Lip And Tongue Ties 101: What You Need To Know

Lip And Tongue Ties 101: What You Need To Know

This article was contributed by fan-favorite contributor, Jenni Allen.


You’ve just given birth and your warm bundle is nuzzling up to you. Time passes without you noticing as you are skin-to-skin staring at this precious creation that is yours. The cries have subsided and you breathe in each moment wondering how you could have ever gotten so lucky. Your baby begins to bob their head looking for your breast to have their first feeding. They latch and suckle away feeling completely comforted by your embrace.


Although this is the moment nature has intended for us and our bodies, it doesn’t always turn out perfect. Even if you did not have the experience above, you can still have a long, healthy breastfeeding journey.


Breastfeeding is one of the best things that you can do for your baby since breast milk is nutritious and provides immunities for your little one. Breastfeeding also assists you in creating a bond with your young one and helps them feel safe while they are learning about the new world around them.


I remember being pregnant wondering what breastfeeding was going to feel like. I had heard people talk about how they were unsuccessful because of their supply or because it hurt, and I was so intimidated. While taking a class to prepare myself for birth, an IBCLC (International Board Certified Lactation Consultant) came to discuss breastfeeding positions with us and answer some of our questions. Taking advantage of the opportunity, I asked,


“I know breastfeeding is supposed to hurt, so what do you do to help the pain?”


She quickly corrected me and told me that breastfeeding should not hurt. I was surprised since I had heard many people complain, but it also made sense to me. Our bodies are made to bring life into the world and then nourish that life with the milk we custom create. It makes sense that there should only be pain if there is a problem.


One of the common misconceptions surrounding breastfeeding is that it will hurt, but it should not hurt. Let me say that again. It should NOT hurt. Pain while breastfeeding is common but is definitely not normal. When you first begin, your nipples may feel sore but if you have pain then it is a symptom of a larger problem; Most commonly, a latch problem is to blame. At the root of that often lies a lip or tongue tie.



What Are Lip And Tongue Ties?

The skin under the lip and tongue that tethers them to the mouth is called a frenum/frenulum. The frenulum under the tongue helps your tongue move correctly while eating, speaking and breathing. If the frenulum is restricting movement of the tongue, is it called ankyloglossia—or a tongue tie.


A lip adhesion—or lip tie—is when the frenulum under the lip limits the flexibility of the lip to flange out. Due to the rise of awareness about lip/tongue ties, many new moms are worried when looking at their baby’s mouth because they see a frenulum and think it is a “tie.”


However, the appearance of a tongue/lip tie is not as important as the function of the lip or tongue. Many times, someone is worried that their child has a tongue or lip tie because they can see the frenulum. Everyone has a frenulum. Ccheck your mouth; you do too! So, that is not a way to diagnose a lip or tongue tie.


How Common Are Lip/Tongue Ties?

According to several studies reviewed and published in the journal Canadian Family Physician, their assessment shows the prevalence of tongue ties, with 4.2% to 10.7% of newborns are affected by it.


Interestingly, boys are more susceptible to tongue ties than girls and there is a link between the MTHFR gene mutation and lip/tongue ties, as per, the website of MTHFR expert, Dr. Ben Lynch.



What Are The Symptoms For Baby?

Here are the common issues seen in babies with a lip and/or tongue tie, as per Healthline and Nashville Birth and Babies:


  • Difficulty latching or popping on and off the breast/bottle
  • Lips curl in on breast
  • Milk leaking out while feeding
  • Suck blisters on the lips
  • Gumming/Chewing on the nipple
  • Clicking noises during feeding
  • Can’t open their mouth very wide
  • Can’t keep a pacifier in their mouth
  • Gassy/Colicky
  • Reflux/Spitting up a lot
  • Slow weight gain
  • Frequent feedings (>12/day) and/or Very long feedings (>45 mins)
  • White coating on baby’s tongue
  • Gap in top gums/teeth
  • Supplementing with bottles
  • Choke/Cough/Sputter during feeding
  • Tooth decay of upper teeth


What Signs Will A Nursing Mama Experience?

Here are some common symptoms that are seen in mama when baby has a lip and/or tongue tie:


  • Damaged or painful nipples
  • Creased nipple after feeding (“lipstick nipple”)
  • Nipple Blanching and Vasospasms
  • Milk Blister/Bleb, Plugged ducts
  • Thrush (breast yeast infection) or Mastitis (breast bacterial infection)
  • Low milk production
  • Dreading feedings or feelings of Anxiety/Depression



What Problems Can Ties Cause?


Lip and tongue ties can cause many problems with breastfeeding, but they can also cause problems later in your child’s life as well. Your lips and tongue affect more areas of your life than you think!


Feeding: Lip and tongue ties affect breastfeeding but they can also affect your ability to eat solid foods. A tongue or lip tie can make it hard to chew or swallow foods (especially thick or crunchy foods) and can cause acid reflux or a hyperactive gag reflex.


Speech: A person with a tongue tie has a hard time making some letter sounds such as R, L, S, SH, TH, and K.


Breathing: The position of your tongue while it’s resting affects the way you breathe. A tongue tie can cause open mouth breathing, teeth grinding, snoring, sleep apnea, and poor sleep because you are unable to breathe well.


Dentition: A tongue or lip tie can cause your teeth to be crooked, crowded, or gapped. It can also cause a high/narrow palate and tooth decay because of your tongue’s inability to clean your teeth effectively.


Additional issues: Tongue and lip ties can affect posture. Your tongue can get tired from speaking, alter your ability to lick things like ice cream cones, inhibit your ability to play wind instruments, and also affect things such as kissing, as per Nashville Birth and Babies.


I Think My Baby Has a Lip Or Tongue Tie — Now What?

Below are some questions you can ask yourself to see if you think your baby might have a lip or tongue tie. If you do think your baby has a tie, the next thing you’ll want to do is set up a consultation with a pediatric dentist or ENT who specializes in lip and tongue tie revisions.


Keep in mind that sometimes you can experience pain because the baby has a bad latch but doesn’t have a lip or tongue tie. You may need to try a different position or focus on helping your baby latch correctly instead.


Either way, it is still beneficial to meet with an IBCLC and do a weighted feed so you can have all the information. Be aware that most lactation consultants, pediatricians and other family doctors are not trained to assess for lip and tongue ties.


  1. Do I experience pain throughout the whole feeding? Is my nipple misshapen or white upon unlatching? Are any sores present?
  2. When baby is latched, are their lips flanged out?
  3. Does baby cough/sputter/pop off the breast when I have a letdown?
  4. Is milk leaking around my baby’s lips?
  5. Do I hear a clicking sound?
  6. Is baby able to drain my breast completely?
  7. Am I experiencing milk blebs/clogged ducts/mastitis?
  8. Is baby spitting up a lot or very gassy?
  9. Is baby gaining weight too slowly or not having enough wet diapers?
  10. Is my baby’s tongue unable to lift completely or does it make a “heart” shape when lifted? (I find this is more noticeable while baby is crying.)


Depending on the severity of the lip or tongue tie, your preferred provider may suggest revising it or leaving it alone. The choice is yours to make and you can also decide to wait. If you do decide to go ahead with the frenectomy, be sure to do the exercises following the procedure and for the next few weeks so that the site can heal properly and the frenulum won’t reattach too soon.


Sources: Canadian Family Physician,, Healthline, Nashville Birth and Babies

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