What Are the Signs of Ankyloglossia Affecting Feeding?

Feeding your baby should be a peaceful and bonding experience, but sometimes it’s not as easy as it seems. If your baby is struggling to latch, making clicking sounds, or seems fussy after feeding, you might start wondering if something more is going on. One possible cause could be tongue-tie (ankyloglossia) — a condition that can make it hard for babies to move their tongue properly. Be with us as our Brisbane Paediatric Dentist explains the possible Signs of Ankyloglossia Affecting Feeding.

Ankyloglossia (Tongue-Tie)

Tongue-tie happens when the small piece of tissue under the tongue is too short, thick, or tight, making it hard for the tongue to move freely. This can make it tricky for your baby to latch and feed properly, whether they’re breastfeeding or bottle-feeding.

Signs of Ankyloglossia Affecting Feeding

Here are some signs that tongue-tie may be causing feeding difficulties:

General Signs to Look Out For

• Limited Tongue Movement – If the tissue under your baby’s tongue is too tight or short, it can make it hard for them to move their tongue properly. You might notice they struggle to lift their tongue to the roof of their mouth, move it side to side, or stick it out past their gums.
• Clicking Noises – If your baby makes clicking sounds while feeding, it could be because they’re having trouble getting a good seal around the nipple or bottle teat.
• Drooling or Poor Saliva Control – If your baby’s tongue isn’t moving well, they might have trouble swallowing saliva, which in some cases cases more drooling.
• Swallowing Air – Poor latch or suction may cause your baby to take in extra air, leading to gas, discomfort, and spit-up.
• Colic-Like Fussiness – Feeding difficulties may make your baby irritable, restless, and hard to soothe.
• Tongue Shape or Appearance Issues – The tongue might appear heart-shaped or have a notched appearance when extended due to the tight frenulum.

Breastfeeding Signs

• Trouble Latching – Your baby may have difficulty attaching deeply to the breast, often slipping off or needing to relatch repeatedly.
• Low Milk Transfer – Despite a good milk supply, your baby may not be able to extract enough milk due to poor tongue movement.
• Long Feeds or Very Frequent Feeds – Your baby might stay at the breast for long periods or want to feed again shortly after because they aren’t getting enough milk.
• Sore or Damaged Nipples – If your baby isn’t latching well, it may cause friction that leads to sore nipples, cracks, and sometimes bleeding.
• Slow Weight Gain – When milk isn’t removed well, your baby might not gain weight properly, even with frequent feeding.
• Refusing the Breast – Your baby might refuse the breast altogether if feeding becomes too difficult or frustrating.
• Milk Leaking from the Mouth – Weak latch and suction may cause milk to escape from the sides of the mouth during feeding.

Bottle-Feeding Signs of Ankyloglossia Affecting Feeding

• Clicking Sounds – Similar to breastfeeding, clicking while bottle-feeding may suggest a poor latch on the bottle teat.
• Drooling and Air Swallowing – Milk or saliva may leak from the mouth, and the baby might swallow extra air, leading to gas and discomfort.
• Colic-Like Fussiness – Swallowed air may cause gas and bloating, making the baby cranky and uncomfortable after feeds.
• Long or Inefficient Feeding Sessions – The baby may take longer than usual to finish a bottle or need more frequent feeds.
• Milk Pooling in the Mouth – The baby may not be able to effectively swallow milk, causing it to pool in the mouth or dribble out.

Signs in the Mother (if breastfeeding)

• Nipple Pain or Damage – If your baby isn’t latching deeply, it may cause nipple pain, cracking, bruising, and even bleeding.
• Engorgement or Blocked Ducts – Poor milk transfer may cause milk to back up in the breast, leading to painful swelling or plugged ducts.
• Mastitis – Inflammation or infection from retained milk may result from poor drainage.
• Low Milk Supply – Inefficient feeding reduces breast stimulation, which may lead to a drop in milk production over time.
• Distorted Nipple Shape – After feeding, the nipple may appear flattened, creased, or have a lipstick-like shape due to improper latch and pressure.

How Do Paediatric Dentists Diagnose Tongue-Tie That Is Affecting Breastfeeding?

Our paediatric dentists use a comprehensive approach to figure out if tongue-tie is causing breastfeeding problems in babies.

This thorough assessment includes:​

Detailed Medical and Feeding History

Our dentists will ask about your baby’s feeding patterns, weight gain, and any breastfeeding challenges you’ve been facing, like nipple pain or trouble with latching.

Visual Inspection

We’ll carefully check your baby’s tongue, looking at the length and flexibility of the tissue underneath and noting signs like a heart-shaped tip or limited movement.

Functional Assessment

Our dentists will check how well your baby’s tongue can move by seeing if they can lift it to the roof of their mouth, stretch it past the lower gums, and move it from side to side.

Feeding Observation

A breastfeeding session may be observed to check the baby’s latch, sucking patterns, and how well they’re feeding while also noting any discomfort the mother may be experiencing.

Manual Palpation of the Frenulum

Our dentist will gently lift your baby’s tongue to feel the tension and flexibility of the frenulum and see how it’s affecting tongue movement.​

Use of Classification Systems

Standard tools like the Hazelbaker Assessment Tool or the Coryllos classification may be used to carefully assess how severe the tongue-tie is and how it’s affecting tongue function.​

Collaboration with Specialists

Lactation consultants, speech therapists, and ENT doctors may collaborate to provide deeper insights and create a well-rounded plan for diagnosing and managing tongue-tie.

Why Early Recognition Matters

Early recognition tongue-tie early is important when a baby has trouble feeding because it allows for quick treatment to support proper nutrition and successful breastfeeding. Early diagnosis helps healthcare providers work with lactation consultants and other specialists to solve feeding issues and prevent problems like poor weight gain and nipple pain, making breastfeeding easier for both the mother and baby.

If Tongue-Tie Is Affecting Breastfeeding, What Are Possible Treatment Options?

If tongue-tie (ankyloglossia) is making it hard for your baby to breastfeed effectively, there are several treatment options available. The right approach will depend on the severity of the tongue-tie, how much it’s affecting feeding, and whether other issues (like lip-tie) are also present. Here are the possible treatment options:

Observation and Monitoring

• Mild cases – If the tongue-tie is not severely restricting movement and your baby is gaining weight and feeding well, the dentist or lactation consultant may recommend monitoring without immediate treatment.
• Feeding adjustments – Sometimes, improving breastfeeding technique (e.g., adjusting the latch) can compensate for mild tongue restriction.
• Follow-up appointments – Regular check-ups help track feeding progress and detect any worsening signs.

Lactation Support

• Lactation consultant guidance – A certified lactation consultant can help you improve positioning and latch techniques to minimise discomfort and improve milk transfer.
• Breastfeeding aids – Nipple shields or alternative feeding positions can help the baby latch more effectively despite tongue-tie.
• Suck training – Exercises to strengthen the baby’s sucking reflex and improve tongue function.

Oral Exercises and Therapy

• Stretching exercises – A paediatric dentist or speech therapist may recommend gentle tongue stretches to increase mobility and flexibility of the tongue.
• Tongue lifting and cupping exercises – Encouraging the baby to lift and cup the tongue can improve latch strength and milk transfer.
• Oral massage – Gentle massage of the tongue and surrounding muscles can reduce tightness and improve coordination.

Frenotomy (Tongue-Tie Release)

• Simple procedure – A frenotomy is a quick procedure where the tight band of tissue (frenulum) under the tongue is snipped using sterile scissors or a laser.
• Minimal discomfort – The procedure is typically quick (a few seconds) and causes minimal bleeding or pain.
• Immediate improvement – Many babies breastfeed more effectively immediately after the procedure.
• Aftercare – Stretching exercises are usually recommended after the procedure to prevent reattachment and ensure proper healing.

Frenectomy (Complete Removal of the Frenulum)

• For more severe or complex cases – If the frenulum is thick, fibrous, or severely restricting tongue movement, a frenectomy may be needed.
• Complete removal of the frenulum – Unlike a frenotomy (which simply releases the frenulum), a frenectomy removes the tissue entirely.
• Performed under local or general anaesthesia – Depending on the baby’s age and the complexity of the case, it may be done with scissors, a laser, or electrocautery.
• Post-operative therapy – Oral exercises and feeding support are often needed after a frenectomy to improve tongue function and prevent scar tissue formation.

Because your child’s comfort is essential, we offer sleep dentistry. According to Brisbane Dental Sleep Clinic, sleep dentistry Brisbane can make dental procedures relaxing and less stressful.

Combination Therapy

In some cases, a combination of:

• • Frenotomy or frenectomy
  • Lactation consultant support
  • Oral exercises and therapy
  • Follow-up care
  • may be required to fully resolve breastfeeding issues.

Support Your Baby’s Feeding Journey with Expert Care

Struggling with breastfeeding or bottle-feeding challenges due to tongue-tie? Our expert team is here to help with gentle, effective treatments to improve feeding and comfort for both you and your baby. Ensuring your little one feels at ease, we offer sleep dentistry and sedation options like laughing gas to create a comfortable, anxiety-free procedural environment.

We offer flexible payment options through Humm and Supercare to make your baby’s care even more accessible. Call us today at 07 3343 4869 to schedule an appointment.