Tongue-tie in babies: signs and next steps
Many babies have a visible band under the tongue. It only needs attention when it interferes with feeding or comfort.
Tongue-tie happens when the band of tissue under the tongue, the frenum, is short or tight and limits movement. Signs can include a shallow latch, clicking during feeds, long or frequent feeding, poor weight gain and nipple pain for the parent. Many tongue-ties cause no problems. A full feeding and oral assessment helps decide if a release is needed.
What tongue-tie and lip-tie are
Everyone has a frenum under the tongue and one under the upper lip. In some babies, the tongue frenum is short, thick or attached close to the tip of the tongue. This is called ankyloglossia, or tongue-tie. A lip-tie is a tight band between the upper lip and gum.
The look of the tissue alone doesn't tell the whole story. What matters is how well the tongue and lip move and whether feeding is affected.
Tongue-tie is often grouped by how close the band attaches to the tongue tip. A 'posterior' tie sits further back and can be harder to see. Professionals often rely on assessment tools that look at how the tongue lifts, extends and moves side to side.
Signs to watch for in babies
- Trouble latching or staying latched
- Clicking or smacking sounds while feeding
- Feeds that take a long time or happen very often
- Slow weight gain
- Milk leaking from the mouth, or extra gassiness
- A heart-shaped tongue tip when the baby cries
- Ongoing nipple pain or damage for the breastfeeding parent
Other causes to rule out
Many of these signs can also come from positioning, milk supply, reflux or other health issues. A lactation consultant and your baby's doctor or nurse practitioner are important partners. Working on latch and positioning first often helps, with or without a release.
Bring notes to the assessment: how long feeds last, how often your baby feeds, weight checks, and any pain or nipple damage. Video of a feed can also help.
How a release is done
If a release is recommended, the tight tissue is gently freed so the tongue or lip can move more easily. At our office, tie releases are considered case by case. When suitable, we use a soft-tissue diode laser (Zolar). In other cases, we refer to another provider.
The procedure itself is brief. A numbing gel is often used, and the laser seals small blood vessels as it works, which usually keeps bleeding minimal. Most babies can feed right afterwards.
After a release
- Expect some fussiness for a few days
- Follow the stretching or movement exercises you're shown, if recommended
- Keep working with your lactation consultant on latch
- A white or yellow patch at the site is normal healing
- Call if your baby has a fever, won't feed or bleeding doesn't stop
Frequently asked questions
Do all tongue-ties need to be released?
No. Many babies with a visible tongue-tie feed and develop well. A release is considered only when the tie is causing real problems.
Can tongue-tie affect speech later?
Most children with tongue-tie learn to speak normally. A speech-language pathologist can assess concerns in older children.
Can older children or adults have a release?
Yes. Older children and adults can be assessed if a tight frenum affects eating, cleaning the teeth, gum health or comfort.
Is a laser release painful for babies?
Most babies cry briefly, mainly from being held still. A numbing gel is often used, and many settle once they're back with a parent and feeding.
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Trusted health information
General information only; not a substitute for an exam. Reviewed by Dr. Sayeh Maralani, DDS, general dentist. Last updated 2026-11-03.
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