Infant tongue ties affect about 5% of newborns and about 11% of infants are born with lip ties. Here we’ll discuss how to spot them, what the difference is, and how it effects breastfeeding versus bottle feeding. In addition, I will make sure you know your resources to reach out for help and what can be done for children with these conditions.

Infant Tongue Tie

A tongue tie is when the tongue’s range of motion is restricted due to the membrane (lingual frenulum) connecting the tongue to the floor of the mouth. This is because this membrane is born short, tight or thicker than normal, making it difficult for the tongue to move normally. Did you know that a tongue tie is more common in boys than girls? It can also sometimes run in families.


  • Your baby may have difficulty sticking out her tongue or lifting the tongue to the roof of her mouth.
  • She may have a notched shape or heart notched shaped tongue due to being tethered at the bottom. However, you may not spot any symptoms at all by simply looking at her.


So, I how would I know if there’s a problem? While tongue ties can affect bottle feeding, the bigger issue is breastfeeding.

With a proper deep latch baby’s tongue will slide over the gums while compressing your milk ducts, thereby “milking the breast” and releasing milk into your baby’s mouth. This should result in Mom not feeling any pain.

In the case where baby is tongue tied, baby is forced to make a chewing motion as she struggles to get a deep latch.  This results in nipple pain for Mom, and poor milk release for baby.  In turn, this interferes with baby’s ability to be properly nourished and could cause failure to thrive, as well as Mom’s milk supply to suffer.

Bottle Feeding

Below is a series of symptoms that may point to your infant’s tongue tie when bottle feeding for your baby.

  • Difficulty feeding
  • Slow or struggling to gain weight
  • Overly long feedings without being satisfied or settled
  • Chokes on feeds
  • Needs a very slow flow nipple without growing to the next level
  • Dribbling milk out of her mouth
  • Pushing the bottle teat out

What can be done?

If treatment is necessary for your infant’s tongue tie, your baby can have a procedure called a frenotomy to assist your baby in feeding and weight gain. This is carried out by specially trained doctors, nurses or midwives. It is a very quick procedure (just a few seconds) and generally no anesthetic is used.

The procedure involves snipping the short, tight piece of skin connecting the underside of the tongue to the floor of the mouth. As soon as it’s done, you can feed your baby (which helps to heal any bleeding). For some babies there will be a short period of “physical therapy” to help stretch and heal the tissues.

Lip Ties in Newborns

A lip tie is when the skin that attaches the upper lip to the gums is too short, thick or stiff, restricting range of motion in the upper lip. Like a tongue tie, a lip tie may cause problems feeding. Look out for:

  • Baby struggling to feed
  • Milk dribbling out of baby’s mouth
  • Unsatisfied feeds
  • Constantly hungry even after a feeding
  • Colic
  • Poor weight gain
  • Poor milk production


During breastfeeding a baby’s mouth is opened wide with the top lip flanged on the breast.  The shorter and tighter the frenulum is, the more difficult and uncomfortable it is for baby to keep her lip flanged or stay on the breast at all.

Bottle Feeding

Similar to breastfeeding, baby’s mouth and lip positioning is crucial for the most effective bottle feeding experience.  When bottle feeding, it is possible for baby to not be able to make a proper seal around the nipple of the bottle to milk it like a “teat.”  Because of this, she may not be able to drink enough and constantly fight against the issue of milk escaping while feeding.

What can be done?

Lip ties can improve on their own as a child grows. It is important to know that there are no peer-reviewed studies showing that surgery of dividing an ULT (upper lip tie) is effective. However, there have been some cases of improved feedings from the procedure. Talk to your pediatrician if this is a continued concern.

We at Boston Baby Nurse & Nanny have lactation specialists that are trained not only in ways of helping you breastfeed, optimize your bottle feeding, but knowing what to look for when it comes to infant tongue ties and lip ties. We can recommend specialists in the area for you to talk to and see what is best for your baby. Reach out to our Certified Lactation Specialists today or call 781-444-4063.

About The Author

Nancy Infant Massage InstructorNancy M. has worked with children for over 25 years, with all ages and stages. She has been a Nursery/Pre-school teacher, an international and domestic travel as well as live-in Nanny, and House Manager. Nancy is an Advanced Newborn Care Expert, Certified Lactation Counselor, Postpartum Doula, and Certified Infant Massage Instructor. She is Mom to one daughter and volunteer foster Mom at her local animal shelter.