Feeding your newborn is hard enough without wondering whether something in their mouth is working against you. If you’re dealing with a painful latch, a baby who seems to nurse constantly but never quite settles, or clicking sounds during feeds, tongue-tie may be part of the picture — but figuring out whether it actually is, and what to do about it, isn’t always straightforward. This guide walks new and nursing parents through what tongue-tie and breastfeeding actually have to do with each other, and why we believe the right support team makes all the difference.
This article is for general education and isn’t a substitute for an in-person evaluation from your pediatrician, lactation consultant, or dentist.
How Tongue-Tie Can Affect Breastfeeding
Tongue-tie, or ankyloglossia, happens when the frenulum under the tongue is short, thick, or tight enough to restrict normal tongue movement. Effective breastfeeding depends on the tongue being able to extend and move in a specific way to compress the milk ducts properly — when that movement is restricted, feeding can become inefficient or painful for both baby and parent.
Common signs include a shallow or painful latch, clicking sounds while nursing, long or exhausting feeding sessions, slow weight gain in the baby, and significant nipple pain, damage, or low milk supply for the nursing parent. That said, it’s worth knowing upfront that most babies with some degree of tongue-tie feed just fine — research suggests only a subset of infants with ankyloglossia actually go on to have significant breastfeeding difficulty, which is exactly why a proper functional evaluation matters more than a quick visual check.
Why This Isn’t a One-Provider Decision
One of the more important shifts in how tongue-tie is approached today is the growing recognition that it shouldn’t be evaluated — or treated — in isolation. A 2024 clinical report from the American Academy of Pediatrics specifically stresses the need for International Board Certified Lactation Consultant (IBCLC) involvement in properly evaluating symptomatic ankyloglossia, since breastfeeding difficulty is a functional, feeding-specific problem, not something a dental exam alone can fully assess. Multiple professional bodies have echoed this same conservative, multidisciplinary approach: rule out and address other common feeding issues first, with an IBCLC’s assessment as a core part of that process, before assuming a frenectomy is the answer.
This is precisely why we have an in-house lactation consultant on our team — not a referral we make and hope goes well, but a coordinated evaluation from day one. When a family comes to us with feeding concerns, our IBCLC and our dental team assess the situation together, which means you’re not stuck choosing between “the tongue-tie people” and “the feeding people” and hoping their advice lines up. You can learn more about that side of our practice on our Lactation & Infant Feeding Support page.
What a Coordinated Evaluation Looks Like
Rather than jumping straight to “does this look like a tie,” a thorough evaluation looks at the whole feeding picture: latch mechanics, positioning, milk transfer, and the baby’s actual tongue mobility and function — not just its appearance. Our lactation and infant feeding support consultant can often identify and address positioning or latch issues that are contributing to (or even fully explaining) the difficulty, sometimes without any procedure being necessary at all. When a frenectomy does appear to be the right next step, having that decision made alongside lactation support means it’s grounded in an actual feeding assessment, not guesswork.
For a full explanation of what a frenectomy is, the different types of ties, and how diagnosis works more broadly, see our pillar guide: What Is a Frenectomy? Tongue-Tie and Lip-Tie Explained.
What the Research Shows After Treatment
For infants where a genuine functional restriction is identified, the evidence on frenotomy’s impact on breastfeeding is encouraging. A prospective cohort study following mothers before and one month after their infant’s frenotomy found significant reductions in breastfeeding pain and significant improvements in latch scores, with the large majority of participants reporting an overall improvement in breastfeeding afterward. That same body of research, though, is clear that frenotomy isn’t a universal fix — which reinforces why the evaluation leading up to that decision matters as much as the procedure itself.
What to Expect If Treatment Is Recommended
If our evaluation does point toward a frenectomy, we use laser technology for many of our releases, chosen specifically for its precision and gentleness with infants — you can read more about that approach in Laser Frenectomy & BabyLase: Why We Use It. Afterward, our lactation consultant continues to support you through recovery and any adjustments needed to get feeding back on track, alongside our general aftercare guidance covered in Frenectomy Recovery: A Day-by-Day Guide for Parents.
Getting Support for Your Feeding Concerns
If you’re struggling with a painful latch, slow weight gain, or a baby who just doesn’t seem comfortable feeding, you don’t have to figure out on your own whether tongue-tie is the cause. Schedule a consultation with our team — including our in-house IBCLC — for a coordinated evaluation that looks at the whole picture, not just the frenulum.
References
- Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants: Clinical Report. American Academy of Pediatrics, Pediatrics. https://publications.aap.org/pediatrics/article/154/2/e2024067605/198022/
- Muldoon K, Gallagher L, McGuinness D, Smith V. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. PMC, National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683371/