For so many new moms, latch issues can feel overwhelming — and when “tongue tie” enters the conversation, the advice online can get confusing fast. To help cut through the noise, we sat down with a pediatric nurse and lactation expert to talk about what tongue tie really is, when a procedure is (and isn’t) necessary, how to choose the right specialist, and what the latest research says about post‑procedure stretching.
Tongue Ties, Lip Ties & Feeding Challenges: What Parents Need to Know
Tongue ties, lip ties, and other buccal ties can affect breastfeeding — and even bottle feeding — but not all ties cause problems, and not all require immediate treatment. Some ties benefit from being released shortly after birth, while others may never need intervention at all.
So how is a parent supposed to know what they’re dealing with and what the right treatment plan is? Your baby’s primary care provider and your lactation consultant are the best starting points. If you’re concerned, talk with them first.
Below, our expert, Linda Hanna (RNC, MSN/Ed., IBCLC), answers common questions parents ask when navigating tongue ties and latch challenges.
Understanding Tongue Tie
What are the signs that a tongue tie might be part of the issue?
Latching can be genuinely hard — and it often catches parents off guard, especially when reality looks nothing like those serene videos online. If something feels off, it’s worth slowing down and taking a closer look at what might be getting in the way.
One thing that sometimes flies under the radar is how well a baby can actually move their tongue. If tongue mobility is limited, milk removal can suffer — and so can you.
Some things to watch for:
- Nipple pain that lingers during or after feeds
- Nipples that come out looking flattened, creased, or pale
- Baby’s tongue is staying put instead of extending over the lower lip or gum
- A clicking sound while nursing
- A latch that stays shallow no matter how many times you reposition
Seeing a few of these doesn’t mean your baby definitely has a tongue tie, but it does mean it’s worth getting a proper look from someone trained in oral assessments. Trust your gut. If something doesn’t feel right, it probably deserves attention.
Are there specific feeding behaviors or symptoms that should prompt an evaluation?
Yes. Sometimes, the way a baby feeds can give clues that they may not be getting milk as easily as they should.
You might notice things like your baby latching and unlatching over and over during a feeding. Some babies fuss, twist, or pull away from the breast. Others spend a long time feeding but still seem hungry afterward. In some cases, babies feed very often but are not gaining much weight.
You may also hear clicking sounds while they suck. Some babies seem especially gassy or uncomfortable after feeds and may look bloated.
At times, a baby can look like they are sucking and swallowing well, but they are not actually transferring enough milk to feel full. When that happens, they may want to feed again soon after what seemed like a full feeding.
If the latch is shallow, babies can also take in extra air while feeding. This can lead to gas and discomfort. You might see your baby arch their back, squirm, or pull their legs up as they try to relieve the pressure.
If these patterns keep happening, it can be helpful to have a lactation consultant or pediatric provider take a closer look. Someone trained in infant feeding and oral function can help figure out whether tongue movement or another issue might be playing a role.
When a Procedure Is (and Isn’t) Necessary
In your clinical experience, when is a tongue‑tie release truly needed?
As lactation consultants, we don’t actually diagnose tongue tie. An evaluation and diagnosis must be made by a clinician trained in infant oral anatomy.
But once a tongue tie has been identified, the decision to release should be based on function instead of only the presence of a band of tissue.
If the feeding parent is not experiencing pain, nipple trauma, or milk supply concerns, and the baby is latching well, gaining weight appropriately, and feeding without significant discomfort or behavioral issues, a release may not really be necessary!
In these situations, working with the mom and baby to ensure a consistently deep, pain-free latch is usually the best thing to do.
However, if there is persistent nipple pain, visible nipple compression, poor milk transfer, weight concerns, or feeding behaviors that suggest ineffective latch, a release may be recommended to improve tongue mobility and overall feeding function.
The goal is not simply to “clip a tie,” but to improve feeding mechanics, milk transfer, and the experience for both parent and baby.
Are there situations where latch issues can be resolved without a procedure?
Yes. Some babies have a visible frenulum and are still able to nurse well. They latch comfortably, transfer milk effectively, and the feeding parent has no pain. In those cases, the tissue may not actually be restrictive, and it can often be left alone.
When things are going well, the best plan is usually simple monitoring with the baby’s provider to make sure feeding and growth continue to stay on track.
There are also times when feeding challenges improve with small adjustments. Changes in positioning, gentle bodywork, oral exercises, or simply giving a baby time to grow and mature can make a big difference.
Some families also choose to try exercises that support tongue and oral movement before thinking about a procedure. If that route is taken, those exercises must be guided by a trained provider so they are safe and appropriate.
A release is not always the first step, and it is not always necessary. Each situation is different, and the decision should be based on how feeding is actually functioning and what feels right for the family.
Choosing the Right Specialist
When seeking an evaluation, how should parents decide between an ENT, a pediatric dentist, or another specialist?
Choosing the right provider is such an important part of this process. Parents should feel comfortable and confident that the person evaluating their baby is recommending a procedure only if it truly benefits the child.
Many families are connected with a specialist through a referral from their pediatrician or primary care provider.
A pediatric dentist has specialized training in the oral anatomy of infants and children. They are experienced in evaluating the tissues under the tongue and lips and can determine whether a frenulum is actually limiting movement. Pediatric dentists are also trained to perform tongue tie releases and to guide families through the aftercare that helps support healing and lowers the chance of the tissue reattaching.
A pediatric ear, nose, and throat specialist, often called an ENT, is a physician who diagnoses and treats conditions involving the head and neck, including the mouth and throat. Pediatric ENTs are also trained to evaluate oral anatomy and can perform tongue tie releases when needed.
Both of these specialists have advanced training in caring for infants and children, and either may be an appropriate provider for evaluation and treatment depending on the family’s situation and comfort.
Are there meaningful differences in approach that families should know about?
Approaches can be different depending on the provider’s training, experience, and clinical philosophy.
Some practitioners may use surgical scissors while others may use laser technology for the release. In addition, recommendations for aftercare, follow-up, and supportive therapies such as oral exercises or lactation support may differ.
For families, the most important factors are working with a provider who has experience evaluating infant feeding function, communicates clearly about the goals of the procedure, and collaborates with the baby’s broader care team.
Post‑Procedure Care & Stretching
There’s a lot of conflicting information about stretching after a tongue‑tie release. What is your stance?
Over the years, I have worked with infants who have had the procedure performed with a post-procedure exercise plan, and others who have had the release without any prescribed stretching or exercises.
In my experience, most infants heal well regardless of whether exercises are included. Even in situations where there is some degree of reattachment, the procedure can be repeated if clinically necessary.
What I have not consistently observed is that stretching or exercises significantly improve healing outcomes.
For that reason, we typically do not recommend routine post-procedure exercises as part of lactation care. However, we also respect the recommendations of the medical provider performing the release and do not interfere with the guidance they provide to the family.
How do you help parents navigate the difference between new evidence and the anecdotal experiences they often hear from other moms?
I think in these cases, parents really need to trust their own capabilities and recognize that they are the ones who know their baby and what is best and most comfortable for them and the baby. If they do not trust their own feelings, they can reach out to the provider for guidance or to the lactation consultant and have the conversation that will give them the support and comfort they need. Each family is facing a different situation, and while some commentary from friends and family may be helpful at times, parents need to know that they will make good decisions for their own family and little one.
Support for Latch Challenges
What are some first steps parents can take if they’re struggling with latch, even before considering a tongue‑tie diagnosis?
Latch-on support is very important, especially in the early hours, days, and weeks after childbirth. We want all parents to know that support and education are available in person or in a virtual setting that can and will guide them to successful infant feeding at the breast. If the early feedings do not result in a comfortable and sustained latch on, pumping the breast milk should be established early so that there is no disruption to the milk production. Once the parent realizes that the baby is struggling with latching, they can take a look inside the mouth and see if they see any tongue restrictions. If they do, the next call should be to the primary physician for an evaluation. Some parents do not want to get a frenotomy done, and they will choose to use a nipple shield, which can help with mouth and tongue placement and assist with breastfeeding. The parents should speak with the lactation consultant so they are aware of the risks associated with using a device at the breast.
What reassurance or guidance do you wish more moms heard during this process?
One of the most important things I want parents to know is that a tongue tie is not something they caused or could have prevented. It is simply a variation in oral anatomy; a small band of mucosal tissue made up of connective tissue, collagen, and muscle that forms during development.
Once families understand this, the focus can shift away from worry or self-blame and toward making the best plan to support feeding in the early weeks of life.
For most families, the goal is simply ensuring that the baby can feed effectively and comfortably. As children grow, the frenulum often stretches and becomes more flexible over time. Because of this natural change, many families find that there are no ongoing concerns as their child gets older.
If questions do come later, like speech development or oral function, those can be evaluated when the child is older, and those developmental stages are more relevant.
What parents often need most during this process is clear guidance and realistic expectations from their providers. When families understand the possible outcomes and the reasoning behind a treatment plan, it can reduce anxiety and help them feel more confident in the decisions they are making for their baby.
Every feeding journey is different, and you deserve support every step of the way.
Navigating latch challenges and the possibility of tongue tie can feel overwhelming, but you’re not alone. We hope this expert guidance gives you clarity, confidence, and a little more peace as you make the decisions that feel right for your baby.
If you’ve navigated latch challenges or tongue‑tie questions yourself, we’d love to hear your experience. Sharing our stories is one of the ways we help other moms feel less alone — and your insight might be exactly what another parent needs to read today.
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Linda Hanna, RNC, MSN/Ed., IBCLC, is the director of Care at Mahmee, and a veteran registered nurse who has helped build maternity care programs across California at Kaiser Permanente, Cedars-Sinai Medical Center, and Providence Saint John’s Health Center, among others. Linda has spent decades at the forefront of maternal and infant care, building a reputation as both a clinical innovator and a champion for new mothers. Her early career in labor and delivery nursing evolved into a pioneering focus on lactation support, where she helped transform what was once an afterthought in hospital care into a recognized, revenue-sustaining clinical specialty. Long before lactation consultants were a fixture in medical settings, Linda was making the case for their place — first at the bedside, then in outpatient programs that set a new standard for postpartum support.
Mahmee is a modern maternal and infant healthcare company working to make the United States the best place to give birth. Families receive continuous wraparound support from early pregnancy through the first year postpartum. Mahmee’s hybrid model integrates virtual services with modern in-person clinics in Los Angeles, San Diego, Fresno, Sacramento, and Orange County, and virtual throughout the country.
