedure, but many experience immediate improvements in feeding.

Tongue tie can be a frustrating hurdle, but with the right support, it’s a manageable one. If you suspect your baby has a tongue tie, trust your instincts and seek out a provider with experience in diagnosing and treating it. Feeding should not be a painful or stressful experience, and help is available to ensure both you and your baby have the best start possible.

If you’ve gone through a tongue tie journey with your little one, we’d love to hear your experience—what helped, what didn’t, and what advice you’d give other parents navigating this challenge.

If you need more support with suspected tongue tie or anything else baby related, you can use our chat box on the membership dashboard to ask a question to our team of midwives.