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A Step-By-Step Guide To Checking For Tongue/Lip Ties

Affiliate Disclosure | in Motherhood | by | with 177 Comments

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

I ♥ Kindergarten Rules

. .  but sometimes I really want to break the one that says “Keep your hands, feet, and objects to yourself.”

“Oh, your baby has reflux?” My hand twitches a bit as I force it to stay by my side.

“You’re struggling with low milk supply?” I put my hand in my pocket . . . it can’t be trusted.

“Your baby is waking every two hours to nurse at six months old?” At this point the urge is so strong I use my other hand to slap myself. 

What do I want to do? Check for a tongue / lip tie, of course!  They can be such a source of SO. MUCH. MISERY. for nursing mamas and their sweet babes, including me.

Unfortunately, the symptoms are often misdiagnosed as other conditions like colic, reflux, and failure to thrive because many pediatricians and lactation do not know how to properly identify them. Since writing about this subject three years ago I cannot count the number of messages I have received that said, “My pedi said there was nothing wrong so we suffered for months, then we got a second opinion and discovered a severe tie!”

Fortunately, Word Is Getting Out

While I was in New York getting Levi’s ties revised last month, Dr. Kotlow informed me that he gets at least one family per week who heard about him here. (If you’re not familiar with him, Dr. Kotlow is considered the foremost expert on tongue/lip ties in the United States.)

Where are all these people hearing about my story? From YOU.  Thank you for sharing my posts and helping get the word out – you have changed more lives than you know!

In this post I’m going to share with you some new tips Dr. K showed me for identifying tongue and lip ties at home, plus I’ll share the #1 critical mistake they make when assessing a tie.

Bottom line: If you’re a mama and you suspect a problem there probably is one. Tongue ties are not just about structure, they’re about function, and there is no one more qualified than you to determine if a baby’s latch feels “off.” Of course, these statements have not been evaluated by the FDA and are not intended to diagnose, treat, or cure any disease. I’m simply saying that a mama’s sense should be trusted, so if your gut says something is off and a home exam gives you reason to believe a tie might be an issue, find an informed care provider that will take your concerns seriously.

Now let’s get started!

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

Step 1: Focus on the symptoms first

“The most important diagnostic tool is not looking at the lip, or looking at the tongue. Although it’s important to clinically evaluate them… it’s mother’s symptoms,” Dr. Kotlow told me.

Why? Because a mother’s breast can come in many different sizes and shapes, as can a baby’s mouth. The crucial factor is how the two function together. Here are some things to look for when determining whether there is a concern:

Mama’s symptoms

  • Creased/flat/blanched nipple after feedings
  • Cracked/blistered/bleeding nipples
  • Discomfort while nursing
  • Plugged ducts
  • Thrush/mastitis
  • Sleep deprivation (Because baby is not able to nurse efficiently they compensate by nursing more often, leading to frequent night feedings. My first son was still nursing every 2 hours at 8 months old)

Baby’s symptoms

  • Difficulty latching on or falls off the breast easily
  • Gumming our chewing the nipple while nursing
  • Unable to hold a paci or bottle
  • Gassy (babies with ties often swallow a lot of air because they cannot maintain suction properly)
  • Poor weight gain
  • Excessive drooling
  • Baby is not able to fully drain breast
  • Choking on milk or popping off to gasp for air while nursing
  • Falling asleep during feedings, then waking a short while later to nurse again
  • Sleep deprivation (due to the need for frequent feedings)
  • Extended nursing episodes  – aka marathon nursing sessions
  • Clicking noises while sucking
  • Popping on and off breast often
  • Biting – Babies who have trouble grasping the nipple sometimes try to use their teeth to hold on. (Once they come in, of course)
  • Gap between teeth/jaw issues

Problems Associated With Tongue and Lip Ties

  • Babies may not be able to stimulate milk production through vigorous nursing, leading to low milk supply
  • Painful nursing/early weaning because child gets too frustrated
  • Improper tongue mobility may prevent babies from clearing milk from their mouth, causing tooth decay (especially in the front teeth)
  • Colic
  • Reflux
  • Sleep deprivation for mama and baby (due to the need for frequent feedings)
  • Speech difficulties
  • Gap between teeth/jaw issues

If some of these issues are present, move on to step 2.

Step 2: Examine the baby

What is the #1 mistake pediatricians and lactation consultants make when diagnosing tongue ties? According to Dr. Kotlow, it’s how they position baby for the exam.

“Correct examination of infants requires the infant be placed on the examiners lap with the infant’s head facing the same direction as the person evaluating the infant and the infant’s feet facing away from them. Just looking at the frenum in the mother’s lap will most likely lead to an incorrect or missed diagnosis.” (Source: Tongue-Tie Fact Sheet provided by Dr. Kotlow)

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

Image courtesy of Dr. Kotlow

Now that you know how to position baby, here’s how to check for a tie:

Look at the tongue

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

Photo courtesy of Dr. Kotlow

Here is a step-by-step exam guide from lactation consultant Catherine Genna.

Though anterior ties (at the front of the mouth) are pretty straightforward, posterior ties may be a bit tricky to identify. Here’s a video in which Dr. Kotlow demonstrates how to get a sneaky posterior tie to reveal itself:

Look at the lip

See that bulbous section in this baby’s lip? ↓

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

It’s called a lip callus, and it forms when babies can’t flange their lip out properly when nursing. Here’s what a latch should look like:

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

When the lip is not able to flange or “flip out” properly  – as is the case with a lip tie – a friction-induced callus can form. Is baby free from a lip tie if you don’t discover a callus? Not necessarily, but if you find one chances are pretty good a tie is present.

Now let’s look for the source of many nursing problems – including the lip callus – a maxillary tie (aka lip tie). Once you lift the lip, look for a band of tissue that connects the lip to the gum area. If the frenulum (aka the band of tissue) is tight, a lip tie is likely.

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

Some of the complications associated with a lip tie are:

  • restricted function which leads to discomfort while nursing
  • gassiness/reflux/colic due to an improper seal that causes baby to swallow excess air
  • tooth decay

Tooth decay occurs because baby may not be able to clear their mouth properly, causing pockets of milk to collect near the upper lip. As the top four teeth come in the milk may rest on them and cause decay.

Check baby’s sucking pattern

Reach in to your mouth with your thumb and feel the roof of your mouth. Toward the back you’ll notice a spot where the hard palate meets the soft palate. Now, using your index finger find this same spot in your baby’s mouth. If you feel compression along the entire length of your finger – like a gentle massage – this is good function.

Colic? Reflux? Baby that won't sleep? It may be an undiagnosed tongue/lip tie. Heres a step-by-step-guide to identifying them at home.

Image courtesy of Dr. Kotlow

If most of the compression is at the front of the mouth, this is an indication that your baby is actually grabbing the nipple to hold on instead of compressing the whole breast. This kind of latch often results in discomfort and poor milk stimulation.

Step 3: Confirm Your Diagnosis & Explore Treatment Options

In this post I share how to get a FREE expert opinion from Dr. Kotlow, who is the leading expert on tongue/lip ties in the United States. I also discuss different treatment options and link to providers around the country. You can also join the tongue tie babies support group on Facebook to talk with and learn from other moms.

Questions, insights, doctor recommendations?

Please share them in the comments!


Tongue Tie Fact Sheet by Dr. Lawrence Kotlow

American Academy of Pediatrics

Photo credits:

Main photo – Mae Burke Photography. Find her on Facebook.

Diathesis, BruceBlaus

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177 Responses to A Step-By-Step Guide To Checking For Tongue/Lip Ties

  1. IF WE EVER HAVE ANOTHER… | Welcoming Little Buddy says:

    […] in the game, we would likely have had it clipped). Here’s a good blog post I recently found: Dr. Newman is also known as a great resource. You can even email him directly and he will […]

    • sarah persons says:

      my granddaughter is three weeks old and we think she has tongue lip-ties she lives in Stark ,Louisiana can you recommend a doctor around that area ?

  2. Natureal Mom – Preventing & Treating Recurrent Blocked / Plugged Milk Ducts says:

    […] tie and can be diagnosed by a lactation consultant, pediatrician or pediatric dentist. Please read here for further […]

    • Pamela Winchell says:

      Hi- we don’t have a lot of the symptoms except for poor weight gain. My daughter is 12 weeks. I just took her to the dr yesterday for my own peace of mind to weigh her then nurse then weigh again. She was only able to get 2.5 oz from me from both breasts. The put her info in the chart and she went from 10th to 5th percentile for weight. I’m in San Tan Valley AZ, whom do you recommend in or near my area to get a proper diagnosis.

  3. Amanda says:

    I had heard of a tongue tie but not a lip tie! My 4 mon old has been diagnosed with sagittal craniosynostosis and I heard that tongue/lip ties were common with his diagnosis. Sure enough, he has a pretty severe lip tie from what I can determine : / He nurses, but struggles staying latched on. I don’t experience much pain but he does seem to get extra gassy and falls asleep a lot while nursing. I’m also concerned with teeth decay and placement so the sooner this gets treated the better! I live near Las Vegas. Are there any Drs you can refer me to?

  4. Should My Newborn Get A Vitamin K Shot?The Mommypotamus | says:

    […] be helpful in establishing a good breastfeeding relationship. Moms also might want to check for a tongue or lip tie to increase nursing […]

  5. Tongue Ties and Lip Ties | Good Families Do… says:

    […] A Step-by-step Guide to Diagnosing Tongue/Lip Ties Here’s a great article to read if you are thinking ties are an issue for you or someone you know. […]

  6. Stephanie says:

    Help please! I am in desperate need of a dental surgeon or Dr. that will take our sons Severe posterior tongue as well as lip tie seriously! We have received a class 4 diagnosis on both from an orofacial myofunctional therapist but when we visited the dental surgeon he said he only saw a lip tie not tongue (he didn’t look at him from the correct position!), and he scheduled surgery for 6 weeks from now, b/c that’s when he gets a surgery block at the hospital. We have every single symptom…we have been to drs., lactation consultants, a breast feeding specialist Pediatrician, and an ENT, and gotten tubes in ears all just trying to figure this out….we live in Central Nebraska but will drive for help of course! Our son is now 8 mo. old and, although still somewhat chubby, has gone from the 75% for weight down to the 16%. Our family doc said that it’s just normal at this age b/c they get easily distracted while nursing…..I tried to hold back the mama bear inside. Does anyone know of someone at least in the Midwest to help us? We would happily drive to any city within 8hrs., Maybe even farther. I wish NY was closer. Thank you for any help! It’s getting very hard to keep up the pumping required to keep up my supply and our little guy can’t take a bottle without gagging and throwing up often…we desperately want to keep nursing.

  7. Bobby Ghaheri MD says:

    You have several options but you’ll need to drive.
    1) Fitzik dentistry in Wichita Kansas.

    2) Mindy Hochgesang in Bettendorf Iowa. – she’s very open to emails.

    You can email me if you need more direction –

  8. Breastfeeding :: Sometimes It’s Easy, Sometimes It’s Not | Columbia SC Moms Blog says:

    […] He still wouldn’t pee. And I recalled, dimly, something about lip and tongue ties. […]

  9. Tips for Successful Breastfeeding and Increasing Milk Supply | Kansas City Moms Blog says:

    […] Make sure you find the support you need to be successful with breastfeeding. Join a breastfeeding class or support group, get connected with a lactation consultant, read great breastfeeding books like Breastfeeding Made Simple, The Nursing Mothers Companion, The Womanly Art of Breastfeeding, The Breastfeeding Book by Dr. Sears or check out (a great resource for nursing mamas). Many pediatricians are not trained in lactation support and unfortunately, many will give advice as if they are – so please speak with a lactation consultant, postpartum doula or breastfeeding professional if you have any issues, especially when it comes to latch and milk supply. If you are experiencing a chronic latch issue, please make sure that your breastfeeding professional checks for a tongue tie. […]

  10. World Breastfeeding Week: What I Wish I had Known » Little Fire Brigade says:

    […] LC would have to look at a number of different things  to determine if there might be a TT/ULT. This is probably the best article I’ve found online that help moms in diagnosing a baby’s […]

  11. karen hoffman says:

    I believe I just discovered both my children – 3yo and 9mo – have lip ties, which explains SO much of my troubles over the past 3 years. I know Dr. Kotlow is in Albany, but can anyone recommend a doctor who uses lasers in the NYC metro area? We live in Brooklyn, so don’t have a car, and I’ve found the following names in my research:
    Scott Siegel in Long Island
    Gina Tanios-Rafla in New Jersey
    Leonard Kundel in Connecticut

  12. Leann says:

    I am pretty sure my son has a mxillary lip tie. He is 10 weeks and has completely fallen off the growth curve. Do you know of any good docs in the gulf coast area (anywhere from New Orleans to south Florida?

  13. ashley23 says:

    Thank you!! I was about to give up BF cuz my baby is 4 weeks and my nipples still hurt and I can’t figure out how to get him to latch any better. I have had to supplement with formula cuz his weight gain was so low. My LC noticed that his top lip wasn’t popped up like it should be during a feeding just yesterday and she looked and said she thought it was lip tie. My ped looked at me like I was crazy and thought my concern was painful nipples vs lip tie cuz he said it was fine. I can handle the painful latching/feeding but he doesn’t stay awake for more than 2 min. He doesn’t feed long enough and needs to eat every hr or less. I have a 4 yr old and a husband who works out of town and that BF schedule is not manageable. I’m calling a dentist that someone recommended tomorrow in hopes to get this fixed and have a happy ever after also. I wasn’t convinced on calling until I read your article though so thank you so much for sharing!!

  14. Toddler Tooth Health | Sweet Pea Families says:

    […] my son has some brown spots in between his front four teeth. I had already discovered he had an undiagnosed lip tie (which I am sure was the culprit for our zillion breastfeeding troubles) and this seemed to be […]

  15. Mishell says:

    Thank you for the info like you said we mom can tell if something wrong I think my one week old has lip tie and or tounge tie. Can any one recommend a doc In California I Live in Los Angeles

    • Bobby Ghaheri says:

      James Jesse DDS in San Bernadino is your best option for a laser procedure. I’m not aware of anyone in LA who does a good job.

      • Meaghan Hernandez says:

        I just had my son go see Dr. James Jesse for an upper lip frenectomy. He was fantastic! I actually flew down to see him. Well worth the trip. It was very quick and painless for my child. They let me be in the room and I held my son’s hand, and everyone made me and my child feel welcome and very comfortable. I highly recommend him!

  16. MR says:

    My son was diagnosed with failure to thrive and admitted to the hospital at 3 months old. He weighed in at 8 pounds and change. It was confusing because he was the happiest baby and never cried, but was skin and bones. He struggled both with breastfeeding and bottle feeding. (Breast milk and formula.) We saw the lactation consultant and went in for weighings. The pediatrician who ordered that he be admitted accused me of neglect, and of purposefully starving my baby. It was the most horrifying day/week of my life.

    Once admitted, he was in the hospital for 5 days. During this time they watched me during feedings to “make sure I was actually feeding him.” They ran every test they could think of, and after 5 days–he weighed LESS than when we came in–they said they didn’t know what was wrong with him, but that they needed our room for somebody else and that we had to go home, and they sent me home with my little 3 month old, 8 pound baby. I reluctantly started him on pureed avocado and sweet potato because I didn’t know what else to do to keep him from starving, and he started gaining weight.

    Fast forward 4 years. Just got home from the dentist today, where I found out he has a SIGNIFICANT tongue tie. I asked if this could contribute to failure to thrive and she said “Oh if he had failure to thrive this is absolutely why, no question.” She also said there is no reason the doctors and lactation consultants shouldn’t have caught this, especially after almost a WEEK in the hospital and THOUSANDS and THOUSANDS of dollars in hospital bills. Because of my son’s extended bout of failure to thrive, he now has developmental delays that effect his–and our family’s–everyday lives. Language delay has caused communication to be extremely difficult, resulting in all sorts of emotional and social problems for him. Sensory Processing Disorder causes seemingly small irritations to bring his world crashing down, multiple times a day. Frustration abounds. Because NONE of these MANY medical professionals could diagnose a simple tongue tie? Am I wrong to be livid??

    • Christina says:

      No you are right!!

      My son and daughter both had mild SPD and my son was heading down a road of withdrawal that would have ended in a diagnosis of RAD (reactive attachment disorder) or ASD. He was sleeping more and more, refusing eye contact with me… at 2 months old, the poor baby thought I was abusing him I’m sure– he aspirated every time he nursed!

      I will say that at 3 months we got his tie released, and began therapies, including oral motor, and dry brushing & joint compression, and he began to steadily improve. We did sensory play and I incorporated as much OT into our daily lives (tooth brushing, water play, bean box etc), as guided by friends who are SLTs or have kiddos with SPD.

      He is now 2 and is absolutely not on the SPD spectrum. He struggles a tiny bit with chewing meat but that is the only remnant of his tongue tie symptoms. He is very affectionate, trusting, cooperative and verbal. My daughter is also considered “normal.”. We also use essential oils to help them balance out when they get overwhelmed.

      All that to say– kids are very resiliant and often improve a LOT. Even though your son is older and has already suffered so much there is so much hope!

  17. Amanda says:

    How do you find a doctor who knows about lip ties?
    We live in an extremely rural area of Arkansas. I have four daughters, none of whom were able to breastfeed. The oldest has apraxia, so I put her inability to latch down to that.

    The other three couldn’t latch properly, either, though. A couple of months ago, I was looking up tongue ties (because I’m pre-med and curious!). I saw a picture of an upper lip tie and realized that all four of my children have them. I had always wondered why their little gums looked so funny, but none of their doctors were concerned, so I just thought it was normal.

    I’m not sure if I need to have them clipped or not. I gave up trying to nurse the youngest a couple of months ago (I have hormonal issues as well.). The oldest doesn’t seem to be having any issues with her teeth, but the middle two have gaps between their two front teeth, I’m assuming caused by the tie.

    The doctors here have never even heard of a lip tie, so they don’t see the potential for a problem. We also don’t have dental coverage, so it’s not like I can just take all four of them in for exams when I don’t know if the particular dentist will even know what I’m talking about. :(

  18. says:

    Thank you so much for your post. i have a somewhat similar question to the person above, do you know of any online submissions of photos I can submit to see just an opinion about a tongue tie. I suspect my 21 yr old daughter, who has been dealign with difficulty with speech and eating might actually be tongue tied and we never knew. I know it is best to go to a doctor (we have a scheduled in a few weeks, but i wanted to get another opinion if possible. Thanks!

  19. Beth says:

    I am afraid that my baby’s lip tie reconnected. We had the procedure done at 6 weeks (almost 2 weeks ago). Our doctor didn’t give us any aftercare instructions so we didn’t start stretching the area until a few days later. Nursing isn’t going well and I can’t seem to get a good latch or have a pain free session. How do I know if it reattached?

  20. Christina says:

    LOVE this post!! I recently typed up a list of all the therapies & stretches & websites that helped me both before and after my babies’ revisions.

    For my son, the revision at 3 mos was a game-changer, but he was so affected my nursing improperly, choking, aspirating, projectile vomiting, etc, that he just didn’t know how to nurse or want to after the revision… so we needed a team of therapists and multiple aspects of therapy. We re-released his tie at 1 year old along with my daughter’s (she was 3 1/2 at the time). I continued nursing him until 2.5, and he did better and better the longer we nursed– it was finally 100% pain-free the last 3 months or so!

  21. Heather says:

    I am so relieved to have come across all of this wonderful material regarding tongue and lip ties. My baby boy went to the ENT yesterday and they released his posterior tongue tie. They said they did not recommend releasing the ULT unless it looks like it will cause a gap between his teeth. I’m a little unsure about that since he is only 2 1/2 months old. But I am grateful to have the tongue released which just since last night he is nursing better and getting more milk. Hopefully this will solve our problems. Thank you everyone for sharing your stories. It’s nice to know I’m not the only mom going through this.

  22. Melissa says:

    My two year old has a severe cavity and another one forming. I was absolutely shocked as we eat very healthy, very little honey and even less sugar and juice, brushed her teeth regularly, etc. Even though I have always nursed her a lot at night, I didn’t think it would cause a problem. I took her to the Pediatric Dentist who said they’d have to put her under anesthesia to get them filled and have caps put on her teeth. When I came home I started looking for any other options and found information on healing tooth decay and the reasons why an otherwise healthy child would have tooth problems. I looked in her mouth and she has a lip tie! I never knew, although the signs were there, I just had no information on it at all. She always nursed VERY frequently, as in every twenty minutes for months! I co-slept and she would nurse all night and would never take a pacifier, it would just come right back out. Luckily, I did not have problems with low milk supply, but I did have problems with mastitis and she got a severe case of thrush. In addition, she had a big nursing callous for quite awhile but I was told it was normal. She drooled a TON. In fact, for several months she had to constantly wear a bib. I was told it was just from teething, although she drooled that much for several months before teeth came through. She has also always been tiny for her age (Around 3rd percentile) despite her massive appetite. Is it too late to get it fixed? Is it difficult to have fixed? Interestingly, I found that I have a lip tie as well and I can remember my mother saying how colicky I was. I wonder if it was because of it. Should I go forward with the anesthesia and fillings or wait to see if I can heal them naturally? I’m just worried because one of the cavities is brown in the middle and extends just about to the root :(

  23. Folate vs Folic Acid, MTHFR, and Why I Regret Taking My Prenatal Vitamin | Health, Home, & Happiness (tm) says:

    […] For more information on lip and tongue ties, Mommypotamus talks about them, and how they impact the nursing relationship, here. […]

  24. Debra Beckman, MS, CCC-SLP says:

    Many of the symptoms described above could be due to factors other than a structural problem of the lip or tongue. It is very important to have a functional assessment of oral motor patterns prior to cutting any baby’s lip or tongue. The best one to use for babies is Beckman Oral Motor Protocol. If muscle function is impaired, surgery will not solve the problem. It is possible to have both muscle impairment as well as structural concerns. By addressing the oral motor movement concerns for durational strength first, any surgery will have better outcome, and may not be needed at all.

  25. Ashley McKenna says:

    Thank you for posting this. I had my daughter examined for a tongue tie, at the recommendation of a lactation consultant. We’ve had to work at it, but she’s not a terrible nurser, and I don’t many of the symptoms (at least not after the first few weeks). What pushed me to have it looked at is the fact that she could not take a bottle. She understood how to do it, but just couldn’t get her tongue to work with the nipples. We finally found ONE that works for her (Mam, if anyone else is having troubles). She never took a paci, and I suspect it’s for the same reason. The doc said that it’s not severe enough for clipping, especially since she was 4 months old and nursing well (and gaining weight like a champ). We have to watch for speech issues and may need to address it then. BUT – the lip callus! She is 6 months old and STILL has one. That’s news to me, and worth checking out again…it’s frustrating that this is such an overlooked condition. Our pediatrician and FOUR lactation consultants checked her, and it still took four months to get it looked at!

  26. Brittany says:

    Just wanted to leave a note to recommend Dr. Allen Sprinkle at Pride Dental in North Arlington, TX. He does great work doing frenectomies on newborns and is part of a holistic/biological dental practice.

  27. Best of the Potamus In 2014 - MommypotamusMommypotamus | says:

    […] a source of SO. MUCH. MISERY. for nursing mamas and their sweet babes, including me. Here’s a step-by-step guide to checking for tongue/lip ties at home that you may find […]

  28. Rachel says:

    Thank you for bringing awareness to this subject. This is something that definitely needs more research and parents bringing up their concerns is the first step in getting that. I think it would be helpful if you also included some pictures of the range of normal frenulums. Everybody has a lingual and labial frenulum. Some are shorter than others without being “ties.” If you’re somebody that isn’t particularly familiar with oral anatomy and doesn’t spend a lot of time looking in other people’s mouths, it might be easy to self-diagnose a tie when there really isn’t one.

    • Christina says:

      Well, ties are diagnosed by both structure and function– so how they look is half, but how they are affecting daily life (eating, drinking, nursing, swallowing, breathing, etc) is another part of an equation. A mom with a baby doing just fine probably won’t be looking in her baby’s mouth for troubleshooting anyway. Moms who have babies choking, crying, struggling to gain weight… they would look. That would just be a starting point, though. The next step would be to find a care provider to confirm the diagnosis and move towards either revision or functional improvement via stretches and oral motor therapy.

  29. Nancy says:

    Oh, how I wish I had found out about this a number of years back. My daughter is now 8 and has a severe lip tie. Her dentist noticed it last year and referred us to an orthodontist because of it. We were nursing constantly for the first 2 years of her life, to the point where it was hard to get anything at all done. It was all nursing, diaper changing or laundry. And sleep? Yeah, there wasn’t much of that — for me anyways. I went through those 2 years in a total blur, hardly able to put a coherent sentence together. We even went to a breastfeeding specialist. Why on earth do doctors not know about this?

    It’s interesting to see that lip ties can affect later speech. I had no idea. My daughter has some speech issues and it never even occurred to me that there might be a connection. I’ll have to look into that.

  30. Mo says:

    Hi. I was thinking that proper latch probably includes a flanged upper lip. You may want to modify the proper latch image to reflect that (well, maybe not the image but adding text to point that out). We suspect an upper lip tie on our baby. She has a tendency to curl her upper lip (at bottle or breast).

  31. KatieW says:

    Are there any good doctors near NE Montana? My daughter has a lip tie for sure, and at 8weeks old I can barley handle breastfeeding her due to how painful it is! We share many of the symptoms listed above… I had same issues with my first daughter but suffered through it for three months until it got better. I didn’t know anything about lip/tongue tie. Will just any ol doctor (family doc) be able to clip it ok or do I need to go to a specialist?

  32. samantha naron says:

    Wow, I could literally start bawling. I have a 5 day old and 3 other children. I just stopped trying to nurse my new born because of the pain. It was just to much and because I could tell he was starving! I was unsuccessful nursing my other 3 children as well to the point that my first ended up in the hospital because she was so underweight. After reading your article, I think all my kids are tongue tied. Every symptom for momma matched except thrush! Even the clicking noise from baby, all of my kids did this even my 5 day old!

    do you recommend a Dr in Tacoma Washington? I have seen a lactation consultant and was told I have very large nipples and that the reason my kids cant nurse is because they cant get enough areola into their mouths! But I think its this! Thank you!

  33. Karell says:

    I am sad yet relieved to have come across this article. 12yrs. ago I felt the pressing need to to stop nursing my little girl (which I always regret) because she was diagnosed with having severe reflux. We tried for 5 1/2 months she just wouldn’t gain weight & her thrush caused a very bad infection for me. Her dentist discovered the extra skin under lip & recommended having it cut when she was three. No one ever said anything about being the possible cause of our nursing troubles. Having successfully nursed both her older & younger siblings for 2 full years, I really feel like we were cheated. I am expecting another child soon, so if any similar issues arrive I know feel prepared, thanks!

  34. Diana says:

    Hi! My 13 month old son just got his lip and tongue revised by dr Kotlow ( we are driving back home to NJ as I type). He is very sweet and patient. He did tell me to use Tylenol or Motrin and topical oragell if my son is in pain. I was wondering if anyone could suggest a natural alternative to pain relieving. I am new to this… Thank you all!

    • Heather says:

      I used a homeopathic remedy called “Rescue Remedy for Kids” with my little one and felt it helped significantly. I gave it to him before the procedure, in the hours and days after the procedure, and when we had to do stretching exercises. For me, the hardest part is that he disliked doing the stretching exercises. Eventually I figured out that it wasn’t so much due to discomfort, but due to the fact that he didn’t like my husband’s huge fingers pressing around in his mouth. We started waiting until he was asleep to do them. We gave him the Rescue Remedy with a dropper as he slept, then waited 10 minutes and did the exercises. He fussed a little but didn’t even wake up most of the time.

  35. Diana says:

    Oh Thank you so much! As always you are a great help! I am having a hard time with the exercises. He is 13 months and bites down really hard. I am able to do the lip but the tongue is impossible. I am going to try while he is asleep. I sent my husband out to get the rescue remedy and it helped big time. I should have asked before… Thanks to you I had this done early enough not to cause him any speech and decay problems. Dr. Kotlow still doesn’t understand how I was able to breastfeed him till now, his tongue was the most severe case. I guess it was God who helped me.

  36. Rosemarie says:

    Wow!! I always wondered why I had so much trouble nursing my daughter and now I have my answer 12 years later!!! Wish this information had been available to me then. Would have saved us both from 12 months of sleep deprivation, painful nursing and colic!!

  37. Jasmin says:

    Any recommendations for a dr in Los angeles, ca. I am just noticing my son has a tongue tie… And it wasn’t caught either… He is now 5 months… Thanks in advance

  38. Kristy says:

    Thank you for this information! Who can recommend a pediatrician or dental practice in western Pennsylvania to treat an infant’s lip tie? If not the Pittsburgh-Erie area, then Cleveland, Columbus, Cincinnati, Buffalo, Harrisburg, Philadelphia, Baltimore, or Washington, DC. As long as we can drive it in a day, we’ll go. I just want to find a true expert who will take this condition seriously and preferably use a laser. Thank you!

  39. Kit Towne says:

    I was just giving my 7 month old daughter teething tablets and noticed what looks for sure like a lip tie. Up until recently we hadn’t had any trouble nursing. And recently I think our troubles have to do more with other things. I feel like it’s still a concern because of the things it could effect later on. But do you think it’s actually a lip tie if there’s no issues arising from it. And will a doctor even care then?

  40. Sarah Follen says:

    Do you have pictures of what the mouth of a baby WITHOUT a tongue/lip tie looks like, by any chance?

  41. Emily P says:

    Any chance anyone has a recommendation for a provider in the Washington, DC area?

  42. Cooper's Lip Tie Story - Real Food With Kids says:

    […] I was on the computer researching food intolerances and gut health as usual when I stumbled across an article by Mommypotamus about tongue and lip ties. I have no idea why I clicked on it. My time was so precious at this point that I didn’t waste it […]

  43. Mothering says:

    […] looking at the article, I thought about one thing: my […]

  44. The Curse of the Upper Lip Tie | says:

    […] has an awesome step-by-step guide on how to identify a tongue or lip […]

  45. Jeannie says:

    Is there a chance you can add Dr Ghaheri’s info as a link up above? I love your TT and LT information. Dr. Ghaheri was trained by Kotlow and is on the opposite coast. He is wonderful and a TT and a LT conference speaker now, as well.

  46. Rochelle simpson says:

    How do I find the best person in Australia to perform correction of posterior tongue tie for my 7 year old? My son attends speech therapy and OTHER has difficulty with chewing (often chokes) but development is normal is every other way …speech therapist says has posterior tongue tie …but general doc says don’t worry about it…I believe his inability to pronounce letters is affecting his reading and spelling …could this be true? Thanks for any info is appreciated

    • Bobby Ghaheri MD says:

      Yes it’s quite possible. The most commonly affected letters are R, S, L, CH, SH, TH, D, Z and occasionally K and G. Where in Australia are you? I have multiple contacts.

  47. Amy says:

    Great site! I had my daughter’s tongue and lip tie diagnosed today after both my midwife team and pediatrician said she didn’t have tongue tie so I definitely appreciate you trying to help everyone identify it easier.

    My poor daughter could have avoided a lot if her tongue tie was identified sooner. When she was four days old she had to go to the hospital for two days because she got jaundice from not feeding enough. Since then, she’s had poor weight gain and constantly seems fussy and hungry – she’s still only at her birth weight and she’s three and a half weeks old.

    Keep up with your efforts. I’d be happy to send pictures of her tongue or video of her nursing (frequent unlatching/latching, her frustration, my pinched nipple) if that helps you guys show people what symptoms of tongue tie look like.

  48. Every Mamas Challenge: Overcoming Disappointment – MommypotamusMommypotamus | says:

    […] For information on how to check for tongue and lip ties at home, please read this post. […]

  49. Maria says:


    I am in Australia, Canberra and would appreciate a professional diagnosis. Do you have any contacts in Canberra? My son has the lip callus, receding chin, flat philtrum, his tongue bowls when he screams/cries, his outer upper incisors have worn away and he has had so many issues with eating solids (to the point of becoming anemic), he has been constantly congested with ear-infections since he was about 6 months. Recently, we started a dairy diet for him and he is not sick as often anymore…but still sounds congested when he sleeps. He is 2 1/2 now. Still has issues with solids and although he falls asleep easily, he doesn’t often stay asleep for long periods….still wakes up often through the night. Have you found a correlation between posterior tongue-ties and breathing issues? BTW, he had noisy Laryngomalacia when he was born till about 10 months old. Any hints to help diagnose what’s going on would be appreciated. ATM, he is having possible behavioral issues, SPD and a delay in communication. However, he is very clever in other areas he can count forever, he knows his ABCs and can play matching cards and re-sing any song he hears.

    Thank you

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