All About Tongue Ties
How do I know if my baby has a tongue or lip tie?
Tethered oral tissues (TOTs) are not simply observed, meaning you can’t just see them and determine there is a problem. You have to watch the mouth and tongue in action, ie at the breast or bottle, to assess fully. Lactation consultants talk a lot about “function,” which is how a baby’s mouth works. If a baby’s function is poor, they likely are not feeding well. If the baby’s function is good, they are likely doing just fine with feeding.
What happens after the ties are released?
You will follow up with your lactation consultant, your baby’s bodyworker, and potentially the release provider in the weeks following. This is to ensure appropriate wound healing and management as well as getting the baby back to breastfeeding well.
What are the symptoms of
tongue ties?
There are several symptoms of TOTs. This is by no means an exhaustive list, but here are some common signs:
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- Poor seal at breast, resulting in a ‘click’ or ‘slurp’ sound
- Excessive gas, crying
- Lip blisters
- Bowl-shape or flat tongue when crying
- Leaking milk from sides of mouth
- Choking/sputtering at breast
- Overactive letdown
- Pain with breastfeeds
- “Colic”
This training helps me take a closer look at the whole feeding picture—not just how your baby latches. I can assess how your baby uses their mouth, tongue, face, and body during feeding while also considering milk supply, positioning, and the ways both you and your baby may have adapted to make feeding work.
When challenges are identified, we can create a realistic care plan that fits your baby, your feeding goals, and your everyday life. This may include gentle exercises, changes in positioning, strategies to support sucking and movement, or collaboration with another healthcare provider when additional support may be helpful.
Most importantly, I want you to understand what we’re seeing and why we’re recommending certain steps. You should leave our time together feeling informed, supported, and confident in the plan—not overwhelmed with a long list of things you have to “fix.”
Feeding is about more than a latch. My goal is to look at you and your baby as a team and help make feeding more comfortable, functional, and sustainable for your family.
How are tongue ties treated?
Typically, tongue ties can be released by a pediatric dentist or otolaryngologist (ENT) who specializes in the procedure. The particular tool used varies, but most typically that tool is a CO2 laser or scissors.
I know it sounds scary but most of the time it is a very quick procedure, and you can feed right after!
Where do I start?
Seeing a lactation consultant who specializes in TOTs first (before making an appointment with a release provider) will give you a better understanding of your baby’s function and why they are behaving the way they are. A trained IBCLC will also give you oral function exercises. This will improve your baby’s function, as well as get them prepared for releases. They will also make referrals to preferred bodyworkers (such as a pediatric chiropractor, physical therapist, or occupational therapist) for help with the baby’s tension so that their outcomes are greatly improved. Once your lactation consultant feels the baby is ready, they will refer you to a preferred provider who then evaluates and treats the TOTs.