Tongue Tie in Babies: What Parents RealLy Need to Know

By Dr Aoife Stack, Dentist.

Being told your baby has a

— or that they don’t — can be confusing and emotional. Tongue tie (ankyloglossia) can affect feeding, breathing, sleep, and even jaw development. Yet because there is no universal standard for diagnosis, many parents find themselves navigating conflicting advice, missed signs, or unnecessary procedures.

This article explains:

• Why tongue tie is often misdiagnosed

• What signs to look for

• What holistic, evidence-based care can look like

Why Tongue Tie Misdiagnosis Happens

🧠 No universal training or definition

There is no single, standardised test for diagnosing tongue tie. Some practitioners base their assessment on how the tongue looks, while others evaluate function — how it moves, lifts, or extends. Because of this variation in training and criteria, you may get different opinions depending on who you see.

⚖️ Over-diagnosis

Feeding issues can be distressing, and tongue tie is often suggested as the cause — but that’s not always accurate.Feeding difficulties may also be caused by:

• Muscle tension from birth (especially in the jaw, neck, or shoulders)

• Digestive discomfort (reflux, food sensitivities)

• Latch or positioning issues

Tongue tie is real and can be impactful, but it’s not always the root cause.

🫥 Under-diagnosis

Some tongue ties — especially posterior ones that are hidden — are missed entirely. Parents may be told everything is fine, even when:

• Breastfeeding is painful

• Baby struggles to latch

• Symptoms like reflux, fussiness, or restless sleep persist

Without a functional assessment (how the tongue moves, not just how it looks), many of these ties remain undetected.

Why Accurate Diagnosis Matters

Tongue tie affects more than just feeding. If missed or misunderstood, it can have long-term consequences on a baby’s:

• Feeding: Poor latch, nipple pain, milk leaking, long feeds, or poor weight gain

• Speech: Delays or difficulty with certain sounds in toddlerhood and beyond

• Breathing and sleep: Mouth breathing, snoring, or poor-quality sleep

• Posture and muscle tone: Forward head posture, tight neck or shoulders

• Jaw and facial development: A low tongue posture can impact palate shape, tooth alignment, and jaw growth

In short: The way a baby uses their tongue affects how they eat, breathe, grow, and sleep.

Signs Your Baby May Have a Tongue Tie

Every baby is different, but these signs may suggest a restriction:

• Difficulty staying latched on breast or bottle

• Clicking or popping sounds during feeds

• Gulping, choking, or milk leaking from the mouth

• Painful breastfeeding or damaged nipples

• Long feeds, frequent hunger, or slow weight gain

• Tongue that doesn’t lift or extend well

• Heart-shaped tongue tip

• Open-mouth posture or mouth breathing

• Fussiness during or after feeds, gassiness, or reflux symptoms

One sign on its own may not be significant — but if you’re noticing multiple issues, it’s worth getting a specialist evaluation.

What to Do If You Suspect a Tongue Tie

✅ 1. Get an expert assessment

Seek a practitioner with advanced training in tongue tie — ideally someone who evaluates function, not just appearance.

👶 2. See an IBCLC (Lactation Consultant)

Many feeding issues can improve with expert help in latch, positioning, and milk transfer. Sometimes a release isn’t needed at all.

🤱 3. Optimise feeding support first

Surgery is never the first step. Supporting feeding and adjusting positioning can make a significant difference.

👐 4. Consider bodywork

Craniosacral therapy, osteopathy, or pediatric chiropractic care can help release tension and improve tongue mobility — especially when used before or after a release.

👅 5. Do oral exercises and suck training

These help babies build strength, coordination, and efficient movement patterns. They’re often key to long-term success.

✂️ 6. If a release is needed...

A frenotomy or frenectomy should always be part of a broader care plan, not a one-time fix. Post-release wound care, oral exercises, and feeding support are essential to prevent reattachment and help babies unlearn compensation patterns.

A Holistic Approach to Tongue Tie Care

The most effective care often involves a multi-disciplinary team, which may include:

• An IBCLC for expert feeding support

• A bodyworker to release tension and improve oral movement

• An oral motor or feeding therapist for exercises and integration

• A trained release provider (pediatric dentist, ENT, or pediatrician)

When these providers work together, the baby can experience better feeding, calmer sleep, and improved growth and development.

Final Thoughts

Tongue tie is often misunderstood — both over-diagnosed and missed — but the impact is real when it exists. Whether your baby needs a release or simply support for feeding and regulation, the right care can make a huge difference.

Trust your instincts. If something doesn’t feel right, keep asking questions and seek a second opinion. With a holistic plan, most babies thrive — feeding more easily, sleeping more soundly, and growing more comfortably.