What to know about tongue tie and breastfeeding - Ruth Health

What to know about tongue tie and breastfeeding

Fast facts:

  • Tongue tie is a condition in which a small band of tissue connects the tip of a baby’s tongue to the floor of the mouth.
  • 5% of newborns are born with this condition.
  • There aren’t always noticeable symptoms, but it can affect a baby’s ability to latch and transfer milk during breastfeeding.
  • A lactation consultant can support you through any related breastfeeding challenges.

5% of newborns experience a condition called tongue tie, in which a small band of tissue connects the underside of the tongue to the floor of the mouth. Mild cases of tongue tie don’t always have noticeable symptoms. 

In other cases, the condition can impact a baby’s ability to latch during breastfeeding and, more rarely, their speech and oral hygiene.

Next steps after a diagnosis depend on the severity of a baby’s symptoms. If the condition affects your child’s ability to latch and breastfeed, lactation support can help. However, it isn’t a substitute for a doctor’s recommendations.

Here’s what to know about tongue tie treatment and symptoms.

What is tongue tie?

While in the womb, a growing baby’s tongue is initially fused together with the floor of the mouth. As the tongue gradually separates, it leaves behind a thick band of tissue — the lingual frenulum — which ties the tip of the tongue to the bottom of the mouth.


For the majority of newborns, the lingual frenulum naturally separates before birth. For babies with tongue tie, however, it remains.


Tongue tie is more common in boys than girls. The specific cause often remains unknown, but in some cases the condition may run in families.


You may also see tongue tie referred to as its clinical name, ankyloglossia.

What are the symptoms of tongue tie?

There is a spectrum of severity in symptoms. Mild cases often do not cause symptoms that interfere with daily activities.

In other instances, an infant may have one or more of the following symptoms:

  • Latching difficulty during breastfeeding
  • Breastfeeding for long periods of time
  • A clicking sound during breastfeeding
  • Excessive hunger
  • Difficulty gaining weight

Toddlers and young children with tongue tie may exhibit one or more of the following symptoms:

  • Speech difficulties
  • Trouble swallowing
  • Limited range of motion of the tongue
  • Difficulty moving the tongue from side to side

How does tongue tie affect breastfeeding?

If you have chosen to breastfeed, your baby’s tongue tie may affect your breastfeeding journey. 

Babies use their tongue to latch onto the breast during breastfeeding. Tongue tie can interfere with your baby’s ability to latch, though this doesn’t happen in all cases. 

Some babies with the condition also have difficulty squeezing the milk ducts while nursing. This can prevent your baby from consuming enough breast milk and, consequently, from consistently gaining weight.

Given these effects, if breastfeeding a baby with tongue tie, you may develop symptoms, including cracked or sore nipples and pain during breastfeeding.

Tongue tie can contribute to the following breastfeeding problems:

  • Low milk supply: your baby’s ability to latch and consume enough milk informs how much milk you produce. Poor latching related to tongue tie can decrease your milk supply.
  • Breast engorgement: if a baby cannot latch and remove enough milk while breastfeeding, your breasts won’t be fully drained of breast milk. This can lead to breast engorgement.
  • Plugged milk ducts and mastitis: these breastfeeding problems can also develop when the breasts aren’t fully drained of milk due to tongue tie.

Breastfeeding is an emotional journey as well as a physical one. It is understandable to feel overwhelmed if your baby has been diagnosed with tongue tie, or if you suspect a diagnosis. This isn’t your fault, and you don’t have to manage this alone.

A lactation consultant can help you protect your milk supply as you navigate your child’s diagnosis and treatment options. Their support can help you fulfill your intentions with breastfeeding.

Tongue tie treatment

Treatment depends on the severity of your child’s condition. In some cases, the lingual frenulum loosens on its own, and no further treatment is required.

In other instances, a doctor may recommend a surgical procedure known as a frenectomy to remove the lingual frenulum. This procedure is typically painless for infants, and some may be ready to nurse immediately after. 

Your child’s doctor will likely recommend post-surgery stretching exercises to prevent the tie from reattaching. Your baby may be fussy for a few days from these stretches.

If your child requires a surgical procedure, a lactation consultant can walk you through effective breastfeeding techniques to use during your child’s healing.

Some children may need support from a speech therapist to address speech difficulties related to tongue tie.

We’re here to support your breastfeeding journey

Support from a lactation consultant is pivotal if you encounter breastfeeding challenges related to tongue tie. 

Ruth Health offers nearly 24/7 virtual lactation support from Certified Lactation Counselors (CLCs) to provide individualized care on your time.

Learn how we can help with your breastfeeding journey.

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