Tongue Tie in Babies: When Does It Actually Need Treatment? (A Lactation Consultant’s Perspective)
- shaleebuxton
- Mar 25
- 3 min read
If you’ve recently been told your baby might have a tongue tie, you’re definitely not alone.
As a lactation consultant, assessing tongue tie in babies is something I do often, and it’s also something that can come with a lot of confusion, conflicting advice, and sometimes pressure to act quickly.
I’ve also been on the other side of this.
My own son had a tongue tie, and like many families, we experienced our fair share of feeding challenges early on. That experience is a big part of why I’m so passionate about helping parents navigate this space with clear, balanced, and evidence-based support.
So let’s break it down.
What is a tongue tie?
A tongue tie (ankyloglossia) is when the thin piece of tissue under your baby’s tongue (the frenulum) is tighter, shorter, or less flexible than usual.
But here’s the key point:
👉 Not all tongue ties cause breastfeeding problems.
Many babies have a visible frenulum and feed completely well, with no pain, no supply issues, and no need for treatment.
It’s not about how it looks, it’s about how it functions
One of the biggest misconceptions around tongue tie diagnosis is that it’s based on appearance alone.
In reality, what matters most is:
- how your baby moves their tongue
- how effectively they transfer milk
- how feeding feels for you
You can have:
- a very obvious-looking tie with no feeding issues
- a subtle tongue restriction that significantly impacts breastfeeding
This is why a functional feeding assessment with a qualified professional is so important.
Signs a tongue tie may be affecting breastfeeding
Not every feeding challenge is caused by a tongue tie, but some common signs include:
- ongoing nipple pain or damage
- clicking sounds during breastfeeding
- baby slipping on and off the breast
- long, unsettled or very frequent feeds
- poor weight gain or slow milk transfer
- reflux-like symptoms or excessive wind
If you’re noticing these, it doesn’t automatically mean your baby needs a tongue tie release, but it does mean feeding is worth assessing more closely.
When does a tongue tie actually need treatment?
A tongue tie release (frenotomy) is usually only recommended when:
✔️ there are ongoing breastfeeding or bottle-feeding difficulties
✔️ challenges persist despite skilled lactation support
✔️ the tongue restriction is clearly impacting function
In other words:
👉 We treat symptoms, not just anatomy.
What does tongue tie treatment involve?
A frenotomy for tongue tie is a quick procedure that releases the restrictive tissue using scissors or a laser.
However, it’s not an instant fix.
Support before and after the procedure is essential to:
- improve latch and positioning
- support effective milk transfer
- help your baby learn new tongue movements
- protect your milk supply
When treatment may not be needed
Sometimes, a tongue tie is present but:
- breastfeeding is comfortable
- baby is gaining weight well
- milk transfer is effective
In these cases, no intervention may be needed, just reassurance and ongoing support if anything changes.
What to do if you’ve been told your baby has a tongue tie
If you’re feeling unsure, the best next step is a comprehensive breastfeeding assessment.
This should look at:
- latch and positioning
- milk transfer
- oral function
- your feeding goals
From there, you can make an informed decision about whether treatment is necessary, without pressure or fear-based advice.
Final thoughts from a lactation consultant (and a mum)
Tongue ties can absolutely impact breastfeeding, I’ve seen it professionally, and I’ve lived it personally.
But they’re also not always the cause of every feeding challenge.
Taking a calm, functional, and whole-picture approach ensures that if a tongue tie procedure is recommended, it’s truly needed and supportive for both you and your baby.
If you’re in Perth and wondering whether a tongue tie is affecting your baby’s feeding, please feel free to reach out and we can work together to help you get clear answers and a plan that feels right for you.
You don’t have to figure it out on your own
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