Can Tongue-Tie or Lip-Tie Release Assist with Breastfeeding in Newborns?

As Brisbane paediatric dentists, we often see concerned parents struggling with breastfeeding challenges, unsure if their baby’s tongue-tie or lip-tie might be the cause. When a baby has difficulty latching, feeds frequently but doesn’t gain enough weight, or causes persistent nipple pain, parents naturally seek answers. Tongue-tie and lip-tie can sometimes contribute to these issues, and in certain cases, a simple procedure can help. In this blog post, we’ll explain how these conditions affect feeding, explore treatment options, and help parents make informed decisions for their baby’s well-being.

Tongue-Tie (Ankyloglossia)

Tongue-tie (ankyloglossia) is a condition where the thin piece of tissue (lingual frenulum) under the tongue is too short, tight, or thick, restricting how well the tongue can move. This can make it harder for a baby to breastfeed properly, as the tongue plays a crucial role in sucking, latching, and milk transfer.

Lip-Tie (Maxillary Midline Frenum) 

A lip-tie occurs when the thin piece of tissue (frenum) connecting the upper lip to the gum is too tight, thick, or stiff. This restriction limits the baby’s ability to move their upper lip freely, which may, in some cases, make breastfeeding more difficult. While not all lip-ties cause feeding issues, in some cases, they may prevent a baby from achieving a deep and effective latch.

How Tongue-Tie and Lip-Tie Impacts Breastfeeding

Tongue-tie (ankyloglossia) and lip-tie may, in some cases, affect a baby’s ability to breastfeed effectively because they restrict movement of the tongue and/or upper lip. This can make it difficult for the baby to latch, suck, and transfer milk properly.

How Tongue-Tie Affects Breastfeeding

Tongue-tie occurs when the lingual frenulum (the tissue under the tongue) is too short, thick, or tight, limiting tongue movement. The tongue plays a crucial role in breastfeeding by helping the baby:

✅ Latch deeply – The tongue should extend past the lower gum to cup the nipple and draw it deep into the mouth. A restricted tongue cannot extend properly, leading to a shallow, painful latch.

✅ Create suction – Effective breastfeeding relies on negative pressure (suction). If the tongue cannot lift or move freely, the baby may struggle to maintain suction, leading to frequent unlatching and poor milk transfer.

✅ Move in a wave-like motion (peristalsis) – The tongue should move rhythmically to push milk towards the throat. A restricted tongue may cause inefficient sucking, leading to:

• Slow weight gain due to inadequate milk intake
• Longer or more frequent feeds because the baby is not getting enough milk per session
• Fatigue and frustration at the breast

✅ Prevent nipple damage – A baby with tongue-tie may compensate by clamping down with their gums, leading to:

• Cracked, sore, or bleeding nipples for the mother
• Compression lines on the nipple (a sign of poor tongue mobility)

✅ Coordinate swallowing and breathing – A baby with tongue-tie may struggle with swallowing, leading to:

• Clicking sounds while feeding (indicating poor suction)
• Gulping or choking on milk
• Excessive gassiness, reflux, or colic symptoms due to air intake

How Lip-Tie Affects Breastfeeding

Lip-tie occurs when the maxillary frenum (the tissue connecting the upper lip to the gum) is too tight, thick, or short. This can restrict lip mobility and may, in some cases, interfere with proper latching.

✅ Shallow latch – The baby may struggle to flange (curl out) the upper lip properly, making it difficult to get a deep latch. A poor latch may sometimes lead to:

• Inadequate milk transfer
• Frequent, prolonged feeds
• Nipple pain for the mother

✅ Poor suction – The upper lip plays a role in creating a tight seal. A baby with lip-tie may have difficulty maintaining suction, sometimes leading to:

• Milk dribbling from the sides of the mouth
• Frequent unlatching and re-latching
• Clicking noises while feeding

✅ Excessive air intake – If the baby cannot form a proper seal, they may sometimes swallow more air, which may contribute to:

• Increased gassiness, burping, and reflux
• Discomfort, colic-like symptoms, and fussiness after feeds

Combined Effects of Tongue-Tie and Lip-Tie on Breastfeeding

In some cases, both tongue-tie and lip-tie are present, compounding feeding difficulties. Babies with both conditions may:

• Struggle to maintain an effective latch
• Have prolonged feeds yet remain unsatisfied
• Experience slow weight gain or weight loss
• Show signs of frustration at the breast (pulling off, crying, or refusing the breast)
• Cause maternal discomfort and nipple trauma

How Tongue-Tie and Lip-Tie Release Can Help with Breastfeeding in Newborns?

Tongue-tie (ankyloglossia) and lip-tie can restrict a baby’s ability to latch, suck, and transfer milk effectively, making breastfeeding challenging. A tongue-tie or lip-tie release—medically referred to as a frenotomy or frenectomy—can improve feeding outcomes in newborns who struggle with these issues.

When the tight frenulum (tissue under the tongue or lip) is released, it allows for:

✅ Better Latching

• A deeper, more secure latch reduces nipple pain for the mother.
• The baby can draw in more breast tissue, improving milk transfer.

✅ Improved Suction and Milk Intake

• The tongue can now move freely, creating better suction for more efficient milk extraction.
• Babies who struggled with poor weight gain due to ineffective feeding often show improvement.

✅ Reduced Nipple Pain and Trauma

• A tight tongue or lip causes increased pressure on the nipple, leading to cracks, blisters, and bleeding.
• After release, the baby’s tongue can cup the nipple correctly, reducing pinching or clamping.

✅ Faster, More Efficient Feeds

• Babies with tongue-tie often feed for long periods but still seem unsatisfied.
• After a release, feeding time shortens as the baby gets more milk per suck.

✅ Reduced Gassiness, Reflux, and Colic Symptoms

• Poor latch and suction cause babies to swallow excess air, leading to:
  • Increased burping and gassiness
  • Reflux (spitting up milk frequently)
  • Colic-like symptoms (crying and discomfort after feeds)
• Post-release, babies can seal the breast better, minimising air intake.

✅ Better Coordination of Sucking, Swallowing, and Breathing

• A tongue that moves freely can maintain a smooth rhythm during feeding.
• Some babies who struggled with choking, coughing, or pulling off the breast during feeds improve significantly.

How Quickly Do Babies Improve After a Frenotomy or Frenectomy?

🔹 Immediate Changes – Some babies latch better straight away and seem more content after feeding.

🔹 Gradual Improvement – Others take a few days to weeks to adjust and strengthen their suck.

🔹 Lactation Support May Be Needed – Working with a lactation consultant helps babies relearn proper feeding techniques.

Treatment Options for Lip-Tie and Tongue-Tie

The treatment for lip-tie and tongue-tie depends on how much they affect feeding. Some babies with mild tongue-tie or lip-tie can breastfeed successfully without any intervention, while others may need support or a minor procedure to improve feeding.

Non-Surgical Approaches

Before considering surgery, non-invasive options can help improve a baby’s ability to breastfeed.

Working with a Lactation Consultant

A lactation consultant can assess how the baby is feeding and recommend strategies to improve latch and milk transfer. They may suggest:

• Techniques to help the baby latch deeper
• Exercises to improve tongue movement
• Assessing whether a release is truly necessary

Trying Different Breastfeeding Positions

Some breastfeeding positions may help babies with tongue-tie or lip-tie latch more effectively. For example:

• The laid-back or biological nurturing position can encourage a deeper latch.
• The football hold may help babies with lip-tie maintain better suction.

Observing If the Baby Adapts Over Time

In some cases, babies naturally adjust as they grow, and feeding challenges resolve without intervention. If a baby is gaining weight well, feeding without excessive fussiness, and the mother is comfortable, treatment may not be needed.

Surgical Intervention: Frenotomy and Frenectomy

If non-surgical methods do not improve feeding, a minor surgical procedure may be recommended.

What is a Frenotomy?

• A quick and simple procedure where a healthcare professional snips the tight tongue or lip tie using sterile scissors or a laser.
• Minimal discomfort, often done without anaesthesia in newborns.
• The baby can be breastfed immediately after to soothe any discomfort.
• Typically low risk with minimal complications.

What is a Frenectomy?

• A more involved procedure where the frenulum is fully removed rather than just snipped.
• Often performed with a laser or surgical instruments, sometimes under local anaesthesia.
• Used when the tie is severe or extends deep into the tissue, requiring a more precise release.

Which Treatment Is Best?

The decision to treat a lip-tie or tongue-tie should be based on how much it affects breastfeeding, not just how it looks. An experienced kids dentist, lactation consultant, or paediatrician can help determine whether a release procedure is necessary or if non-surgical approaches are sufficient.

Aftercare Following Frenotomy and Frenectomy

After a tongue-tie or lip-tie release (frenotomy or frenectomy), proper aftercare is essential to ensure healing, reduce discomfort, and prevent reattachment of the tissue. While the procedure itself is quick and straightforward, the baby’s mouth heals rapidly, and parents play a crucial role in supporting recovery.

Immediate Post-Procedure Care

• Breastfeeding or bottle-feeding right after the procedure is encouraged to soothe the baby and promote healing.
• Some babies may be fussy or unsettled for a few hours after the release, while others feed better straight away.
• A small amount of bleeding is normal, but it usually stops quickly with feeding or gentle pressure from a clean cloth.

Pain Management

• Most babies experience minimal discomfort, but if needed, pain relief options include:
  • Breastfeeding frequently, as skin-to-skin contact and sucking provide comfort.
  • Offering a dummy (pacifier) briefly to soothe discomfort.
  • Using infant-safe pain relief (such as paracetamol) if recommended by a doctor.

Wound Care and Stretching Exercises

• The tongue or lip may try to reattach as it heals, so stretching exercises help prevent this.
• Parents are often advised to gently stretch the treated area multiple times a day for one to two weeks.
• These exercises should be quick but firm—babies may fuss, but it is important for proper healing.

Monitoring Feeding Improvements

• Babies may need time to adjust to their newly freed tongue or lip.
• Some show immediate improvements in latching and feeding, while others need a few days to weeks to relearn how to suck efficiently.
• A follow-up appointment with a lactation consultant can help ensure the baby is latching and feeding well.

Signs to Watch For

• Mild swelling or white/yellow healing tissue over the wound is normal.
• Contact a healthcare provider if you notice:
  • Persistent bleeding that doesn’t stop with gentle pressure.
  • Refusal to feed or extreme fussiness beyond the first 24 hours.
  • Signs of infection, such as pus, a foul smell, or increasing redness around the wound.

Important Considerations

• Professional Assessment: If breastfeeding difficulties arise, seek guidance from lactation consultants, speech pathologists, or paediatric dentists to assess the need for a release procedure.
• Multidisciplinary Opinions: Be aware that healthcare professionals may have differing opinions on the necessity and management of tongue-tie and lip-tie.
• Limited Evidence: While some studies suggest benefits, the evidence base for the effectiveness of frenotomy and frenectomy procedures is still developing.
• Individualised Approach: Each case should be assessed individually to determine if a release is warranted, considering the severity of the tie and its impact on feeding.
• Non-breastfeeding outcomes: Evidence is insufficient to conclude that surgical interventions benefit non-breastfeeding feeding (i.e. bottle) outcomes for infants with ankyloglossia.
• Impact of Lip-Tie: The connection between lip-ties and breastfeeding issues isn’t completely clear. Some experts believe a tight upper lip frenulum might make latching harder, affect suction, or cause babies to swallow more air, but research hasn’t consistently proven that lip-ties directly lead to feeding problems.

Helping Your Baby Breastfeed Comfortably

Breastfeeding challenges can be stressful, especially when tongue-tie or lip-tie might be part of the problem. Our paediatric dentists are here to provide gentle and effective tongue-tie and lip-tie treatments to support better latching, improved feeding, and a more comfortable experience for both you and your baby. Our experienced team will guide you through every step, ensuring the best possible outcome.

To make your child’s visit stress-free, our clinic offers sleep dentistry in Brisbane and laughing gas for optimal comfort during procedures. Brisbane Dental Sleep Clinic believes that sleep dentistry makes dental visits comfortable and stress-free for everyone.

Facing a sudden dental issue? Get in touch with our emergency dentist Brisbane for timely, professional care that restores your comfort and smile.

Flexible payment options are available, including Humm and Supercare. Call us today to book a consultation at 07 3343 4869.