Feeding your baby is meant to be a time of nourishment and connection. But when every feed feels difficult, tiring or uncomfortable, it is natural to wonder why.

Your baby may struggle to stay latched, make clicking sounds during feeds, take a long time to feed or seem unsettled afterwards. Breastfeeding may also feel painful or uncomfortable for you.

Sometimes, restricted tongue movement can play a part.

One possible cause is tongue tie, also known as ankyloglossia. Tongue tie occurs when the tissue connecting the underside of the tongue to the floor of the mouth restricts tongue movement.

But feeding difficulties can have many causes, and not every baby with a tongue tie will have feeding problems.

Understanding the signs and looking at the whole feeding picture can help you know when it may be worth seeking professional advice.

What is tongue tie?

Tongue tie is a condition where the tissue beneath the tongue, called the lingual frenulum, restricts the tongue’s movement.

Some babies have a frenulum that is shorter, tighter or attached differently. However, simply having a visible frenulum does not necessarily mean that a baby has a problem.

The important question is whether the tongue’s movement is restricted and whether that restriction is affecting function, such as feeding.

Tongue tie can be present from birth, but its appearance can vary considerably between babies.

Some babies with a tongue tie feed comfortably without needing treatment, while others may experience difficulties.

How does feeding normally work?

Feeding involves much more than simply opening the mouth and sucking.

For breastfeeding, a baby needs to coordinate several movements involving the tongue, jaw, lips and mouth. The tongue helps with creating and maintaining an effective seal and moving milk during feeding.

When tongue movement is restricted, some babies may find parts of this process more difficult.

However, feeding is complex, and many factors can influence how well a baby feeds. This is why it is important not to assume that a tongue tie is responsible for every feeding concern.

What signs might you notice during feeding?

Feeding difficulties can look different from one baby to another.

You may notice that your baby:

• Struggles to latch deeply
• Slips off the breast during feeds
• Has difficulty staying attached
• Makes clicking sounds
• Has difficulty maintaining suction
• Takes unusually long to feed
• Seems tired during feeds
• Becomes unsettled while feeding
• Has milk leaking from the mouth

None of these signs automatically means your baby has a tongue tie.

They are simply signs that feeding may not be working as comfortably or effectively as it could. A thorough feeding assessment can help determine what may be contributing to the difficulty.

When feeding feels difficult for you, too

A baby’s feeding difficulties can also affect the breastfeeding mother.

You may notice that:

• Latching feels painful
• Your baby frequently loses their latch
• Your nipples feel sore after feeds
• Feeds are very long or tiring
• Your baby needs to relatch repeatedly
• You are unsure whether your baby is transferring enough milk

Breastfeeding difficulties and nipple pain are common in the early postpartum period and don’t necessarily mean tongue tie is involved.

However, persistent feeding difficulties deserve attention rather than being something you simply have to put up with.

When tongue movement is restricted and breastfeeding difficulties continue despite appropriate feeding support, tongue tie may be one factor worth considering.

Sometimes, the tongue tie plays a part

A restricted tongue may make it harder for some babies to achieve the coordinated tongue movements needed for effective feeding.

This can potentially contribute to difficulties with latch, suction or milk transfer.

But there is an important distinction between having a tongue tie and having a tongue tie that is causing functional problems.

A baby can have a visible frenulum and feed well. Another baby may have restricted tongue movement alongside clear feeding difficulties.

That’s why assessment should focus on how your baby is feeding rather than the appearance of the frenulum alone.

Tongue tie isn’t always the answer

When feeding is difficult, it can be tempting to look for one clear explanation. But feeding problems can have many possible causes.

They may relate to:

• Positioning and attachment
• Milk supply
• Prematurity
• Oral motor skills
• Coordination
• Your baby’s overall health
• Other anatomical or developmental factors

Sometimes more than one factor may be involved. This is why a thorough feeding assessment is important before deciding that tongue tie is the cause or that a procedure is needed.

What happens during an assessment?

A healthcare professional may want to understand what feeding is actually like for you and your baby.

This can include asking about:

• When feeding difficulties began
• How often your baby feeds
• How long feeds usually take
• Whether your baby stays latched
• Whether feeding is painful
• Your baby’s weight and growth
• Wet and dirty nappies
• What happens during and after feeds

Your baby’s mouth and tongue movement may also be assessed. Where appropriate, feeding may be observed so that the clinician can consider how your baby is using their mouth and tongue during an actual feed.

The aim is to understand the whole picture, rather than focusing only on the frenulum.

Does every tongue tie need treatment?

No. A tongue tie does not automatically mean that a baby needs a procedure.

If a baby is feeding well, growing appropriately and not experiencing significant functional difficulties, treatment may not be necessary.

On the other hand, if restricted tongue movement is contributing to ongoing feeding difficulties, a healthcare professional may discuss available options with you.

The decision should be based on your baby’s individual circumstances and functional needs.

When should you seek help?

You don’t need to wait until feeding becomes overwhelming before asking for support.

Consider speaking with your baby’s healthcare professional if:

• Feeding is consistently painful
• Your baby struggles to stay latched
• Feeds are consistently very long
• Your baby frequently becomes unsettled during feeds
• You are concerned about milk transfer
• Your baby isn’t gaining weight as expected
• You notice persistent clicking or milk leaking
• Something about feeding simply doesn’t feel right

These signs don’t necessarily mean your baby has a tongue tie. They are simply reasons to have feeding assessed.

Trust your observations

Parents often notice subtle changes before they can explain exactly what feels wrong.

You may notice that your baby repeatedly loses their latch or that every feed follows the same difficult pattern.

You may notice that feeding leaves your baby tired and unsettled. Or you may simply feel that something isn’t quite working.

You don’t need to diagnose the problem yourself. Your observations can give your healthcare professional valuable information about what is happening during everyday feeds.

Feeding is about more than a latch

It can be easy to become focused on whether your baby is latching correctly. But feeding is about much more than one part of the process.

Your baby’s comfort, ability to coordinate feeding, milk intake, growth and overall wellbeing all matter. 

And your experience matters too. If breastfeeding is painful, exhausting or leaving you worried, you deserve support just as much as your baby does.

Supporting your baby and your feeding journey

If tongue tie is suspected, the most helpful next step is usually not to focus immediately on whether your baby needs a procedure. Start by understanding what is happening.

A healthcare professional can help assess your baby’s tongue movement, feeding pattern, growth and overall development, while considering other possible reasons for feeding difficulties.

Sometimes, simple feeding support may be enough.

Sometimes, further assessment is appropriate.

And sometimes, a tongue tie release may be considered.

The right approach depends on the individual baby.

Conclusion

Tongue tie can affect feeding for some babies, but it isn’t always the reason feeding is difficult. If your baby is struggling to latch, maintain suction, feed comfortably or transfer milk effectively, it’s worth looking at the bigger picture.

A careful assessment can help identify whether restricted tongue movement is contributing to the problem — or whether something else may need attention.

Most importantly, you don’t have to figure it out alone.

At Tiny Tusk Paediatrics, we take the time to understand your baby’s feeding, development and individual needs, providing thoughtful, evidence-based care for children and families.

Because sometimes, understanding what’s making feeding difficult is the first step towards making it feel easier.

Frequently asked questions

What is tongue tie?

Tongue tie is a condition where the tissue beneath the tongue restricts its movement. It only becomes a functional concern when the restriction affects things such as feeding.

Can tongue tie affect breastfeeding?

It can. For some babies, restricted tongue movement may make it harder to latch, maintain suction or feed effectively. However, not every baby with tongue tie has feeding difficulties.

Does tongue tie always cause feeding problems?

No. Some babies with tongue tie feed well without treatment. The focus should be on function and feeding, not simply the appearance of the frenulum.

What are common signs of feeding difficulty?

Difficulty latching, slipping off the breast, clicking sounds, long feeds, milk leaking and persistent unsettled feeding can be signs that feeding may need assessment.

Can tongue tie cause breastfeeding pain?

It may contribute to difficulties with latch that result in nipple pain, but breastfeeding pain can have many causes. Ongoing pain should be discussed with a healthcare professional.

Does every baby with tongue tie need a release?

No. Treatment isn’t automatically needed. A healthcare professional should assess whether restricted tongue movement is causing meaningful functional difficulties.

Can tongue tie affect bottle feeding?

It may affect some aspects of bottle feeding for some babies, but feeding difficulties can have many causes. An individual assessment can help identify what may be contributing.

When should I see a paediatrician?

If feeding is consistently painful or difficult, your baby struggles to stay latched, feeds for unusually long periods, seems unsettled during feeds or you’re concerned about growth or milk intake, consider seeking professional advice.