What it is Tongue Tie?

It is a membrane that is connecting the underside of the tongue to the base of the mouth. This attachment can interfere with the tongue mobility and therefore breastfeeding.

Depending of the degree of tongue attachment, this may cause problems with breastfeeding such as:

  • Nipple pain.
  • Latch problems.
  • Low maternal milk supply.
  • Weight gain issues.

Types of Tongue-ties:

  • Anterior: are closer to the tip of the tongue and very obvious to see. In these cases the tongue has a very tongue restrictive movement.
  • Posterior: are thicker and further back. These are not always visualized and are usually diagnose by a Lactation consultant.

What to do?

It is important that you see a Lactation consultant to have a global assessment of the situation and proper diagnosis. If a tongue –tie is confirmed then the LC will guide you towards a specialist.


A parental consent to do the surgery may be required. Clipping the tongue-tie is a minor procedure, it is safe and effective treatment. Frenotomy as a surgical procedure that may present some risks.

  • Possible bleeding on the incision site.
  • Infection.
  • Salivary gland trauma.
  • Tongue-tie re-attachment.


This procedure can be perform by a 2 specialist:

  1. MD who has had the proper training to do a tongue release. Most of the time is a family Dr.
  2. Dentist.

There are 2 techniques to release a tongue-tie. One by scissors and/or by laser. The technique itself takes a few seconds. Your baby will be bundle up to prevent unnecessary movement during procedure. Parents will be present during procedure.


The MD or Dentist will examine your baby to make sure the bleeding stop and then your baby will go straight to the breast as breastfeeding helps to stop bleeding, aids-healing and soothing effect on your baby. It is possible that your baby will be irritable during the next 6h post procedure. If needed you can give some Tylenol for infants. The amount should be calculated by his/her weight.

Tongue exercises:

Some mothers may not feel a difference right away since baby needs to learn how to use his tongue. For this reason it is important to perform the exercises as soon as possible or as indicated by your IBCLC.

It is important to trim your nails and wash your hands with soap and water prior exercises to avoid injuries and/or infection.

Repeat this exercises in sequences of 3 and at least 4 times a day. It is recommended to do this prior feeds or in between feeds.

It is possible to see a minimal bleeding while performing the exercises and this is stop by breastfeeding. If bleeding does not stop, it is recommended to apply direct pressure to the site with a clean gaze and your finger. Call the clinic, the lactation consultant or go to the emergency room with this document.


You may notice that the frenotomy site will turn white, beige or grey. The scar post laser can be darken, gray and you may not be able to see the romboid right away. This is part of the healing process and will eventually dissapear.

If your baby swallows blood during procedure, you may see few black or dark stools after the frenotomy.

Some babys refuses the breast after frenotomy, do not force him/her. Do skin-to-skin as frequent as possible and continue offering the breast at the same times you were offering the breast before frenotomy. You may supplement your baby with expressed breast milk when needed. *Please contact us if you are worried.*

Follow up:

It is important to see your Lactation consultant 24-48h post procedure and then 5 days alter to ensure proper transition and latch improvement.

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