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Could my baby be tongue-tied?

Updated: Feb 23, 2023

a baby wearing white pajamas smiling in front of a lady wearing gray top who's about to carry her

Many parents have heard about breastfeeding difficulties associated with tongue-tie (or other Tethered Oral Tissues/TOTs). I bet many of you have heard first-hand stories... about pain, misdiagnosed, or over-diagnosed babies. Tongue tie is a popular hot topic with breastfeeding these days. Although a tongue tie, lip tie, or buccal/cheek tie (oral restrictions, TOTs) can cause breastfeeding issues, it is not always the cause of the problem. Sometimes the struggle is from a low supply, uncoordinated suck, or poor latch and positioning. And there are other things to consider and assess for, like high palate (roof of the mouth), hyperactive gag reflex, muscle tension, structure, and more. A tongue tie or other TOTs may cause breastfeeding difficulties, OR it may not. It is important to have breastfeeding assessed and the baby’s oral function evaluated to see if the baby is able to drink and move their tongue properly. IBCLC Lactation Consultants have been trained to assess oral functioning and then can refer for further evaluation. Most often if a referral is given, it is to a pediatric dentist who is skilled in working with mouths and in TOTs revision by laser or scissors. The tongue is important for many things in life like eating, drinking, coordinating swallows, talking, and breastfeeding. As IBCLC lactation consultants, our job is to assess oral functioning, develop a plan that helps you reach your goals, and support you along the way. We are here for families every step along the breastfeeding journey. The journey isn’t always an easy one, but can be very rewarding, and oftentimes with great outcomes for both mom and baby.

If you think your baby may have a tongue tie or other restriction, you may want to consider..

Does your baby have..?

GOOD tongue motions:

· Extension- Sticks their tongue out

· Lateralization- Moves their tongue side to side

· Elevation- Lifts their tongue up to the roof of their mouth

· Suction- Can suck and PULL finger or nipple into the back of their mouth with a TUG motion

Some signs and symptoms of TOTs may be:

· Pain with breastfeeding despite good latch and positioning

· Low milk supply (due to feeding and removal issues)

· Unable to sustain a good, deep latch (with or without a nipple shield), leaking milk

· Baby makes noises, besides swallowing, while breastfeeding (clicking, smacking..)

· Uncoordinated suck- biting or chewing motion

· Long feedings, and not just occasionally, but most of the time (longer than 40 minutes)

· Very frequent feedings

· Slow weight gain

· If taking a bottle, baby may leak, choke, or make clicking or smacking noises

· Refusing to take a bottle or pacifier

Please reach out if you have questions, concerns, or want to talk more.

Another helpful resource with photos:

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