If your baby has been diagnosed with a tongue-tie or lip-tie, you may be wondering whether a release is necessary, why breastfeeding feels painful, or what steps you should take next. The reality is that every baby is different. While some oral restrictions can affect feeding, not every breastfeeding challenge is caused by a tongue-tie, and not every baby requires a procedure. American Academy of Pediatrics guidance emphasizes carefully evaluating feeding function and collaborating among healthcare professionals before deciding on treatment. [publications.aap.org], [healthychildren.org]
As an International Board Certified Lactation Consultant (IBCLC), I help families understand how oral restrictions may affect breastfeeding and provide evidence-based support before and after a tongue-tie release.
What Is a Tongue-Tie and How Can It Affect Breastfeeding?
A tongue-tie (ankyloglossia) occurs when the tissue connecting the tongue to the floor of the mouth limits tongue mobility. A lip-tie refers to a restrictive upper lip frenulum. In some babies, these restrictions may contribute to:
Shallow latch
Nipple pain
Nipple damage
Clicking during feeds
Poor milk transfer
Prolonged feeding sessions
Inadequate weight gain
Frustration at the breast
Challenges maintaining milk supply
Research has shown that symptomatic tongue-ties can be associated with maternal pain, ineffective latch, and poor milk transfer in some breastfeeding dyads. [publications.aap.org], [healthychildren.org]
Why an IBCLC Is Important for Tongue-Tie and Breastfeeding Challenges
Many parents are surprised to learn that the appearance of a frenulum alone does not determine whether a baby will struggle with breastfeeding. What matters most is function.
An IBCLC evaluates:
Latch quality
Milk transfer
Infant oral function during feeding
Maternal comfort
Weight gain patterns
Feeding efficiency
Milk supply concerns
Overall breastfeeding goals
As an IBCLC, I do not diagnose tongue-ties. Instead, I assess how feeding is functioning and whether oral restrictions may be affecting breastfeeding outcomes. This functional assessment helps families make informed decisions and determine whether referral to a pediatric dentist, ENT specialist, or other provider may be beneficial.
Research has found that improved access to IBCLCs is associated with higher breastfeeding rates and better long-term breastfeeding outcomes. International Board Certified Lactation Consultants are widely recognized as the clinical standard for lactation care. [pmc.ncbi.nlm.nih.gov]
Breastfeeding Support Before a Tongue-Tie Release
Before considering a frenotomy or frenectomy, an IBCLC can provide a comprehensive feeding assessment and often identify strategies that improve breastfeeding immediately.
This assessment may include:
Weighted feeds to evaluate milk transfer
Observation of latch and positioning
Evaluation of oral function during feeding
Assessment of maternal milk production
Review of infant weight gain
Development of a personalized feeding plan
The American Academy of Pediatrics recommends prioritizing breastfeeding support and nonsurgical interventions whenever appropriate. [publications.aap.org], [healthychildren.org]
Breastfeeding Support After Tongue-Tie Release
One of the most common misconceptions is that a tongue-tie release automatically resolves breastfeeding challenges.
Following a release, babies often need time to learn new tongue movements and feeding patterns. Continued lactation support can help optimize outcomes.
Post-release support may include:
Latch optimization
Milk transfer assessment
Feeding management strategies
Monitoring infant weight gain
Protecting and rebuilding milk supply when needed
Coordination with other healthcare providers
Many families find that ongoing lactation care is one of the most important components of successful breastfeeding after a tongue-tie release. The American Academy of Pediatrics recommends a multidisciplinary approach to care for infants experiencing breastfeeding difficulties. [publications.aap.org], [publications.aap.org]
The Benefits of a Collaborative Tongue-Tie Team
The best tongue-tie outcomes often occur when providers work together.
Your care team may include:
IBCLC
Pediatrician
Pediatric dentist
ENT specialist
Speech-language pathologist
Occupational therapist
Physical therapist
Bodywork providers when appropriate
Because provider training and evaluation methods vary, a team approach helps ensure that feeding concerns are assessed comprehensively and treatment recommendations are individualized. [publications.aap.org], [healthychildren.org]
How Early Tongue-Tie Support Helps Protect Breastfeeding
Breastfeeding provides significant health benefits for both infants and mothers.
Breastfed infants have lower risks of respiratory infections, gastrointestinal illnesses, ear infections, obesity, type 1 diabetes, childhood leukemia, and sudden infant death syndrome (SIDS). Mothers who breastfeed have reduced risks of breast cancer, ovarian cancer, type 2 diabetes, and high blood pressure. [cdc.gov], [cdc.gov], [publications.aap.org]
The World Health Organization, Centers for Disease Control and Prevention, and American Academy of Pediatrics recommend exclusive breastfeeding for approximately the first six months of life, followed by continued breastfeeding alongside complementary foods as long as desired by the family. [who.int], [cdc.gov], [abm.memberclicks.net]
When tongue-tie or lip-tie concerns interfere with feeding, early intervention and skilled lactation support can help families maintain breastfeeding and achieve their feeding goals.
Tongue-Tie and Lip-Tie Support for Maryland Families
Whether you are preparing for a tongue-tie evaluation, considering a release, or navigating breastfeeding after a frenotomy, working with an expert tongue-tie IBCLC can provide clarity and support throughout the process.
Ready for Expert Tongue-Tie and Breastfeeding Support?
If you're struggling with painful feedings, latch difficulties, concerns about milk transfer, or questions about a possible tongue-tie or lip-tie, you don't have to navigate it alone.
At Raiz Materna Lactation, I provide comprehensive tongue-tie and breastfeeding assessments for families throughout Maryland, including Catonsville and surrounding communities. Whether you're seeking guidance before a tongue-tie evaluation, preparing for a release procedure, or working through feeding challenges afterward, you'll receive individualized, evidence-based support tailored to your family's needs.
Schedule Your Consultation
Comprehensive breastfeeding assessment
Tongue-tie and lip-tie feeding evaluation
Pre- and post-frenotomy support
In-home lactation visits
Virtual consultations available
Personalized care from an RN, BSN, IBCLC
Take the next step toward comfortable, effective feeding.
Contact Raiz Materna Lactation today to schedule your consultation and receive expert breastfeeding support from an experienced IBCLC.
Serving families throughout Maryland with in-home and virtual lactation care.
Schedule a Tongue-Tie Assessment
Frequently Asked Questions About Tongue-Tie and Breastfeeding
Can a tongue-tie affect breastfeeding?
Yes. In some infants, a tongue-tie may contribute to nipple pain, shallow latch, ineffective milk transfer, prolonged feedings, and poor weight gain. [publications.aap.org], [healthychildren.org]
Do all babies with tongue-ties need a release?
No. Many breastfeeding concerns can improve with skilled lactation support and a thorough feeding assessment. Treatment decisions should be individualized. [publications.aap.org], [healthychildren.org]
Should I see an IBCLC before a tongue-tie release?
Yes. An IBCLC can evaluate feeding function, milk transfer, and breastfeeding mechanics before determining whether referral for additional evaluation may be helpful. [publications.aap.org], [publications.aap.org]
Can an IBCLC help after a frenotomy?
Absolutely. Many babies benefit from continued breastfeeding support after a release to improve oral function, feeding efficiency, and milk transfer. [publications.aap.org], [publications.aap.org]
What is the difference between a tongue-tie and a lip-tie?
A tongue-tie restricts tongue mobility, while a lip-tie involves the tissue connecting the upper lip to the gums. Both may affect breastfeeding in some infants, but assessment should focus on feeding function rather than appearance alone. [publications.aap.org], [healthychildren.org]
References
American Academy of Pediatrics. (2024). Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants. Pediatrics, 154(2). This clinical report reviews the diagnosis and management of tongue-tie, breastfeeding challenges, maternal nipple pain, milk transfer concerns, and multidisciplinary care recommendations. [publications.aap.org]
American Academy of Pediatrics. (2024). AAP Addresses Rise in Tongue-Tie Diagnoses for Breastfeeding Concerns. Highlights the importance of skilled lactation support and recommends considering nonsurgical interventions before frenotomy when appropriate. [healthychildren.org], [publications.aap.org]
Centers for Disease Control and Prevention. (2026). Breastfeeding Benefits Both Baby and Mom. Reviews the health benefits of breastfeeding for infants and mothers, including reduced risks of infections, obesity, diabetes, and certain cancers. [cdc.gov]
Centers for Disease Control and Prevention. (2026). About Breastfeeding. Provides current breastfeeding recommendations, health outcomes, and public health data related to breastfeeding duration and support. [cdc.gov]
Dockins, J. F., Pahl, H. D., & Lingerfelt, D. J. (2025). Lactation Consultant Access and Breastfeeding Outcomes in the United States: Cross-Sectional Analysis. Interactive Journal of Medical Research, 14, e70098. This study found that greater access to IBCLCs was associated with improved breastfeeding outcomes, including exclusive breastfeeding rates. [pmc.ncbi.nlm.nih.gov]
World Health Organization. (2023). Optimal Duration of Exclusive Breastfeeding. Recommends exclusive breastfeeding for the first six months of life and continued breastfeeding with complementary foods thereafter. [who.int]
Academy of Breastfeeding Medicine. (2024). Recommendation for Exclusive Breastfeeding: Avoidance of Underfeeding and Overfeeding. Position statement supporting exclusive breastfeeding for the first six months and continued breastfeeding as long as desired by the family. [abm.memberclicks.net]
HealthyChildren.org. (2024). Tongue Tie in Babies: How Ankyloglossia Affects Breastfeeding & Other Concerns. Parent-focused summary of current evidence regarding tongue-tie, breastfeeding, and treatment considerations. [healthychildren.org]
About the Author
Carolina Pimenta, RN, BSN, IBCLC, RLC is the founder of Raiz Materna Lactation and provides evidence-based lactation care for families throughout Maryland. She specializes in complex feeding challenges, tongue-tie and lip-tie support, milk supply concerns, pumping, and individualized breastfeeding care through in-home and virtual consultations.