Tongue Ties in Babies: What to look for, how they affect feeding and who can help

When to suspect your baby has a tongue tie

Are you struggling with breastfeeding? You've tried different positions and worked on latching, but your nipples feel raw and damaged after every feed. Or maybe you're bottle feeding, but your baby gulps air, fusses, or tires before finishing — and something just doesn't feel right.

If any of this sounds familiar, you're not alone.

One of the most common (and often missed) reasons babies struggle to feed is a tongue tie. As osteopaths we regularly see babies with tongue ties and we're here to help you work out what's going on and what to do next.

But first, what is a tongue tie?

A tongue tie occurs when the thin piece of tissue under your baby's tongue (known as the frenulum) is shorter, thicker or tighter than usual. This tension can restrict how well the tongue moves, particularly its ability to lift or extend.

How does a tongue tie affect feeding?

To breast-feed (or bottle feed) well, a baby needs to be able to open their mouth wide, draw the breast deep into the mouth, and use their tongue to create a strong, sustained seal around the breast. This allows them to compress and release the breast in a rhythmic wave to draw out milk.

When a baby has a tongue tie the tongue is pulled down to the floor of the mouth by the frenulum. This tension restricts how freely the tongue can move, meaning instead of cupping the breast and sucking in a smooth, rhythmic way, the baby has to create the seal around the breast in another way.

Babies with tongue ties may chew the breast rather than suck, make clicking sounds, slip off the nipple repeatedly, or clamp down to maintain the latch. And for babies, feeding like this is exhausting! They may feed for long stretches but still seem unsatisfied, take in excess air which can lead to tummy discomfort, or simply give up before they've had enough.

For mums who are trying to breast-feed, tongue ties often lead to nipple pain, damage to the nipple, and incomplete breast drainage — which may lead to supply concerns, blocked ducts, or mastitis. It can feel too much when you're sleep deprived, and then there's the guilt of not being able to breast-feed that we see so many of our mums contend with.

With the right support, tongue ties can be managed well. If you're trying to breast-feed, know that many of the mums we see had a difficult start, but they successfully breast-fed their babies until they were ready to stop. If your baby bottle feeds or mixed feeds, we find that many of the same struggles apply — the clicking, the gulping, the wind, the fussiness — and that babies respond just as well to support, regardless of how they're being fed.

Types of tongue ties

Not all tongue ties look the same; the frenulum can be attached to different parts of the tongue, sometimes making tongue ties difficult to identify, particularly when a baby is very young. If you feel like the symptoms indicate your baby might have a tongue tie, it's worth getting a second opinion. There are two main types of tongue tie:

Anterior Tongue Tie

The tie is located towards the front of the tongue, is often more visible and easier to diagnose, and the tongue may appear heart-shaped when lifted.

Posterior Tongue Tie

The tie is located deeper under the tongue, closer to the base, is less visible and often missed on quick examination. The tongue may look normal but lacks proper mobility.

Signs to watch for if you suspect a tongue tie

Tongue ties can present differently in every baby, but there are a number of common feeding, behavioural and physical signs.

Feeding Difficulties

• Trouble latching or staying latched

• Frequently slipping off the breast

• Clicking sounds while feeding

• Feeding for long periods but still seeming unsettled

• Falling asleep quickly during feeds (baby finds feeding exhausting)

Digestive or Behavioural Signs

• Excessive wind or gassiness

• Reflux-like symptoms (arching backwards, discomfort after feeds, excessive crying)

• Hiccups frequently

• Irritability or fussiness, especially during or after feeds

Physical Signs

• Limited tongue movement: your baby can't stick their tongue out far and the tongue doesn't lift well

• Tongue appears heart-shaped

• Preference for one side during feeding

• Blisters on the baby's lip

Signs you might notice as a breastfeeding mum

• Painful breastfeeding (beyond normal tenderness and ongoing)

• Cracked or damaged nipples

• Blisters on or around the nipple

• Recurrent blocked ducts or mastitis

• Lipstick-shaped nipples after feeds

• Feeling like your baby is "chewing" or "clamping down" rather than sucking

Why early identification of tongue ties matters

When feeding is hard work, babies are remarkably resourceful — they'll find a way. But when a tongue tie is limiting what the tongue can do, that often means your baby will use other muscles to compensate. The jaw works harder, the lips grip tighter, and the neck and shoulders brace in ways they shouldn't have to during a feed.

In the short term this might look like a baby who manages to feed — just. But underneath, feeds are less efficient, more air is being swallowed, and tension can start to build through the neck and jaw. If left unaddressed, these patterns may contribute to ongoing feeding challenges and may contribute to general discomfort and fussiness in your baby.

Early support matters. The sooner a tongue tie is identified and addressed, the less time your baby has to develop compensatory habits — which means a smoother path to more comfortable, effective feeding for both of you.

What to do if you suspect a tongue tie

If something feels off, trust that instinct — you know your baby better than anyone. As osteopaths with a specialist interest in newborn and infant care, we can assess your baby, talk through what you're experiencing, and help you build a clearer picture of what's going on. We can also work alongside any other professionals you may already be seeing.

Tongue tie rarely exists in isolation. We often work alongside lactation consultants, who can support you with feeding and latching techniques, and where a release procedure is recommended, we can refer you to or liaise with a dentist or oral health professional who focuses in this area. Together, this team approach gives your baby — and you — the best chance of a smoother feeding journey.

If you're not sure whether what you're experiencing is tongue tie related, that's okay too. Come and talk to us, we'd love to support you and your baby.

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, osteopathy, nursing or other professional health care services, including the giving of medical advice, and no practitioner/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.