10 Hidden Tongue Tie Symptoms You Need to Know About
Two months.
I can’t tell you how many times I considered giving up breastfeeding during that time. The teeth-grinding pain when my daughter nursed, her obvious frustration, and the constant battle between an overactive letdown and low milk supply had removed any joy from the act of breastfeeding. I spent the majority of it wondering how in the world this task could ever be considered “beautiful” when it was so obvious that my baby and I both hated it.
When my daughter was two months old, I finally bit the bullet and met with a lactation consultant. In a matter of minutes, she was diagnosed with a posterior tongue tie and moderate upper lip tie.
If you’re reading this, there is probably something off with your breastfeeding relationship. Maybe you’re already voiced your concerns to a pediatrician. Or perhaps you’ve already done your fair share of research and have begun to wonder, “Does my baby have a tongue tie?”
If that’s the case, I’m so glad that you stumbled upon this article. I’ve been exactly where you’ve been, Mama, and I know how frustrating and confusing this condition can be. In this post, you’ll learn about the more subtle tongue tie symptoms. While none of these symptoms exclusively point to a tongue tie, it may shed light on the issues that you’ve been experiencing.
What Does it Mean When Your Baby is Tongue Tied?
If you’re completely new to the concept of a tongue tie, you’re not alone. Despite its increasing occurrence, many doctors, midwives, and pediatricians are still researching this condition and may even deliver mixed information.
When your baby has a tongue tie (also known as ankyloglossia), the small flap of skin under his tongue (the lingual frenulum) is either too tight, too short, or located too close to the tip of his tongue. The result is limited tongue mobility, ranging from mild to severe.
The easiest way to understand how a tongue tie inhibits your baby is to try it on yourself. Use your thumb and index finger to lightly pinch the little flap of skin under your tongue. Holding your frenulum, try to move your tongue from left to right, or try to touch your tongue to your lips. At minimum, this movement should be difficult. At worst, it should sting.
Depending on the severity of your baby’s tongue tie, he will experience this every time he nurses. The most common tongue tie symptoms stem from this limitation (which we’ll get into in just a moment).
While we won’t discuss the main types of tongue ties in this post, keep in mind that there are three: anterior, posterior, and lip ties (which is technically a separate condition).
Related Article: 5 Helpful Tips for Breastfeeding a Tongue Tied Baby
10 Hidden Tongue Tie Symptoms You Need to Know About
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1 Improper Latch – I.E. Your Baby’s Lips Won’t Flange
If you’re a nursing mama, you’ve probably taken a breastfeeding video tutorial or two (if you haven’t, this breastfeeding class is AWESOME). You probably already know that the key to an amazing latch is beautiful, flanged, fish lips.
If you’ve used various techniques to achieve a proper latch and your baby’s lips are still pressed around your nipple, there’s a good chance your lack of success isn’t your fault. Severe lip tie cases prevent babies from latching properly. The muscle tissue connecting your baby’s gums to his upper lip is too taut, causing an improper latch.
Even babies exclusively diagnosed with a tongue tie may not be able to achieve a good latch, due to their lack of tongue mobility. We’ll get to that in a moment.
( FYI, if you still feel like you’re struggling with catching on to latching and breastfeeding, the best breastfeeding book I’ve been able to find is the Breastfeeding Handbook. It’s an easy read (only 28 pages) and filled with tutorials, diagrams, and trackers. My absolute favorite part of the book is the information that you might be missing or may have easily overlooked, like how to latch properly, how to use different breastfeeding positions, reading your baby’s hunger cues, etc. etc.)
2 Your Baby Makes a Clicking Sound While Breastfeeding
The next time you nurse your baby, just listen. If you hear a frequent clicking sound, it’s time to visit a lactation consultant.
When your baby nurses, he doesn’t just milk your nipple like a cow udder. The combination of negative pressure and mouth movement against your areola draws milk from the breast. Your baby latches on, creates a flange with his lips, cups your breast with his tongue (creating the vacuum), and your nipple is nestled safely at the top of his palette. (That’s the non-professional gist of the mechanics of breastfeeding but hopefully you get the general idea).
A tongue tied baby may not be able to create this vacuum or, if he can, this vacuum will be interrupted frequently.
3 Pain during Breastfeeding
When you’re just beginning breastfeeding, you will probably experience discomfort. With that said, you should never–EVER–be in pain. If you’re currently experiencing breast pain, you know what I’m talking about. It’s the kind of pain that makes every single nursing session the ultimate sacrifice. The kind of pain that is so unbearable that many moms have to give up breastfeeding altogether.
The most common cause for this pain is a bad latch.
Milk is ejected from the breast by the negative pressure your baby creates. When no vacuum is present, your baby’s lips naturally slip to your nipple. Not only with these lips slip, they’ll pressed down in an effort to stabilize his latch.
Your nipple is not meant to be suckled.
When your baby isn’t suckling properly, your nipple can shred in as little as one nursing session.
In my early days of breastfeeding, each and every nursing session was torture. I would dread our time together and cringe every time her little mouth came near me. So many people dismissed my pain as a new mom problem. The end result? I endured this off and on for two months, because I blamed this experience on myself.
Mama, if this is you, let me be the one person to tell you that pain is NOT a new mom problem. It’s a dead giveaway that something is wrong. Schedule a visit with a lactation consultant ASAP. There are a myriad of reasons why breastfeeding is painful and not one of them is good.
Related Post: The Best Organic Nipple Creams to Relieve Breast Pain
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4 Short Nursing Sessions, Snack Feedings and Lazy Eaters
Snack feedings are short, frequent feedings.
A “good” feeding is about 20-40 minutes long (depending on your baby’s age, your milk flow, and his preferences). If your newborn is nursing for about 5-10 minutes at a time, more frequently than every two hours, then he’s a snack feeder.
Snack feeding and “lazy eaters” tend to go hand-in-hand. A lazy eater is a baby that only nurses small amounts at a time before either falling asleep or rejecting the breast.
When your baby has a tongue tie, nursing will take twice the effort. His little mouth will be latched onto your nipple. He won’t have negative pressure to draw your milk out as efficiently as he should. The end result is a baby that depends on his mother’s let down reflex or simply becomes too exhausted to nurse any longer (thus the five minute feedings).
Just to give you some context, my lazy eater would practically claw at my breast for milk, then after my let-down had diminished after 8 minutes, she would pull off and scream. At first, I chuckled about the situation; I believed she just didn’t want to work for her food. Little did I know, her “preference” was due to an underlying disability.
(I should probably note that snack feeding is extremely common for breastfed babies. It isn’t a sign of tongue tie on its own, but it can be an unwanted side-effect.)
Depending on your breastfeeding philosophy, snack feeding and lazy eaters may not bother you. If you’re more into attachment parenting, you may not have an issue with frequent nursing.
However, if you’d like to train your baby to sleep through the night, this habit can quickly become a major hindrance.
Related Post: How to Get a Breastfed Baby to Sleep Through the Night
5 Fussiness or Screaming During Breastfeeding
Breastfeeding with a tongue tie is a frustrating situation for you and your baby. He’s working his hardest for his dinner with barely any results. Some tongue tied babies are starving, but they don’t possess the suckling skills to nurse!
Combine that with the natural discomfort and pain that comes from limited tongue mobility, and you’ll have a very cranky baby.
When my daughter suffered from a tongue tie, she would start to scream about 5-10 minutes into nursing.
Sometimes I could appease her by switching breasts. On a bad day, she’d try to latch and fail immediately. Other times, she’d latch successfully, but pull away after a minute or two, screaming again.
I know now that this behavior was probably caused by her dependence on my let-down. At the beginning of nursing sessions, she could simply latch and drink the milk. After my let-down dissipated, she would fuss, still very much hungry.
Fussiness during breastfeeding is a pretty common event when your baby is young. It could be your baby’s personality, gas, GERD, a slow let-down, or simply to signify that they are done.
I think the key lies within when your baby starts fussing. Does he start crying right at the beginning (slow let-down), middle (gas, milkflow), or the end (hunger, done, GERD). In any case, if your baby is continuously crying during nursing, it could be a sign that something is going on. Trust your mommy gut and mention it to a professional.
6 Dribbling Milk
Bottle feeding is a much, much easier way to feed your tongue tied baby. Your baby will be able to suckle easily, despite his tongue’s limited mobility. Unfortunately, bottle fed babies have their own set of tongue tie symptoms.
Dribbling milk when bottle feeding isn’t necessarily a diagnosing symptom of tongue tie, but it is a pretty common side-effect. Your baby may be unable to create a good seal or perhaps he has a weak suck. Either side-effect causes a baby to leak milk while bottle feeding.
If you’re seeing this behavior, watch out. It isn’t just messy; your baby could be taking in a lot of air, which can cause painful gas and exasperate GERD symptoms.
(Keep in mind that leaking milk is also caused by the wrong nipple. See if a slow-flow nipple helps!)
7 Low Milk Supply
Your milk production is a two-part process; your baby needs to stimulate your areola correctly and empty your breast in order to tell your body to produce more milk. In other words, your body needs a good latch just as much as your baby does.
A tongue tied baby that relies on a let-down reflex is often unable to empty the breast or stimulate the areola correctly. It’s no surprise that a constant battle with low milk production is one of the most common tongue tie symptoms moms experience.
I’ve struggled with low milk supply throughout my breastfeeding experience, but it was never worse than when my daughter was still tongue tied. If you’re finding that your milk supply can only be maintained by additional pumping sessions, that’s a good indication that your baby isn’t draining your breast properly.
8 Milk or Lip Blisters
Newborn lip blisters are pretty common. In normal cases, they are simply markers that your baby’s body is adjusting to breastfeeding. If your baby’s lips are sensitive, they might continue until the skin has “toughened up”.
Long-term lip blisters are a sign of tongue tie.
Above is a picture of my daughter’s lip blisters (if you look very closely, you can also see it in the picture at the top of this post). This picture was taken at about sixs weeks. She continued to have these blisters until about a month after her frenotomy.
These blisters are caused by an improper latch. Your baby’s lips are attempting to hold on to your breast without the assistance of his tongue. The pressure and friction caused by this improper latch causes the blisters. You’ll find these blisters on your baby’s upper and lower lip and even on the inside of his gums.
It’s unclear how lip blisters affects breastfeeding. If you’re wondering how to treat breastfeeding lip blisters, the good news is that they go away if you really focus on a good latch.
Related Post: 5 Helpful Tips for Successfully Breastfeeding a Tongue Tied Baby
9 Failure to Thrive
Every new mom dreads these three words. If your baby’s weight, height, or head circumference falls below third percentile, she may be diagnosed with a failure to thrive.
In this case, your baby may not nurse efficiently enough to gain these nutrients.
Failure to thrive is one of the most commonly accepted symptoms of tongue tie, but it is not a prerequisite. Many, many tongue tied babies are able to gain weight by leaps and bounds in the first two months of life, thanks to their mother’s letdown reflex. When my baby was diagnosed with a posterior tongue tie and upper lip tie, she was in the 90th percentile!
However, more often than not, the side effects of a tongue tie will catch up to your baby, and you’ll notice that he will struggle to get the nutrients he needs. Dr. Ghaheri, pretty much the guru of all things tongue tie, actually addresses this situation; he notes that many tongue tied babies can thrive until a new mom’s production becomes dependent on her baby’s intake. Unfortunately, by that point, the baby will not have developed the proper suckling skills need to trigger adequate milk production. Even if he could stimulate milk production properly, he would still be dependent on his mother’s letdown, and would show signs of a hindmilk/foremilk imbalance.
Related Post: The Secret to Breastfeeding with Successfully an Overactive Letdown
10 Gas, Colic, and GERD
Which brings us to our last tongue tie symptom: Gas. Colic, or GERD. This is a pretty common issue with tongue ties. Not only does your baby’s dependence on your let-down create a milk imbalance, but his improper latch will cause him to take in a lot of air. Bottle fed babies can suffer from this as well.
Gas, colic, and GERD are common newborn issues, but these conditions can become especially exasperated by a tongue or lip tie.
This was the case for my daughter. While I don’t have the medical background to confirm this hypothesis, I believe her gas was caused by my overactive letdown and her tongue tie. During nursing I’d hear her click (the seal breaking) and a moment later she would arch her back, her little body stiff with pain. During this painful time, we practically lived on gripe water to ease her symptoms.
Anatomical Tongue Tie Symptoms
There are several physiological markers of a tongue tied baby. Just keep in mind that, with the exception of an actual diagnosis from a pediatrician, none of these markers can directly point to a tongue tie.
Tongue Won’t Go Past Lips
Watch your baby’s tongue the next time he cries. Where does his tongue lie? Many tongue tied babies can’t move their tongue past their gums. The picture above shows my daughter’s restricted tongue motion. After the frenotomy, she could almost touch her chin with the tip of her tongue. It was almost disturbing how long her tongue seemed to “grow” overnight!
Tongue is Flat, Heart-shaped, or Crooked
The classic sign of a tongue tied baby is the heart-shaped tongue. However, if your baby has a posterior tongue tie, it can look flat at times and crooked at others.
Narrow Mouth Opening
Have you ever watched those breastfeeding videos where the baby’s mouth gapes wide open when he’s about to latch? If your baby won’t open his mouth wide to latch, it’s not by choice. There’s a good chance his lip tie or tongue tie is preventing him from following instinct. Unfortunately, a frenotomy won’t magically fix an older baby’s habit. You’ll have a lot of work ahead with tongue and mouth-work rehabilitation.
Be Your Baby’s Tongue Tie Advocate
I know I keep saying it, Mama, but remember: none of these symptoms can prove, definitively, if your baby has a tongue tie.
Having said that, your mommy gut is telling you that something is wrong. Maybe you think it’s not normal to have so many issues with breastfeeding. Maybe you feel deep down that your baby is in discomfort. Don’t hesitate! If you’re a breastfeeding mama, visit the lactation consultant. If your baby is bottle fed, visit a pediatrician that has a reputation for dealing with tongue ties.
My lactation consultant warned me that some medical providers minimize the effects of a tongue ties. I have personally experienced this behavior and you might too. They might dismiss you initially, claiming that since your baby is gaining weight, there’s no chance he has a tongue tie. If this is the case and your mommy gut is still speaking to you, don’t hesitate to seek out a second opinion.
Tongue tie symptoms can be so subtle that you almost don’t recognize them or so grevious that you can’t go on breastfeeding. If you ran down this list silently checking off each symptom, PLEASE see a lactation consultant. There’s no harm in a simple visit. Otherwise, really focus on getting a good latch. With mild tongue ties, you can overcome any complications simply by focusing on a good latch. Focus on that, (or check out the Breastfeeding Handbook if you don’t know how). You might also find my post about how to breastfeed a tongue tied baby helpful.
Please let me know how your experience goes in the comments below!
Good luck, Mama!
Do you know of any connection between being tongue tied and a subsequent speech impediment?
This is just speculation, but my doctor mentioned that an upper lip tie may cause a lisp later on down the road. I’ve read a couple articles that mentioned that a tongue tie might cause speech impediments, but I’ve also heard that this can be mostly corrected by therapy as the child gets older.