Integrative Lactation Care

Many parents are unaware that a tongue tie can manifest in a variety of different ways, depending on their individual baby. These symptoms are ones I see commonly dismissed by pediatric care providers who lack a comprehensive understanding of infant feeding, sleep, & oral function. Read on to see if any of these are true for your baby.

Milky Tongue

Commonly misdiagnosed as thrush, a white milky coating on baby’s tongue ONLY tells us that the tongue is not being wiped clean of milk after a feeding. (True thrush will usually be present all over the mouth, not just the tongue, and cannot be wiped off with a washcloth.)

When the tongue has optimal mobility, the tongue rests (suctions, actually) to the roof of the mouth, wiping clean any milk residue or dead skin cells.

When the tongue is restricted, the tongue may not be resting on the palate, and a milky tongue coating will be visible.

Low resting tongue posture can lead to mouth breathing, increased risk of allergies, poor craniofacial development, and sleep issues.

Sucking Blisters

Sucking blisters form on an infant’s lips from excessive friction. The tongue should be responsible for the majority of the muscle action necessary for feeding – but when its range of motion is limited, a baby will often recruit their lips to help sustain the latch. This can result in blisters on the lips, or “two-tone” lips, where each lip appears to have two different color tones.

Clicking During Feeding

When a baby cannot maintain an effective seal on the breast/chest or bottle, you will often hear a clicking sound, indicating a loss of suction. Every click is a loss of suction and is likely resulting in swallowed air, which can lead to or exacerbate symptoms of gas, reflux, and general discomfort in baby.

Leaking During Feeding

Similarly, if your baby is leaking milk out of the side of their mouth during feeding (breast or bottle), it is a strong indicator that their seal is not optimal and the tongue may not be doing its job adequately. Sometimes, this is due to an inappropriate bottle (see here for my guide to choosing an optimal bottle), but if it persists even with a true slow-flow, sloped-shape nipple, it may very well be due to restriction in the tongue.

Pain With Feeding

It’s hard to believe it is the year 2025 and this is still up for debate, but let me be quite clear: NO amount of pain with nursing is normal. Nursing should be painless and comfortable. Period.

We all have an off latch now and then that needs tweaking, but if you are consistently experiencing pain and/or damage with nursing, a tongue tie could very well be the reason why.

Seeking Help

This is not an exhaustive list of symptoms by any means; it is simply the ones I see most often dismissed by the primary care providers in my area.

Your baby does not have to experience ALL of the above symptoms to have a tongue tie. Because a tongue tie can vary in presentation, severity, and how well the infant manages to compensate around it, symptom profiles are highly variable from baby to baby.

You can download my full screening tool for oral dysfunction for free here:

If you are experiencing one or more symptoms from the above list, please do not hesitate to find a tie-savvy IBCLC near you for an evaluation. ILC also offers virtual care for oral function screening & support internationally.