6 Signs Your Baby Has a Tongue Tie


As you prepare to welcome a new baby into your home, you likely have some ideas of how you would like this whole process to go. A snuggly baby who contentedly lies against your chest, peaceful days and nights at home, a quick adjustment to the demands of breastfeeding...

This isn't necessarily out of the realm of possibility...until a tongue tie throws a wrench into your plans!

What is a Tongue Tie?

A tongue tie is a term for an oral restriction in your baby's mouth which inhibits the full range of motion of the tongue. In some babies, the frenulum (or that “string” of soft tissue you see when your baby lifts up their tongue) presents shorter, tighter, or thicker than it's supposed to be, and your baby has trouble moving their tongue properly. A restricted range of tongue motion can not only make breastfeeding and weight gain a difficult uphill journey, but later on down the road it could cause speech delay, dental cavities, palate malformation, and other issues. If a tongue tie is present, your baby probably also has a lip tie, limiting the range of motion of the upper lip and presenting an extra breastfeeding challenge.

How is a Tongue Tie Diagnosed?

While any OB-GYN, midwife, pediatrician, or lactation consultant could look into your newborn's mouth and see whether or not the tip of the tongue is tied down to the mouth by a piece of tissue (and also probably grab the scissors!), you need a pediatric dentist specializing in oral restrictions to diagnose a more insidious form of restriction: the posterior tongue tie.

A posterior tongue tie prevents the tongue from fully realizing the undulating movement required to drain milk from the breast, and is diagnosed by a pediatric dentist manually lifting the baby's tongue to assess the range of movement. You can get the ball rolling on this process by keeping an eye out for possible signs that your baby has a tongue and/or lip tie that may require an evaluation.

Based on our work with new babies and lactation consulting, here are six signs that your baby may have a tongue tie. While this list applies to newborns and is not exhaustive, these are some of the symptoms we most commonly see in our practice.

1. Breastfeeding is Painful

If you are experiencing pain during breastfeeding, in some cases this can be due to a baby's inability to open their mouth wide enough for a good latch. A compressed nipple, cracked nipple, and burning pain could indicate a tie-related latch problem.

2. Your Baby “Clicks” at the Breast

Believe it or not, your baby isn't supposed to be making that loud “clicking” sound while eating! A baby who isn't opening their mouth wide enough and using enough of their tongue doesn't have a strong suction hold on the breast and can slip off easier.

3. Your Baby Struggles to Gain Weight

A baby who is struggling to keep up on the growth charts, yet is being put to the breast frequently, could have anatomical issues transferring milk. While there could be many reasons for slow growth and a pediatrician should always be consulted, there are countless parents who have felt sad or guilty that their milk “wasn't good enough” when the issue turned out to be oral restrictions instead.

4. You Suffer Frequent Clogged Ducts and/or Mastitis

Those hard lumps and sore red streaks that ruin your day shouldn't be happening if you are frequently putting the baby to the breast. A baby's inability to fully drain all the milk from the breast will eventually cause the milk ducts to become painfully clogged, even leading to infection.

5. Your Baby's Tongue Looks Heart-Shaped

Notice when your baby sticks their tongue out. Does the tip of the tongue appear in a “heart shape” rather than elongated and pointy? The tongue can also have a “notched” appearance, or struggle to even protrude from the mouth at all. A healthy baby should stick their tongue out as a hunger cue, so you'll be able to watch and see what happens.

6. Your Baby is in Discomfort

If your baby is fussy, gassy, drools excessively, doesn't want to nurse on a particular side, or is diagnosed with reflux or colic, these could all be signs that your baby is struggling with milk transference, sucking in air, and other discomfort from the effects of tongue and/or lip ties.

Help, I Think My Baby Has a Tongue Tie!

We understand that you may be anxious and apprehensive if you believe that your baby may have a tongue and/or lip tie. However, you can be assured that we have supported many families through the tongue tie revision process and it is very safe and quick. Your pediatric dentist will do a thorough and gentle evaluation of your baby's mouth, and the procedure is done with a laser and only takes a few minutes. Newborn babies heal very quickly, and by following the doctor's aftercare procedure and continuing to see your lactation consultant frequently, you and your baby will be able to get past this and be likely to develop a more satisfying breastfeeding relationship.

Have more questions about tongue ties, lip ties, or breastfeeding difficulties? Our postpartum doulas and lactation consultants are here to walk you through the process and support you the whole way. Utilize our frenectomy support to help you determine if an official diagnosis should be sought; and support you through the revision procedure. Then, use your favorite Arkansas lactation consultant to get you back on the right track!