Does My Baby Have A tongue-tie?
Maybe a nurse in the hospital mentioned the possibility of a tongue-tie.
Maybe a friend or family member pointed it out.
Or perhaps you’ve noticed a tight string-like tissue under your baby’s tongue and are wondering if it is significant.
If you’re feeling unsure, you’re not alone. Navigating the world of tongue-tie can feel confusing—and often overwhelming. No parent wants to feel like they are rushing their baby into a procedure without fully understanding whether it is truly needed.
It’s also important to know: not all tongue-ties require a tongue-tie release, and many feeding challenges can improve with the right support.
So where do I start?
Feeding challenges—whether at the breast or bottle—can have many causes, and a tongue-tie is only one possibility.
Tongue-tie (also called ankyloglossia) refers to a variation in the tissue under the tongue. In some babies, this tissue may restrict tongue movement, but whether it impacts feeding depends on function rather than appearance alone.
The first step is often a feeding assessment with a lactation consultant.
An International Board Certified Lactation Consultant (IBCLC) is trained to assess feeding holistically and support improvements before considering further intervention.
For example, nipple pain and damage may be associated with a restricted tongue, but may also result from a shallow latch or positioning challenges. Working on latch and feeding mechanics first often leads to meaningful improvement in comfort and effectiveness.
In bottle-fed babies, concerns may present differently. Some infants make a repeated “clicking” sound while sucking and swallowing. This can occur when there is a repeated loss of seal around the bottle nipple. While this may be associated with a restricted tongue, it can also relate to nipple shape or flow rate that is not well matched to the baby’s feeding pattern.
These variations highlight why a full feeding assessment is important, as similar symptoms can have more than one underlying cause.
What is assessed during a feeding evaluation?
As part of a feeding assessment, lactation consultants may also evaluate oral anatomy. All babies have a frenulum—the tissue connecting the underside of the tongue to the floor of the mouth. What matters is not its presence, but whether it restricts tongue movement in a way that impacts feeding.
This may include observing how the tongue moves and functions, including:
Lifting (elevating) the tongue
Extending the tongue
Cupping and coordinating movements needed for effective feeding
These observations are considered alongside a breast or bottle feeding session to build a complete picture of how your baby is feeding and identify where support may be needed.
While a lactation consultant cannot diagnose tongue-tie, they can assess how oral function is impacting feeding and support families in deciding next steps.
Possible next steps
These may include:
Optimizing milk supply and feeding in the lead-up to a tongue-tie release
Preparing you for what to expect if a tongue-tie release is recommended
Supporting and helping to strengthen the feeding relationship between parent and baby
Referring to appropriate healthcare providers for a tongue-tie release, when indicated
What about bodywork or other therapies?
Some families may explore additional support from professionals such as physiotherapists, chiropractors, or speech-language pathologists.
Some infants develop tension patterns or movement preferences when tongue mobility is restricted. This may present as a consistent head-turn preference, stiffness, or frequent arching during feeds.
A lactation consultant can help identify these patterns and discuss whether additional support may be helpful. Physiotherapists and chiropractors with experience working with infants may support assessment and management of musculoskeletal tension patterns, while speech-language pathologists with infant feeding experience may assist with oral-motor and feeding-related concerns.
When should I seek support?
A feeding assessment may be helpful if you are experiencing:
Nipple pain and damage
Difficulty achieving or maintaining a latch
Clicking, leaking, or slipping during feeds
Long, frequent, or very tiring feeds
A fussy baby with frequent gas pain, discomfort during or after feeds, or unsettled behaviour that seems feeding-related
Concerns about weight gain
A sense that feeding does not feel right
What if my baby already had a tongue-tie release?
Follow-up support is just as important as the procedure itself.
Babies often need time and guidance to adapt to new tongue movement patterns after a tongue-tie release. Lactation support can help ensure feeding becomes more comfortable, effective, and sustainable for both baby and parent.
In some cases, families notice that feeding challenges persist after a tongue-tie release. This may be related to ongoing oral function patterns, healing and adaptation after the procedure, or residual restriction in tongue movement. A lactation consultant can reassess how well the tongue is moving and whether it is functioning freely during feeding, and help determine what additional support may be helpful.
A team-based approach
Ideally, the healthcare provider performing a tongue-tie release will either be an IBCLC in addition to their primary designation, or will refer you to an IBCLC. This helps ensure families receive comprehensive, evidence-informed care before and after the procedure.
If a referral is not provided, families are welcome to self-refer to a private IBCLC for feeding support. In Alberta, lactation consultants commonly work in private practice and can be accessed directly without a physician referral.
About Oral Function Assessment
Assessment of both the appearance and function of the tongue requires additional, specialized training that not all lactation consultants have. Some IBCLCs pursue further education in oral function assessment to better support families navigating concerns such as tongue-tie.
Jenn has completed additional training in oral function assessment and is able to assess both the appearance of your baby’s oral structures and the function of their suck. This provides a more complete understanding of how tongue movement may be impacting feeding.
As an IBCLC with this additional training, Jenn integrates oral function assessment into a full feeding evaluation and supports families in determining appropriate next steps within her scope of practice.