Baby Tongue Ties

Common signs in infants include:

Breastfeeding difficulties:

• Poor latch or difficulty maintaining latch
• Clicking or smacking sounds while nursing
• Frequent feeding (every 1-2 hours) with little satisfaction
• Prolonged feeding sessions (45+ minutes)
• Excessive gassiness or reflux
• Poor weight gain or failure to thrive
• Falling asleep at the breast from exhaustion

Physical signs in baby:

• Heart-shaped tongue when crying or sticking tongue out
• Inability to lift tongue to the roof of the mouth
• Tongue movement side-to-side rather than up
• Inability to extend tongue past the gum line or lower lip
• White coating on tongue that doesn’t wipe away (from milk pooling)

Maternal symptoms:

• Painful, damaged, or creased nipples
• Nipple blanching (turning white) after feeding
• Incomplete breast emptying or recurrent mastitis
• Low milk supply due to poor milk transfer
• Extreme fatigue from constant feeding demands

Even bottle-fed babies experience difficulties with tongue ties, including:

• Taking excessive time to finish bottles (45+ minutes)
• Milk dribbling from the mouth during feeding
• Chomping or chewing on the nipple instead of sucking
• Preferring faster-flow nipples to compensate
• Excessive air intake causing gas, reflux, and colic
• Frequent breaks during feeding
• General fussiness and dissatisfaction after feeding

Yes, absolutely. We strongly recommend having your baby assessed by both an IBCLC (International Board Certified Lactation Consultant) and a tongue tie release provider even when breastfeeding appears to be going well initially. Here’s why:

For breastfed babies: Sometimes a mother has an excellent let-down reflex and abundant milk supply that compensates for a baby’s poor tongue function in the early weeks. However, around the 3-month mark, supply often decreases because the baby’s inefficient suck cannot adequately stimulate continued milk production. What seemed like “successful” breastfeeding can suddenly become problematic, with concerns about supply, weight gain, and nursing frequency emerging months into the journey.

For bottle-fed babies: Even if your baby is gaining weight appropriately on the bottle, it’s crucial to have an IBCLC assess whether your baby is taking the bottle with proper oral function. Weight gain alone doesn’t tell us if the baby is feeding efficiently or developing healthy oral motor patterns. Poor feeding mechanics can lead to issues with:

• Transitioning to solid foods
• Speech development
• Dental and jaw development
• Sleep and breathing

Function is what matters most. The presence or absence of immediate feeding struggles doesn’t tell the complete story. A comprehensive functional assessment evaluates how well the tongue, lips, and oral structures can perform their intended roles—not just whether the baby is surviving, but whether they can thrive with optimal oral function. Early identification and treatment prevent downstream complications in feeding, speech, dental health, and airway development.

As soon as breastfeeding difficulties are identified. Early intervention prevents weeks of painful nursing for mother, poor weight gain for baby, and potential breastfeeding relationship breakdown.

There’s no “too late” for treatment, though earlier intervention typically yields easier adaptation and prevents secondary problems.

Contact Family Dental Guelph to schedule a tongue tie assessment. During your consultation, we will:

• Take a comprehensive history
• Perform a thorough oral examination
• Observe feeding (for infants)
• Discuss symptoms and functional limitations
• Review treatment options and expected outcomes
• Answer all your questions
• Provide information about the procedure and aftercare

No referral is necessary to schedule your assessment.

Infants (0-6 months):

• May be fussy for 24-48 hours
• Can typically nurse immediately after the procedure
• Acetaminophen can be used for comfort if needed
• Stretching exercises required 4-6 times daily for 2-3 weeks

Results vary by individual and the issues being addressed:

Breastfeeding: Many mothers notice immediate improvement in latch and comfort. Full improvement typically occurs over 2-4 weeks as baby learns to use their newly mobile tongue and any oral motor dysfunction resolves.

Bottle feeding: Improvements in feeding efficiency often occur within the first week.

Speech: May take weeks to months, especially if speech therapy is needed to retrain muscle patterns. Younger children often see faster improvement.

Sleep and breathing: Often improves within weeks as the tongue can better position itself in the mouth.

Dental and jaw issues: Long-term improvements as facial and dental development proceeds more favorably.

Sometimes, yes. Babies who have compensated for a tongue tie may have developed dysfunctional feeding patterns. After the release, they need to learn to use their tongue correctly. This is why immediate improvement isn’t always seen—the baby needs time to develop new motor patterns. Working with a lactation consultant or feeding therapist can be extremely helpful during this transition.

If symptoms persist or don’t improve as expected:

1. Ensure stretches are being done correctly and consistently (the most common reason for reattachment or poor outcomes)
2. Work with a lactation consultant to address any feeding technique issues
3. Consider bodywork if not already incorporated
4. Evaluate for other contributing factors (reflux, oral motor dysfunction, allergies)
5. Follow up with your provider to assess healing and ensure complete release
6. Speech or feeding therapy may be beneficial for older children

For breastfeeding difficulties, absolutely. A skilled IBCLC (International Board Certified Lactation Consultant) can:

• Assess latch and positioning
• Identify tongue tie symptoms
• Provide pre- and post-procedure support
• Help you and baby optimize feeding technique
• Address supply and pumping concerns
• Support the breastfeeding relationship

Many feeding issues can be improved with lactation support alone, and even when a release is needed, lactation support significantly enhances outcomes.