Tongue Tie and Lip Tie in Newborns: What Every Mom Needs to Know
Expert-reviewed in collaboration with Dr. John Humphrey Jr., DDS — Dentist & Owner, KC Dental Works, Newborn & Infant Frenectomy Specialist
If breastfeeding feels like it should be working but somehow isn’t, if you’re wincing through every latch, noticing your baby fall asleep before finishing a feed, or hearing that little click with every suck…I want you to know something: you’re not doing anything wrong. Sometimes there’s a structural reason feeding feels so hard, and one of the most common (and most missed) culprits is a tongue tie or lip tie.
Tongue and lip ties affect a significant number of newborns and yet they’re regularly missed during initial newborn checks, leaving moms struggling without answers. This guide, created in partnership with Dr. John Humphrey of KC Dental Works, walks you through everything you need to know: what these conditions actually are, how to spot the signs in your baby and yourself, what treatment looks like, and how to advocate for your family through the process. If you’re still in the thick of early postpartum recovery, you might also want to read our postpartum self-care guide for new moms.
Quick answer:
A tongue tie (ankyloglossia) occurs when the tissue under the tongue is too tight or short, restricting tongue movement. A lip tie is a similar restriction under the upper lip. Both can significantly impact breastfeeding for both baby and mom, but they’re treatable, and relief is possible.
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What Is a Tongue Tie or Lip Tie, Really?
Let’s start with a little anatomy. Every single one of us has a frenulum: the small band of mucosal and connective tissue that helps hold moving parts in place in the body. You can feel yours right now by running your tongue along the bottom of your mouth. It’s completely normal. The issue arises when that tissue is too short, too tight, or positioned in a way that restricts natural movement.
When this happens under the tongue, it’s called a tongue tie, or ankyloglossia. When it happens at the upper lip, where the lip attaches to the gum, it’s called a lip tie. Many in the medical and lactation world refer to both conditions together as “tethered oral tissues.”
Here’s the thing Dr. Humphrey is always clear about with his patients: the frenulum itself is not the problem. We all have one. The problem is when it’s symptomatic. If it’s actually restricting your baby’s ability to feed, breathe, or move comfortably. Not every tie needs treatment. But when it does, the impact can be profound for the whole family.
How to Tell If Your Baby Has a Tongue or Lip Tie
This is where things can get murky, because the signs of a tongue or lip tie often look a lot like other newborn feeding challenges. That said, there are some patterns worth paying attention to, both in your baby and in yourself.
Signs in Baby
– Shallow latch at breast or bottle
– Falls asleep while eating
– Clicking or smacking noises during feeds
– Colic or reflux symptoms
– Snoring or noisy breathing
– Spitting up frequently
– Very gassy or fussy
– Poor weight gain
– Frequent hiccups
– Lip curls under during feeds
– Milk leaks out of the mouth
Signs in MOM
– Pain or nipple damage during nursing
– Flattened or lipstick-shaped nipples after feeds
– Blistered, cut, or bleeding nipples
– Incomplete breast drainage
– Recurring mastitis or thrush
– Feeling like baby is never satisfied
– Dreading every feeding session
If you’re nodding along to several of these, trust that instinct. As Dr. Humphrey says, “As a mom, one of your most valuable tools is your intuition.” The families he sees most often come to him feeling overwhelmed, sometimes even hopeless, after weeks of struggling without a clear answer. And if that overwhelm is starting to affect your mood and mental health, you’re not alone, our postpartum hormones timeline breaks down exactly what your body is going through week by week. Getting an evaluation doesn’t mean you’re jumping to conclusions; it means you’re advocating for yourself and your baby.
Does Every Tongue or Lip Tie Need to Be Treated?
No! And this is an important nuance that gets lost in a lot of online conversation about this topic. Not every baby with a tie will have symptoms, and not every symptomatic baby will need a release procedure. The American Academy of Pediatrics recommends a team-based approach to diagnosis and treatment to avoid unnecessary procedures. The goal isn’t to treat the tie itself; it’s to relieve symptoms and support your baby’s development.
That said, when feeding is painful for mom, when baby isn’t gaining weight, when breastfeeding feels unsustainable, that’s when a release can change everything. Tongue and lip ties can affect people of all ages, from newborns to adults, so early intervention when symptoms are present is generally the right call.
The decision isn’t just clinical, either. Dr. Humphrey always considers the whole picture: the mother-baby relationship, family goals around feeding, and what will genuinely support this family’s quality of life. It’s never a one-size-fits-all answer.
What Does the Treatment Process Actually Look Like?
If you’re considering pursuing an evaluation, knowing what to expect can make the whole thing feel a lot less daunting. Here’s how the process typically unfolds.
- Bodywork first. Many providers recommend bodywork for baby before the procedure. This can look like chiropractic care, craniosacral therapy, or working with an occupational therapist. Getting baby’s body prepared tends to improve outcomes significantly.
- The initial evaluation (about 30 minutes). A thorough history is taken, the anatomy is assessed, and a functional evaluation is completed. This is where your provider answers your questions and you explore together what makes sense for your baby and your family’s goals.
- The procedure itself. If a release is indicated, a topical anesthetic gel is applied first to minimize discomfort. A CO2 laser is then used to release the tissue. The whole thing takes only a few minutes. Look for a provider trained through organizations like The Breathe Institute or Tongue Tied Academy who uses CO2 laser technology.
- Recovery and aftercare. Baby comes right back to you immediately; nursing, bottle feeding, or skin-to-skin time is encouraged right away. You’ll be given specific stretches to do for the next 4–6 weeks to support healing. Some babies are fussy afterward; many act completely normal. Both are okay.
In the meantime, if sleepless nights from feeding struggles are hitting hard, our newborn sleep schedule guide has practical tips for exhausted new parents.
Finding the Right Provider
Multiple types of providers can legally perform tongue and lip tie releases, dentists, pediatricians, ENTs, and others, but training and experience vary widely. The level of care you receive, the time spent educating you, and the technology used all impact your experience and your baby’s outcome.
When looking for a provider, look for someone trained through recognized programs like The Breathe Institute or Tongue Tied Academy, who uses a CO2 laser. And think about the full team around you: an IBCLC (lactation consultant), chiropractor, craniosacral therapist, occupational therapist, or speech-language pathologist can all be invaluable parts of your support system.
You don’t need a referral to see a dentist for this procedure, though many families arrive through a referral from their IBCLC, midwife, or pediatrician. Many practices specializing in this work choose not to work directly with insurance in order to maintain full control over the quality and time they give each family.
What Does It Cost?
Cost is often a significant factor, and it’s worth going in with realistic expectations. Out-of-pocket costs typically range from $250 to $1,500 depending on the provider’s training, experience, and the technology they use. Many families find that the cost (though real) is far outweighed by the relief from weeks or months of feeding struggles.
A Note on Advocating for Yourself
Navigating a potential tongue or lip tie diagnosis can feel overwhelming, especially when you’re sleep-deprived, in pain, and second-guessing every choice.
Educate yourself.
Listen to what your pediatrician says, and also seek out other trusted voices. Ask questions. Find a provider who takes time to listen and who respects your experience. And trust your gut — because ultimately, you are the expert on your baby.
Frequently Asked Questions
How do I know if my baby has a tongue tie?
Common signs include a shallow latch, clicking sounds during feeding, poor weight gain, excessive gas or reflux, and a baby who falls asleep at the breast before finishing a feed. Moms often notice nipple pain, flattening, or recurring mastitis as well. An evaluation with a qualified provider or IBCLC is the best way to get a clear answer.
Can a lip tie affect breastfeeding?
Yes. A lip tie can prevent baby from flanging the upper lip properly during feeding, which impacts the seal and quality of the latch. Moms often describe nipple pain, lipstick-shaped nipples after feeds, and a baby who takes in a lot of air during nursing.
How old does my baby need to be for a tongue tie release?
A baby can be treated at any age, there’s no minimum. Many families have the procedure done in the first few weeks of life. Preparation matters though, and some providers will want to refer for bodywork first before proceeding.
Is a tongue tie release covered by insurance?
Many specialized providers, including those who use CO2 laser technology, choose not to participate with insurance so they can provide more individualized care. Out-of-pocket costs vary: roughly $250–$1,500 depending on your location and provider.
What is the difference between a tongue tie and a lip tie?
A tongue tie (ankyloglossia) is when the frenulum under the tongue restricts the tongue’s movement. A lip tie is when the tissue attaching the upper lip to the gum is too tight, limiting how well baby can flange the lip during feeding. They can occur together or independently.
Do I need a referral to get a tongue tie release?
No. You can contact a qualified dentist or provider directly without a referral. Many families are referred by their IBCLC, midwife, doula, or pediatrician, which can be helpful for coordinating care, but it is not required.
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