Tongue-tie (ankyloglossia) is a condition in which the thin piece of skin under the baby’s tongue (the lingual frenulum) is abnormally short and may restrict the movement of the tongue.
There is a limited amount of high-quality evidence-based studies, including randomized-controlled trials and longitudinal data, to guide clinicians in developing the optimal management of this condition.
The most immediate impact of a tongue-tie is on the baby’s ability to breastfeed effectively. It may interfere with a baby’s ability to latch and suckle at the breast, leading to:
- Poor breast milk intake, leading to decreased milk supply over time.
- Ongoing nipple pain and trauma and/or a misshapen nipple after breastfeeding despite intervention
- Compression/stripe mark on the nipple after breastfeeding
- Loss of suction during breastfeeding
- Clicking sounds may be heard while the baby is feeding
- Poor weight gain
- Premature cessation of breastfeeding
- Consider tongue tie in the setting of parents presenting with mastitis
If tongue-tie is suspected, the GP should refer the patient to a Lactation Consultant or MCHN for assessment and modification of the latch.
Where to find a credentialed Lactation Consultant:
- Birthing hospital
- Local Council breastfeeding support services
- Private lactation consultant
Resources:
- Academy of Breastfeeding Medicine Position Statement
- Policy Statement 2.13 Ankyloglossia and Oral Frena
- Australian Breastfeeding Association; Tongue-tie and breastfeeding
Last reviewed February 18, 2025.