Tongue-Tied: How Ankyloglossia Affects Breastfeeding

Breastfeeding isn’t always easy. While it’s a natural part of motherhood, there can be complications that make the experience less than ideal for mother and baby. One problem to look out for is ankyloglossia, or “tongue tie.” If you suspect your infant is struggling with a tongue (or lip) tie, make sure to consult with a lactation specialist so your baby can properly feed. Laura Aucoin (a former lactation consultant at La Leche League) and Amanda Western (a private-practice IBCLC) share more information about how ankyloglossia may affect mothers and their babies.


A tongue tie is caused by a tight frenulum, which is the connective tissue that connects your tongue to the floor of your mouth. A lip tie is caused by the same thing, except it affects the tissue that connects your upper lip to that spot above your front teeth. A baby can have one or both of these ties, which create a restriction in the lips and mouth that does not allow the tongue to properly position itself for breastfeeding.


“It usually starts when somebody calls me saying it hurts when they breastfeed or that their baby is gassy and uncomfortable,” says Western. 

It can be hard to identify ankyloglossia just by looking in your baby’s mouth. That’s why the first sign is a problem with breastfeeding. Breastfeeding requires a baby to keep their tongue on top of their lower gum while feeding. So, when they have a tie, they struggle with keeping their tongue in the right position because their tongue is restricted. Your baby may chew on, pinch, or slide off the nipple as a result, which can cause a great deal of pain.

“Sometimes we can see immediately that your baby has an issue when he or she is born just because their mouth is so tight,” Aucoin adds. “But, sometimes that doesn’t mean there will be an issue. Sometimes the baby and momma turn out fine because they can still latch on and feed well.”


Along with pain for the mother, the baby will struggle to get an adequate amount of milk. This is why the feedings never seem to end for a baby with a tie. This is a secondary clue for ankyloglossia.

“It may seem like your baby never settles and is never satisfied,” Aucoin notes. “Your baby never gets enough in one feeding, so they keep going.”

On the other hand, your baby may completely refuse to feed. Both the refusal to feed and the struggle to eat enough will make it difficult for your baby to gain enough weight and ultimately slow their growth. Since your baby is not latching or feeding well, your milk supply may reduce, your nipples may crack, and you may develop mastitis. This is why it’s important to seek treatment for your baby’s tie as soon as you notice the signs.


Tongue and lip ties are not difficult to fix; it’s only a matter of finding the right caretaker to treat the tie. The first thing you should do is see a skilled lactation consultant. While surgery is an option, it is often the last resort when it comes to tie treatment.

“I’m specially trained in identifying ties and helping through the process of oral habilitation,” says Western. “The first thing I do is perform a functional exam, so I look at your baby on your breast and see if they are using muscles they really shouldn’t be using. That’s my first clue. Then, I pull up the baby’s lip and tongue, check their range of motion, and see what may be restricted there.”

Your lactation consultant will then work on oral habilitation with specific activities and training for your baby. Your baby may require a chiropractor or physical therapist to work on their body because babies engage their whole body to feed.

“Tie release surgery can be done in a couple ways, either with scissors, a laser, or a scalpel. You want to see someone who is specialized in that, which is why we recommend the lactation consultant first because the consultant will point you to a dentist or ENT who can perform the surgery,” Western informs. 

This surgery, also known as a frenectomy, is a quick procedure that requires local anesthesia to numb the area before the cut is done. Most parents find the surgery is much quicker and easier than they anticipated! You’ll need to breastfeed immediately after the procedure, and your surgeon and consultant will guide you through aftercare as well.

Even if your newborn does not have a lip or tongue tie, it is still good to see a lactation consultant for a second opinion on any other issue there may be. Most insurance plans are required to cover lactation consulting, so you can have peace of mind when finding help for yourself and your infant. All babies are different, and all lactation consultants are there to cater to every baby’s needs.

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