Untangling Tongue Tie

A Guide to Help Parents Recognize Red
Flags and Know When to Get Help

Written by: Nicole Salter, RN, IBCLC

What is a tongue tie?
The condition known as a tongue tie (tethered oral tissue) is characterized by an abnormally short or thick frenulum, the little piece of tissue that links the tongue to the floor of the mouth, limiting the tongue's mobility. For both the mother and the child, this can make breastfeeding challenging.

Some signs that may indicate your baby has a tongue tie:

1. Difficulty with Latching:
   Difficulty latching onto the breast or trouble maintaining a latch.
   May also slide off the nipple or make clicking sounds while breastfeeding.

2. Poor Weight Gain:
   Difficulty getting enough milk during feedings can lead to poor weight gain.

3. Short Feeding Sessions/Sleepy Baby:
   Babies who cannot transfer milk effectively tend to fatigue easily and fall asleep quickly at the breast.
   This can lead to much shorter and more frequent feeding sessions.

4. Decrease in Milk Supply:
   If a baby is unable to stimulate the breast or transfer milk effectively, you may begin to notice a decrease in milk production.

5. Choking or Gagging:
   Baby may choke or gag during feedings, as they may not be able to swallow effectively.

6. Excessive Gas or Discomfort:
   Swallowing more air during feedings can lead to excessive gas and discomfort.

7. Nipple Pain or Damage:
   A tongue-tied baby may cause nipple pain or damage due to their inability to latch effectively.
   This is a BIG RED FLAG.

8. Mouth Breathing
   Baby sleeps with their mouth open

“My baby can stick their tongue out so they can’t be tongue tied, right?”
While some babies have an anterior tie that prevents them from extending their tongue over the lower gum and lip, others have more posterior tethers preventing them from elevating their tongue. This is necessary to create a vacuum to transfer milk successfully.

Not all tongue ties are obvious and can be easily overlooked.
If you suspect that your baby may have a tongue tie, it is important to consult with a healthcare professional, such as a Thrive Lactation & Wellness CLC (Certified Lactation Counselor) or IBCLC (International Board Certified Lactation Consultant) who can properly assess latch, suck, oral structures (togue/lip/buccal) and provide guidance to support your breastfeeding goals.

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