Understanding Tongue Ties: A Parent's Guide to Oral Ties in Infants
If you're a parent struggling with breastfeeding challenges, fussy feeding sessions, you may have heard the term "tongue tie." Understanding what tongue ties are and how they affect your baby can feel overwhelming, but you're not alone. This guide will help you navigate this journey with clarity and confidence.
Baby with mouth open doing tummy time
What Are Oral Ties?
Tongue tie (ankyloglossia) happens when the thin piece of tissue under the tongue—called the lingual frenulum—is too short, tight, or thick. This restricts how your baby's tongue can move, which can cause real problems with feeding and development.
But tongue ties aren't the only type of oral restriction:
Lip ties restrict the movement of the lips
Cheek ties (buccal ties) limit how the cheeks move
Think of these ties as tethers that prevent your baby's mouth from moving the way it needs to for effective feeding and proper development.
The Whole-Body Connection
Here's something surprising: oral ties don't just affect the mouth. There's a web of connective tissue called fascia that runs throughout our entire body, connecting the tongue all the way down to the toes. When the tongue is restricted, there are usually other tension patterns throughout your baby's body, affecting:
Head and neck position
Body symmetry
Muscle tension
Overall development
Signs Your Baby Might Have an Oral Tie
Baby's Symptoms:
Fussy or colicky behavior
Clicking or smacking sounds while feeding
Frequently popping off the breast or bottle
Shallow latch or "gumming" the nipple
Reflux or excessive hiccups
Poor weight gain or milk loss during feeding
Lip blisters from working so hard to feed
Excessive drooling
Keeping their mouth open often
High or narrow palate shape
Your Symptoms (If Breastfeeding):
Sore, cracked, or damaged nipples
Pain during breastfeeding
Reduced milk supply
Feeling like your baby never fully empties the breast
Whole-Body Signs:
Head preference (always turning to one side)
Torticollis (head tilt or neck tightness)
Difficulty with tummy time
Body appears very tense or very floppy
The Myth of "Early Milestones"
Here's something many parents don't know: meeting developmental milestones too early can actually be a red flag for tension related to oral ties.
If your baby is:
Lifting their head before 2 months (might indicate neck stiffness, not strength)
Rolling over before 4 months (could be from body moving as one rigid unit)
Tightly grasping objects before 3 months (may show difficulty relaxing muscles)
Common Myths Debunked
"Just use a bottle if breastfeeding is hard."
Bottle feeding can be just as difficult and disorganized for babies with oral ties. The issue is how the mouth functions, not just the feeding method.
"If your baby can stick their tongue out, there's no tie."
Tongue movement isn't just about extension. Your baby needs to be able to lift, cup, and move their tongue in multiple directions for effective feeding.
"The tie will stretch on its own."
Unfortunately, this rarely happens. Oral ties are structural restrictions that typically don't resolve without intervention.
"If my baby is gaining weight, why should I worry?"
This is one of the most common myths about tongue ties. Weight gain is important, but it's not the only indicator of healthy feeding. Your baby might be working much harder than they should to eat, and you might be experiencing pain or other challenges that significantly impact your quality of life.
The New Approach to Treatment
Treatment for tongue ties has evolved significantly. The old approach was quick and minimal—a simple snip with little follow-up care. The new paradigm recognizes that optimal results require a comprehensive, team-based approach:
Comprehensive Assessment - A full evaluation of your baby's feeding, body symmetry, and function
Pre-Release Therapy - Preparing your baby's body before any procedure
Surgical Release - A complete release of restricted tissue (often using laser)
Post-Release Therapy - Teaching your baby's muscles how to work properly
Follow-Up Care - Ongoing support to ensure lasting results
Who Can Help?
A team approach provides the best outcomes. Your team might include:
IBCLC (Lactation Consultant) - Feeding assessment and support
Dentist or ENT - Surgical release procedure
Occupational Therapist (OT) - Whole-body and oral motor assessment and treatment
Chiropractor or Bodyworker - Releasing tension patterns
What Is Pre-Release Therapy?
You might be surprised to learn that therapy before a release can significantly improve outcomes. Pre-release therapy helps:
Reduce oral sensitivity and defensive reactions
Increase tongue awareness and control
Maximize existing range of motion
Release facial and body tension
Regulate your baby's nervous system thus help your baby tolerate the procedure better
The Importance of Post-Release Care
After a release, the body naturally wants to heal the wound. Without proper exercises, the tissue can reattach, and you won't see the improvement you're hoping for. Post-release therapy focuses on:
Active wound management - Specific exercises to prevent reattachment
Neuromuscular re-education - Teaching muscles to work in new ways
Functional training - Improving feeding efficiency and oral skills
Frequently Asked Questions
Do we need the release?
This depends on how the oral tie is affecting function and quality of life for both you and your baby. Function matters more than just the presence of a tie.
How long can we wait?
You don't need to feel rushed or pressured. Some families prefer to try conservative treatment first, and that's completely valid.
What happens if we wait?
Compensations can develop, and symptoms may affect feeding, speech development, sleep, and overall body development as your child grows.
Why are we talking about the whole body?
Because oral ties affect the entire body, not just the mouth. The tongue connects through fascia to the whole system, creating tension patterns that impact development.
Moving Forward
If you suspect your baby has an oral tie, start by:
Seek assessment - Find providers who take a comprehensive, functional approach
Build your team - Look for professionals who work collaboratively
Ask questions - A good provider will take time to explain and support you
Trust your instincts - You know your baby best
The goal is always the same: a happy, healthy baby and a feeding relationship that works for both of you.
Finding Support
Look for providers who:
Take a comprehensive approach to assessment
Consider the whole body, not just the mouth
Offer both pre- and post-release therapy
Work as part of a collaborative team
Support your family's goals and concerns