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Tongue and Lip Tie Resources

Inclusion in this Resource Guide is not an endorsement nor a guarantee of services, products, or information provided by those listed.

What are tongue and lip ties?

We all have frenula. A frenulum is a small piece of tissue that connects soft tissues (tongue, lips, gums, etc.) and helps hold them in place. The problems known as "tongue tie" and "lip tie" occur when these frenula are so tight or thick that they prevent the proper movement of the mouth.

Symptoms may include, but are not limited to:

  • Clicking noises while feeding

  • Tiring during feeding

  • Crying and other signs of distress during or just after a feeding

  • Difficulty latching (“nibbling” at the nipple)

  • Nipple pain and trauma (cracks, bleeding, etc.)

  • Difficulty transferring milk

  • Slow weight gain

  • Decreasing milk supply

Problematic tongue and lip frenula should be assessed by an IBCLC and may be formally diagnosed by a Pediatrician, ENT, or Pediatric Dentist. Assessment and diagnosis must be done in person (not by photos alone) and is based on the restriction of oral motor function. Treatment is typically done by an ENT, Pediatric Dentist, or Oral Surgeon. Always ask if the medical professional has training and experience specific to lactation and tongue ties.

An anterior tongue tie means that the part of the tongue in the front of the mouth is not free to move normally​. This means that the tip of tongue may not be able to reach the roof of the mouth or outside the lips.

A posterior tongue tie means that the part of the tongue that is towards the back of the mouth is not free to move normally. This means that the length of the tongue may not be able to form a good vacuum for safe and effective sucking and swallowing of milk or other foods.

An upper lip tie means that the upper lip is not free to move normally. This means that the lips may not form an effective seal for effective sucking.

A lower lip tie means that the lower lip is not free to move normally. This is not typically diagnosed as a problem, however, it may impact the effectiveness of a lip seal for sucking and could contribute to collection of food or saliva.

The anterior tongue tie and upper lip ties can often be clipped by a trained professional with a pair of surgical scissors. No anesthesia is needed and administration of anesthesia might prevent baby from being able to feed safely until it wears off.

You can expect that there will be some initial screaming (mostly due to discomfort with objects & fingers in the mouth). Also expect there to be some bleeding. This usually stops on it’s own once baby begins feeding. You should be able to feel a difference in the latch right away, but it takes time and practice for baby to fully adjust to the greater range of motion. Ask for post-procedure care instruction and stretching exercises.

A posterior tongue tie should be addressed by a medical professional with surgical training specific to tongue ties. Since this is a surgical procedure, anesthesia is usually administered. You can expect to have 2-3 visits to the medical practice treating a posterior tongue tie. The first appointment is usually a consultation during which the appropriate diagnosis will be confirmed and the procedure will be discussed. The second visit is often when the procedure occurs. This may take place at the same office as the first visit or at an outpatient surgical center. The actual surgery may be done with a scalpel or with a laser. Ask for post-procedure care instruction and stretching exercises.

Some practices require a third visit to check on the healing of the incision and the function of the mouth, while other practices use phone calls, emailed photographs, and communication with a local provider (IBCLC, Pediatrician, etc.) for follow up.

This is a great resource for understanding lip and tongue ties (Not affiliated with LVBC.)

You may be interested in joining this Facebook support group (Not affiliated with LVBC.)

Remember: Assessment of frenula and diagnosis of tongue tie or lip tie must be done in person (not by photos alone) and is based on the restriction of oral motor function.

The following are links to medical professionals who evaluate and treat Tongue Ties in Infants. LVBC has no affiliation with these practices and their inclusion here does NOT represent an endorsement of their services. ALWAYS ask questions before choosing a medical professional to diagnose and treat your child. Your Pediatrician or IBCLC may have recommendations on additional providers.

Lehigh Valley Breastfeeding Center

1517 Pond Road
Allentown, PA 18104

Mt Airy Children's Dental Associates
602 Center St #203, Mt Airy, MD 21771
(301) 829-6588

Dr. Lawrence A. Kotlow, DDS, PC

340 Fuller Rd, Albany, NY 12203
(518) 489-2571

Paul A Bahn III DDS, Pediatric Dental Associates

6404 Roosevelt Blvd #2, Philadelphia, PA 19149
(215) 743-3700

Gina Tanios-Rafla, DMD

646 NJ-18 #114, East Brunswick, NJ 08816
(732) 238-1760

Dr. Naomi Hillel, Growing Faces Pediatric Dentistry

799 Amboy Ave, Edison, NJ 08837
(732) 375-1000