Some mothers and babies find that, regardless of how they work on position and attachment together, they can’t seem to get a good latch. This can lead to pain when feeding, weight gain issues and problems with milk supply. Difficulty with feeding can be due to a baby having restricted tongue movement, caused by the way their tongue joins the base of their mouth. This is called a tongue-tie.

A tongue-tie can be difficult to diagnose. Some tongue-ties are obvious, when they are at the front of the tongue (anterior) and others need professional skill to diagnose, when they are a posterior tongue tie, at the back of the base of the tongue.

A good latch on to the breast is the key to your baby getting all the milk out of your breast and stimulating more milk production during the feed. When a baby is attached and positioned well, their tongue massages the breast in a wave-like fashion. This stimulates let down (when the breast releases streams of milk through the nipple) and allows all the milk ducts within the breast to release their milk. The more the breast is drained, the more that the body will know to continue production for the next feed. 

Tongue tied babies often struggle to do this wave-like motion with their tongue and will use their lips and gums to compensate. Their latch will not be deep enough for your nipple to reach the soft part of the palate, which causes damage to the nipple. Some mothers find this damage is so painful that they start to dread feeds and many will develop problems with their breasts and their milk supply. 

There are a range of issues to mother and baby but the most common are below:

Issues for baby

  • Unsettled behaviour during feeds
  • Difficulty staying attached to the breast, with clicking noises
  • Frequent and often extremely long breastfeeding sessions
  • Poor weight gain
  • Colic, crying, dislike of being laid flat
  • Vomiting after feeds.

Issues for mother

  • Sore nipples which can be cracked and sometimes even bleeding
  • Misshapen nipples (the shape of a new lipstick)
  • Mastitis (a breast infection caused by too much milk being left in the breast)
  • Low milk supply
  • Distress due to pain and difficulty establishing breastfeeding.

Many women don’t realise that their baby has a tongue-tie, especially if it is their first baby. Not all healthcare professionals are trained in diagnosing tongue tie so if you’re not sure, do seek advice from a IBLC (Internationally Board-Certified Lactation Consultant).

Diagnosis of a tongue-tie involves a feeding assessment as well as examining your baby. If you’re happy, the person performing the assessment will use their gloved fingers to assess your baby’s tongue movement.

Depending on how your baby is feeding and the problems you are experiencing, you may want your baby to have a procedure known as a tongue-tie division (frenulotomy). This is a quick procedure done with a pair of blunt-ended curved scissors and you will need to feed your baby directly afterwards.

Find out more about tongue-tie and the procedure.

Tongue-tie will normally be diagnosed at a local specialist breastfeeding clinic.  These are available via an appointment from your local health visiting teams in Kent and Medway.  There are some local breastfeeding drop-ins that also offer tongue-tie consultations.  Please check what is available in your area.