Parents often show up already convinced their baby has a tongue tie, sometimes based on a single photo from a parenting group, and sometimes they’re right. Just as often though, the tongue is doing exactly what a baby’s tongue is supposed to do.
The American Academy of Pediatrics estimates ankyloglossia, the technical term for tongue tie, shows up in about 4% to 10% of newborns. Lip ties get mentioned less often, but they tend to travel together, and both come from a band of tissue that’s tighter or shorter than it needs to be. At All Star Kidz Pediatrics, we get plenty of questions about this from parents who want to know what to watch for before their child’s early dental care visit. The guidance below can help you decide if you should come in for a closer look.
What a Tongue or Lip Tie Actually Looks Like
A tongue tie means the strip of tissue connecting the tongue to the floor of the mouth, the lingual frenulum, is too tight or attached too far forward. A lip tie is the same idea, but with the tissue connecting the upper lip to the gum. Neither one is rare, and neither one is automatically a problem.
Some babies with a tie can still latch and feed just fine. Others struggle from day one. That’s part of why this gets confusing for parents, since two babies with what looks like the same tie can have completely different experiences.
Signs to Watch For in Infants
Feeding is usually where a tie shows up first, if it’s going to cause trouble at all. A clicking sound while nursing, frequent unlatching, or a baby who seems to tire out fast without actually getting full can all point toward a tongue or lip tie. You should look for:
- Feeding fatigue: Your baby falls asleep at the breast or bottle before finishing a full feed.
- Poor weight gain: Growth slows despite frequent feeding sessions throughout the day.
- Nipple pain: You have ongoing nipple pain or damage that doesn’t improve with a latch adjustment.
- Gumming or chewing: Your baby seems to chew rather than suck during feeding.
- Limited tongue movement: Your baby’s tongue can’t lift toward the roof of the mouth or extend past the lower gum.
Not every baby with a tie will show all of these, and plenty of babies have mild ties that never cause a single feeding issue. If you’re noticing several of these together, it’s worth bringing up so we can actually take a look.
Signs in Toddlers and Older Children
Once a child moves past infancy, the signs tend to shift from feeding toward speech and mouth function. You might notice your child has trouble making certain sounds, like L, R, or TH, or they may seem to struggle with foods that require more tongue coordination, like licking an ice cream cone or moving food around while chewing.
A gap between the two front teeth, difficulty sticking the tongue out past the lower lip, or a tongue that looks heart-shaped at the tip when extended are also worth a mention at your child’s next checkup and cleaning. None of these confirm a tie on their own, but together they give us a fuller picture of what’s going on.
Why We Don’t Rush to a Diagnosis
Here’s where we tend to differ from what parents read online. Diagnoses of tongue tie have gone up substantially in recent years, and so has the number of babies referred for a release procedure that may not have needed one. Appearance alone doesn’t tell the whole story. A tongue can look tied and function completely fine, and a tongue that looks looser can still be limiting a child in ways that only show up with time.
This is why we look at function first, not just the visual. We want to know how your child is actually eating, talking, and moving their tongue day to day, not just whether a certain band of tissue looks short in a photo. A tie that isn’t affecting function rarely needs anything more than watching.
We’re comfortable being the ones who say a wait-and-see approach is the right call, even if that’s not the answer a parent expected to hear. Special needs pediatric care works the same way for us. We look at the individual child in front of us rather than applying a blanket answer to every family that walks through our doors.
Let All Star Kidz Pediatrics Take a Look
If you’re noticing feeding struggles, speech delays, or anything else on this list, we’d rather you bring it up than sit with it. Dr. Christopher Lamb has spent his career focused specifically on kids, and that includes taking tongue and lip tie questions seriously without jumping straight to a procedure that a child might not need.
We’ll look at how your child is actually feeding, eating, or talking, and go from there together. Reach out through our contact form and we’ll get your child on the schedule.
