Tongue-tie may make breastfeeding harder for some babies. Here’s what to know.
Tongue-tie, also called ankyloglossia, is when the membrane under the baby’s tongue (the lingual frenulum) limits tongue movement and makes it harder for a baby to attach well and breastfeed comfortably.1,2
About 8% of newborns have tongue-tie, and it’s slightly more common in boys.3
Not every baby with a visible frenulum has trouble feeding. Many breastfeed just fine. If you’re having feeding difficulties, remember that tongue-tie isn’t always the reason. Getting breastfeeding support to improve positioning and attachment is often the first step before considering tongue-tie.4
When breastfeeding isn’t going smoothly
Breastfeeding can sometimes be challenging. Signs that things aren’t going well include:
- Nipple looking flattened or showing compression or stripe marks after feeds
- Visible damage like a crack on or round the nipple
- Pain during feeds
- Poor milk transfer
- Slow weight gain in your baby
Many of these signs can happen for reasons other than tongue-tie. A breastfeeding counsellor or lactation consultant can help improve positioning and attachment before looking into tongue-tie as a possible cause.
Why tongue-tie can be a problem
Your baby’s tongue needs to move freely to effectively remove milk from your breast. If it’s anchored by tongue-tie, your baby might not get a full mouthful of breast tissue. They aren't able to draw your nipple far enough back into their mouth and this results in baby 'nipple-feeding'. This is likely to cause nipple damage and may also mean your baby isn’t getting enough milk.
What to do if you’re concerned
ABA counsellors aren’t medically trained to diagnose tongue-tie. If you’re worried, a lactation consultant can check your baby’s mouth and how feeding is going. They’ll talk through what they find and suggest options. If tongue-tie seems to be causing your breastfeeding problems, you can be referred to a health professional for diagnosis and possible treatment.
Treatment
If your lactation consultant or other breastfeeding specialist decides that tongue-tie is interfering with breastfeeding, a simple surgical procedure to release the tight frenulum can help. There’s no formal accreditation for professionals doing tongue-tie releases right now.
Other ties
There’s not enough evidence yet about whether upper lip-ties or cheek (buccal) ties affect breastfeeding, or if releasing them helps.1,4
Dr Lisa Amir, a GP and lactation consultant, talks about tongue-tie in the following video.
References
- LeFort, Y., Evans, A., Livingstone, V., Douglas, P., Dahlquist, N., Donnelly, B., Leeper, K., Harley, E., & Lappin, S. (2021). Academy of Breastfeeding Medicine Position Statement on Ankyloglossia in Breastfeeding Dyads. Breastfeeding Medicine, 16(4), 278–281. https://www.bfmed.org/assets/Anklyloglossia%20position%20statement%202021.pdf
- Australian Dental Association. (2020). Ankyloglossia and oral frena: Consensus statement. Retrieved from https://aapd.org.au/wp-content/uploads/2021/01/Ankyloglossia-and-Oral-Frena-Consensus-Statement_June-2020.pdf
- Hill, R. R., Lee, C. S., & Pados, B. F. (2021). The prevalence of ankyloglossia in children aged <1 year: A systematic review and meta-analysis. Pediatric Research, 90(2), 259–266. https://doi.org/10.1038/s41390-020-01239-y
- American Academy of Pediatrics. (2024). Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in infants: Clinical Report. Pediatrics, 154(2). https://doi.org/10.1542/peds.2024-067605
© Australian Breastfeeding Association June 2026
