Understanding the Impact of Tongue Ties on Breastfeeding Quality

Starting the breastfeeding journey as a new mom can be a bit overwhelming. There is often an expectation that both you and your baby will effortlessly get the hang of it. In reality breastfeeding typically involves a learning curve – especially if a tongue tie is involved! Every mom-baby duo has their unique breastfeeding experience, and it is completely normal if it feels like a bit of a challenge at first. Breastfeeding is a complex process with many components. Each baby brings their own uniqueness through their personality and anatomy. While we often talk about the importance of supply and demand with breastfeeding, it’s equally important to understand how the quality of your baby’s suck shapes the breastfeeding journey and how a tongue tie might impact this experience. 

baby breastfeeding

The Importance of Baby’s Tongue in Breastfeeding

Breast milk supply is closely linked to your baby’s ability to stimulate the breast tissue and nipple. This stimulation triggers the release of hormones such as prolactin and oxytocin, responsible for milk production and the letdown reflex. Achieving a deep latch is key to this process. Your baby’s tongue is crucial in achieving this deep latch. It moves up and down, under the nipple in a smooth, motion. However, if a baby’s tongue is restricted, this up and down motion is impeded. This can lead to insufficient stimulation and potential issues like sore nipples, damage, and even decreased milk supply.

crying baby, showing tongue

Understanding Tongue Ties

Tongue ties, classified into 4 stages, can significantly impact the breastfeeding relationship. Typically stage one ties are visible and easier to diagnose. Stage four tongue ties are usually posterior or hidden beneath baby’s mucosa. These “posterior tongue ties” usually require a professional assessment as many times they are felt and not seen. It’s important to recognize that breastfeeding challenges arising from tongue ties can manifest immediately or possibly even weeks or months after the initiation of breastfeeding.

Tongue Tie Assessment and Support

During a visit to the doctor or a home visit, healthcare professionals or trained specialists can assess your baby’s mouth for tongue and lip ties. They should also offer a feeding assessment to give insights into how these may be affecting your breastfeeding relationship. The goal is not only to diagnose but also to educate on the potential impact of tongue ties. Persistent pain and discomfort during breastfeeding are not normal, and seeking help can lead to a more positive experience for both mom and baby.

mom comforting crying baby looking in mouth for tongue tie

Symptoms of Tongue Ties

Recognizing the symptoms of tongue ties is crucial for early intervention. You or your little one may experience one of these symptoms, all of these symptoms, or something in between. Ultimately the main consideration should be how the tongue tie is affecting both you and baby overall. These symptoms may include:

  • If your nipple looks “lipstick-shaped” after nursing — this could indicate a tongue tie.
  • Your child may latch onto your nipple vs. your breast. They may “gum” or chew it, causing severe pain and breakdown of the nipple.
  • Nipple damage can present as cracking, distortion, blanching, or bleeding from the nipple. Sometimes damage may be followed by an infection or in severe cases, inflammatory mastitis.
  • A tongue-tied infant may not be able to lift their tongue when crying –it may look curved or only lift slightly.
  • Tongue-tied infants may not be able to make a good seal around the breast. This may lead to noisy feeding or clicking, and milk dribbling from their mouth when sucking.
  • These infants may be gassy — often they do not have an effective seal at the breast and suck in lots of air while feeding.
  • Milk supply may drop as the breast is not being efficiently emptied and the nipple is not being effectively stimulated.
  • Tongue-tied infants can often present fussy (hungry) due to ineffective feeds. Theey may also have sleep issues, vomiting, reflux, and could have incessant crying.
  • Infants with a tongue tie can either feed frequently for short periods and fall asleep, or fuss and the feeds can take hours without the infant ever appearing satisfied.
mom with baby assessing for tongue tie

Debunking Tongue Tie Misconceptions

Tongue ties have been a common discussion as long as breastfeeding has been occurring. There was a time when formula was the primary choice of nourishment for baby’s and the talk of tongue ties faded away. That being said, over the last 50 years breastfeeding has reemerged. This means the topic of tongue ties has also come back into the spotlight. While some consider tongue ties as trends or fads, evidence-based studies emphasize their legitimacy as potential issues affecting breastfeeding and potentially even causing moms to end breastfeeding early.

Your Experience Matters in Treatment

Unfortunately due to many of the different opinions on tongue ties and their impact on breastfeeding it is common for many women to feel as though their experience is being brushed off. The impact of tongue ties extends past just the physiological complications and also involves significant mental health impacts on moms. Fortunately, tongue ties can be swiftly corrected by providers who emphasize the importance of listening to a mom’s experience. The method of revision depends on the severity of the tie. If the provider and mom decide on a frenectomy- rest assured that it’s typically a quick process that doesn’t involve medication. This procedure often provides fairly quick relief for both mom and baby.

Mom with baby in close embrace

Trusting Your Instincts

The bottom line is simple: if something feels off during breastfeeding, whether it’s pain, slow weight gain, or persistent fussiness, there’s a reason. Trusting your instincts and seeking professional help can lead to solutions–even if not instantly. These solutions can prevent prolonged discomfort and potential challenges in the breastfeeding relationship. Remember that there are providers available who will listen to you and it is ok to get a second- or third opinion. We have a global team of RN’s IBCLC’s and NP’s who would love to help you and your baby, you can find the closest one to you here.

As always, I am sending you so much love and support.

Carrie Bruno RN, IBCLC, MSCP


Merritt, L. S. (2019). The effect of tongue-tie and lip-tie on breastfeeding. The Journal for Nurse Practitioners, 15(5), 356–360. https://doi.org/10.1016/j.nurpra.2019.02.021
P;, S. L. R. M. (n.d.). Prevalence, diagnosis, and treatment of ANKYLOGLOSSIA: Methodologic Review. Canadian family physician Medecin de famille canadien. https://pubmed.ncbi.nlm.nih.gov/17872781/
Shekher, R., Lin, L., Zhang, R., Hoppe, I. C., Taylor, J. A., Bartlett, S. P., & Swanson, J. W. (2021). How to treat a tongue-tie: An evidence-based algorithm of care. Plastic and Reconstructive Surgery – Global Open, 9(1). https://doi.org/10.1097/gox.0000000000003336
Tongue-tie (ankyloglossia). Johns Hopkins Medicine. (2022, April 12). https://www.hopkinsmedicine.org/health/conditions-and-diseases/tongue-tie-ankyloglossia
Waterman, J., Lee, T., Etchegary, H., Drover, A., & Twells, L. (2020). Mothers’ experiences of breastfeeding a child with tongue‐tie. Maternal & Child Nutrition, 17(2). https://doi.org/10.1111/mcn.13115


Need Support?

Find Us Elsewhere

The Mama Coach- Content Campaign-18

About Us

The Mama Coach is a global team of Registered Nurses and Nurse Practitioners.

Our mission is to guide families through every stage of their parenting journey by providing evidence-informed education infused with non-judgmental support, compassion, and empathy.