How to manage tongue tie in babies


Whenever there are issues related to breastfeeding, tongue tie should be considered as a diagnosis. Symptoms the mother might experience include sore or mis-shapen nipples, mastitis, or poor milk supply. For the baby, the following symptoms might a concern;

  • Restricted tongue movement
  • Small gape resulting in biting/grinding behaviour
  • Unsettled behaviour during feeds
  • Difficulty staying attached to the breast or bottle
  • Frequent or very long feeds
  • Excessive early weight loss/ poor weight gain/faltering growth
  • Clicking noises and/ or dribbling during feeds
  • Colic, wind, hiccoughs
  • Reflux (vomiting after feeds)

What is Tongue Tie? 

Tongue Tie or Ankyloglossia is caused by a short or tight membrane under the tongue (the lingual frenulum).It is considered to be a congenital issue, and seems to have a hereditary link. It's unclear whether Tongue Tie is being diagnosed increasingly because it is more prevalent, or if there is more awareness about it. Tongue Tie may or may not be associated with Lip tie (where the underside of the top lip is attached).

How is it diagnosed?

It is not always easy to diagnose a Tongue Tie. They can be termed posterior, i.e. far back in the mouth, and therefore difficult to observe (babies don't generally like having people peering into their mouths!) A specialist may use a gloved finger to palpate inside the mouth and feel for a tie.  Tongue Tie might be diagnosed by your midwife, health visitor or lactation consultant.

How can it be treated?

You may be advised to have a frenulotomy (or snip), which is a simple procedure without anaesthesia to release the tie.  Simple breastfeeding changes such as positioning can make it easier for the baby to latch correctly (find your nearest breastfeeding cafe or lactation consultants for advice). Massage around the tongue and jaw can also be helpful. There is also a laser procedure which is done which is considered to be quicker for tissue healing. In some cases, such as if the tie is not painful, there may not be a treatment. In the long term there can be links to speech issues, so it is prudent to get an assessment. Generally whilst not all tongue-ties are symptomatic, if is going to be treated, the earlier the better.

How can osteopathy help?

An osteopath looks at the whole person, and this is also true for conditions such as Tongue Tie. A full case history about the pregnancy, birth and early weeks will be taken. This will be followed by a full examination of the baby's skull, jaw, tongue, spine, thorax and abdomen. Using skilled touch the osteopath looks for areas of tension or strain which could be influencing the symptoms. Breathing patterns, efficient sucking and swallowing are all necessary movements for efficient feeding. I frequently treat alongside other approaches such as the 'snip' or laser, and sometimes instead of other treatment.

Breastfeeding issues can be distressing for mother and baby. With good support, issues such as Tongue Tie can be swiftly dealt with, leaving the baby free to develop well.

Contact me on if you have any questions about osteopathic treatment for tongue tie.

More information

Nice Guidelines on Tongue Tie

Lactation Consultants Great Britain