Tongue Tie Symptoms in Babies

The picture on the top left is what everyone pictures when someone says “tongue tie”.  Lingual frenulum attachment at the tip of the tongue and right behind the lower gum ridge. The tongue is U-shaped and you can see it would not be possible to elevate the mid-tongue.  It would be impossible for this baby to move their tongue in the peristaltic motion needed to remove milk. Mom’s nipples would become excoriated almost immediately and she would dread the next feed. The baby would also latch and unlatch with frustration and compensate by “chewing” to remove milk. Feedings take a long time.


Here’s a surprise for you!  The second picture is also a tongue tie but is often missed because the lingual frenulum is not thin and to the tip of the tongue.  Instead, it is fibrous and vascular and the tongue appears cupped.  Latch would be painful and milk transfer would be difficult.  

Symptoms to look for:

Chewing sensation



Dimpling of cheeks

Lipstick-shaped nipple after feed

Long feeds

”Faux” reflux 


When a mom reports any of these to me, I assess the tongue and observe a feed.  As a nurse, I don’t diagnose but I can evaluate and refer based on my findings.

Choose the Prepared Lactation Professional 


Most lactation consultants and pediatricians have varying degrees of experience and training on tongue tie.  Make sure that the lactation consultant that you work with has taken the “Habilitation of the Breastfeeding Dyad: A Master Class”.  Corollary to that, the pediatric dentist should require you to work with a lactation consultant before and after release. 

Besides 10 years of experience, below are 40+ hours of training I have completed:

Tongue Tie: A Modern Breastfeeding Miasma (4 hrs)


Tongue Tie Assessment and Treatment (4 hours)

Untying Ankyloglossia: The Impact on Infants and Children (7 hrs)


Oral Functional Assessment of the Breastfeeding Dyad: Compensation or Competency? (3 hrs)


Tongue Tie, Lip Tie & Tethered Oral Tissue and Infant Feeding (1 hr)


Oral Habilitation of the Breastfeeding Dyad: A Master Class (27 hrs)


More than Reflexes (3 hrs)