What’s Tongue Tie?

December 9, 2022

updated, Nov 2, 2025 – While there are four types of tongue-tie in babies, it is rarely a medical problem. However, being born with a slightly limited range of motion in the tongue can make feeding difficult. Karen King, PCD-DONA, CLC explains how this easy-to-fix condition presents below in What’s Tongue Tie?

Most cases of tongue-tie are mild and not medically serious, but even a small restriction can make feeding more tiring for babies.  Additionally, it is much more common than generally thought.  And while tongue-tie is typically very easy to fix, it does lead to frustrating feeds because baby is not able to get a strong latch on breast or bottle.

What is Tongue Tie?

A tongue-tie (ankyloglossia) is a condition present at birth where the thin piece of tissue (frenulum) under the tongue is unusually short, tight or thick. This restriction can limit tongue movement, sometimes making breastfeeding, bottle-feeding, or later speech more difficult.

Severity varies; some babies have no problems, while others need evaluation by a pediatrician or lactation consultant. Babies with tongue tie are able to drink, but not as efficiently as they could be. They are getting enough milk/formula to keep them interested in feeding and often fall asleep before they are full because they are working so hard to get milk.  Additionally they may take in unnecessary air, due to their limited latch, which causes them to have excess gas and a reflux misdiagnosis.

What are the signs of Tongue-Tie?

If you suspect baby might be tongue-tied, observe how feeding feels and looks. The following signs may suggest a restricted tongue movement:

• Baby’s tongue lifts in a small “hump” instead of cupping around your finger or nipple.
• Baby makes clicking sounds while sucking, or milk dribbles from the corners of the mouth.
• Baby tires easily during feeds, often falling asleep before finishing.
• The nursing parent’s nipples appear sore, creased, or with a red circular spot after feeding.
• When you gently sweep your finger under baby’s tongue, you feel a tight band or bump instead of a smooth surface.

If any of these signs are present, or if feeding remains painful or inefficient despite good positioning, suggest contacting the pediatrician, ENT (ear, nose, and throat specialist), or IBCLC-certified lactation consultant for an assessment. These professionals can evaluate how the frenulum is affecting feeding and recommend next steps.

What’s Posterior Tongue Tie?

Posterior tongue-tie is the most common presentation of  tongue tie, and there are three quick ways to tell if baby is tongue-tied.  If any of the three below is present, ask a pediatrician for an ear, nose & throat referral so the ENT doctor can give baby a proper diagnosis and help.

1. Give baby your pinky and let her suck on the tip to see what her latch looks like.  If the back of her tongue goes up in a little hump, that is indicative of tongue tie.  A proper latch will be tongue enveloping your pinky, where her tongue wraps around the pinky.
2. For breastfeeding moms, examine your nipple- if a red circular spot is present on your nipple, it indicates baby’s tongue is rubbing back and forth in that one area which shows TT.   There is enough milk coming out to keep baby feeding but perhaps not enough to satiate baby.
3. Sweep your pinky under baby’s tongue.  If you feel a bump where the side-to-side sweep is interrupted, that can be indicative of tongue-tie.  If the underside of her tongue is smooth she is not tongue-tied.

Do Preemies Have a Greater Chance of Tongue Tie?

Yes there is evidence that premature babies experience tongue tie at a greater rate than full term babies. However the assessment and interventions are no different and are just as effective. (Wiley)

How is Tongue-Tie Is Treated?

Tongue-tie is treated with a quick procedure called a frenotomy. During a frenotomy, a trained provider snips the tight tissue (the frenulum) under the tongue to improve movement. It usually takes only a few seconds, causes minimal discomfort and babies can feed immediately afterward.

Most mild tongue-ties don’t need treatment though; they’re managed with positioning support, lactation guidance and monitoring feeding and weight gain.

In cases where the frenulum is thicker or extends further back, a frenuloplasty may be done instead. This involves a slightly longer procedure and a few stitches to allow for proper healing.

After either procedure, gentle stretching exercises are sometimes recommended to prevent the tissue from reattaching. This usually means gently sliding a clean finger under the tongue and lifting it toward the roof of the mouth, until you see the diamond-shaped healing area. Many babies feed and latch more easily once the tongue has full range of motion.

Tongue-tie is one of those things in babies that we may not find unless we really look. But once it is corrected baby will nurse and bottle-feed much more efficiently.

For more tips and evidence based info like this, visit Your Newborn and Postpartum Questions Answered: Expert Advice from Let Mommy Sleep