You’re at your baby’s appointment and someone mentions a tongue-tie.
Then another provider says something about a lip tie.
And now you’re home, phone in hand, trying to figure out: Are these the same thing? Does my baby have one or both? And what does any of this mean for feeding?
Mama, I hear you. This is one of the most confusing topics in the newborn feeding world and it’s often explained in medical language that leaves parents with more questions than answers.
So let’s slow down and walk through it together.
What Is a Tongue-Tie?
A tongue-tie: medically called ankyloglossia happens when the piece of tissue under the tongue (called the lingual frenulum) is too short, thick, or tight.
This restricts how freely the tongue can move.
And tongue movement matters a lot for feeding.
When a baby nurses or bottle feeds, they need to use their tongue to:
- Create a seal around the breast or nipple
- Compress and massage to draw out milk
- Move in a wave-like motion from front to back
- Lift, extend, and move laterally
When the frenulum is restricted, some or all of those movements become harder. The baby compensates. And that compensation is often where feeding problems begin.
What Is a Lip Tie?
A lip tie happens when the piece of tissue connecting the upper lip to the gum (called the labial frenulum) is too short or tight preventing the upper lip from flanging outward freely.
During breastfeeding, the upper lip needs to flange (curl outward) to help create a wide, deep latch.
When the lip is tethered too tightly, it may:
- Curl inward or under instead of flanging out
- Make it difficult for baby to maintain a seal
- Contribute to clicking sounds during feeding
- Cause air intake and gassiness
Lip ties are almost always found alongside a tongue-tie not on their own. Which is why they’re often mentioned together.
Lip Tie vs. Tongue Tie: The Key Differences
Here’s a simple way to think about it:
| Tongue-Tie | Lip Tie | |
|---|---|---|
| What’s restricted | Tongue movement | Upper lip movement |
| Frenulum location | Underside of tongue | Inside of upper lip |
| Primary feeding impact | Compression, seal, milk transfer | Latch depth, seal, air intake |
| Found alone? | Yes | Rarely — usually with tongue-tie |
| Diagnosed by | Functional evaluation + anatomy | Visual + functional evaluation |
The most important thing to understand: tongue-tie has a greater impact on feeding than lip tie in most cases. The lip tie matters, but the tongue does the heavy lifting.
How Each One Affects Breastfeeding
How Tongue-Tie Affects Breastfeeding
A tongue-restricted baby often:
- Has a shallow latch
- Slides off the breast repeatedly
- Makes clicking sounds while nursing
- Feeds for a very long time without seeming satisfied
- Causes significant nipple pain or damage for mom
- Falls asleep at the breast quickly, then wakes again soon after
- Has slow or inadequate weight gain
From mom’s side, tongue-tie can cause:
- Cracked, bleeding, or misshapen nipples
- Pain throughout the feed (not just at latch-on)
- Recurring plugged ducts or mastitis
- Decreasing supply over time because the breast isn’t being drained well
How Lip Tie Affects Breastfeeding
A lip-tied baby often:
- Has difficulty flanging the upper lip during nursing
- Creates a shallower latch, drawing in less breast tissue
- Makes clicking or smacking sounds
- Takes in more air, leading to gassiness or reflux symptoms
- Has difficulty maintaining a seal, which can reduce milk transfer
Lip ties on their own may cause milder symptoms. But combined with a tongue-tie, the two together can make feeding much harder.
How Do I Know If My Baby Has One (or Both)?
This is the question I get most often and the honest answer is: you need a functional evaluation, not just a visual one.
Many tongue-ties and lip ties are missed because providers only look at anatomy whether something looks restricted without assessing how the baby actually functions during feeding.
Some signs to watch for at home:
With breastfeeding:
- Feeding is consistently painful for you
- Baby seems to work very hard to eat but tires quickly
- You hear clicking or smacking sounds
- Baby frequently comes off the breast
- Nipples look creased, flattened, or lipstick-shaped after feeds
- Baby is gassy, colicky, or spits up frequently
- Weight gain is slow or a concern
With your baby’s mouth:
- The tongue looks heart-shaped when baby cries
- The tongue doesn’t lift easily to the roof of the mouth
- The upper lip doesn’t flange outward
- You can see a tight or thick band of tissue under the tongue or inside the upper lip
But here’s the thing: a baby can have a significant tie that’s hard to see without proper evaluation. Posterior tongue-ties, in particular, are often missed on a quick visual glance.
“My Pediatrician Looked and Said It Was Fine”
I hear this often, and I want to respond gently.
Pediatricians are wonderful providers who care deeply about your baby. But tongue-tie and lip-tie assessment is a specialized skill and not all providers have the same training in functional oral evaluation.
If your baby is:
- Not gaining weight appropriately
- Causing you significant pain during feeds
- Struggling to feed efficiently
…and you’ve been told everything is fine, it is completely okay to seek a second opinion from someone who specializes in feeding and oral function.
You are not being dramatic. You are advocating for your baby.
Does Every Baby With a Tie Need a Release?
No. And this is important.
Not every tongue-tie or lip-tie causes feeding problems significant enough to require a release.
Some babies feed beautifully even with a tie present. Some respond well to:
- Positioning and latch adjustments
- Oral motor exercises
- Bodywork with a chiropractor or craniosacral therapist
- Feeding therapy support
The goal is never to release a tie just because it’s there. The goal is to understand how the tie is affecting this baby’s feeding and make the best decision from there.
What Happens If a Tie Is Released?
If a release is recommended and you decide to move forward, here’s what to expect:
- The procedure is typically quick — a laser or scissor frenotomy performed by a dentist, ENT, or oral surgeon who specializes in this area
- Aftercare involves stretches to prevent reattachment and oral motor exercises to help baby learn new movement patterns
- Improvement in feeding is not always immediate — baby has to learn a new way of using their tongue and lips
- Support from a lactation consultant and/or feeding therapist before and after the procedure makes a significant difference in outcomes
A release without follow-up support is often where families feel let down. The procedure addresses the structure but baby still needs to learn how to use the new freedom.
What I Look At During a Feeding Evaluation
When I work with a family, I’m looking at the full picture not just anatomy.
I assess:
- How baby positions at the breast
- The quality and depth of the latch
- Tongue movement, elevation, and coordination during feeding
- Lip flange and seal
- Whether baby is effectively transferring milk
- Mom’s comfort and nipple appearance after feeding
- Weight gain history
From there, I can help you understand what’s actually going on and what your options are without pressure, and without guessing.
Your Next Step
If any of this resonates if feeding has been hard, if something just feels off you don’t have to keep wondering.
Getting a feeding evaluation can give you real answers.
Whether it turns out to be a tie, a latch issue, something else entirely, or a combination of factors you deserve clarity. Not just reassurance. Not just “wait and see.”
👉 Book a free consult to talk through what you’re experiencing
👉 Learn more about feeding evaluations and what to expect
Frequently Asked Questions
What’s the difference between a lip tie and a tongue tie?
A tongue-tie restricts the movement of the tongue due to a tight frenulum underneath it. A lip tie restricts how freely the upper lip can flange outward due to a tight frenulum inside the upper lip. Both can affect feeding, but tongue-tie typically has a larger impact on breastfeeding. Lip ties are almost always found alongside a tongue-tie.
Can a baby have both a lip tie and a tongue tie?
Yes — and this is actually very common. Lip ties rarely appear on their own. When a lip tie is present, there’s often a tongue-tie as well. Together, they can compound feeding challenges by making it harder for baby to create a deep latch, maintain a seal, and transfer milk effectively.
How do I know if my baby’s lip tie or tongue tie needs to be released?
Not every tie requires a release. What matters most is how the tie is affecting feeding not just whether it’s present. If baby is gaining weight well, feeding is comfortable for mom, and there are no significant symptoms, many families choose to monitor rather than treat. A functional feeding evaluation with a specialist helps you understand your specific situation before making any decisions.
Will a tongue-tie release fix breastfeeding immediately?
Not always. After a release, baby has to learn new movement patterns and that takes time and practice. Many families notice gradual improvement over days or weeks. Working with a lactation consultant and/or feeding therapist after the procedure is important for getting the most out of the release and supporting baby’s progress.
Is it too late to address a tongue-tie if my baby is older?
No. Tongue-ties can be addressed at any age. Older babies and toddlers may need more post-release support to unlearn compensatory patterns, but it is never “too late” to seek an evaluation. Some families don’t discover the impact of a tie until speech challenges or eating difficulties emerge later in childhood.
You Deserve Real Answers
Feeding your baby is hard enough without being left confused by terminology or dismissed when something feels off.
Whether you’re wondering about a tie, dealing with a painful latch, or just not sure why breastfeeding feels so much harder than you expected I’m here to help you figure it out.
You’re not overthinking this. You’re paying attention. And that matters.
Rooting for you, Bethany
