By Dr. Medhat Abu-Shaaban — Specialist Pediatrician, myPediaclinic Dubai
If your baby is struggling to feed, you may have heard the term “tongue-tie” and wondered whether it could be the cause. The short answer parents most want: tongue-tie is a common, treatable condition where a band of tissue under the tongue limits its movement — and the most reliable early signs are feeding difficulties, not the look of the tongue alone. Some babies with a tongue-tie feed perfectly well and need no treatment at all; others struggle, and a simple assessment makes the difference. This guide walks through what tongue-tie is, the five signs worth watching for, when it does and doesn’t need treating, what actually happens at an assessment, and the treatment options available in Dubai.
What Is Tongue-Tie in Babies?
Tongue-tie, known medically as ankyloglossia, is a condition present at birth in which the strip of tissue connecting the underside of the tongue to the floor of the mouth — the lingual frenulum — is shorter, tighter, or attached further forward than usual. This can restrict how far the tongue can lift, stretch, or move from side to side, which in turn can affect feeding and, later, speech.
Not all tongue-ties look the same. An anterior tongue-tie is attached near the tip and is usually easy to see, sometimes giving the tongue a heart-shaped or notched appearance when the baby cries or lifts it. A posterior tongue-tie sits further back and can be harder to spot — it’s often felt rather than seen, which is one reason a proper assessment matters more than a glance. The key point for parents is that tongue-tie is defined by how the tongue functions, not just how it looks.
What About Lip-Tie?
A related condition, lip-tie, occurs when the band of tissue connecting the upper lip to the gum (the labial frenulum) is tight enough to restrict the lip’s movement. A lip-tie can make it harder for a baby to flange the upper lip and create a good seal at the breast or bottle, and the two conditions sometimes occur together. Because lip-tie and tongue-tie can both affect feeding in similar ways, an assessment usually looks at both.
How Common Is It — and Should I Worry?
Tongue-tie is one of the more common things we assess in newborns, and it exists on a spectrum from mild to significant. Crucially, having a tongue-tie does not automatically mean there’s a problem. Many babies with a degree of tongue-tie feed and grow without any difficulty and never need treatment. The reason to pay attention is not the tie itself but its effect: if feeding, weight gain, or comfort are affected, that’s when an assessment is worthwhile. So if you’ve spotted something, there’s no need to panic — but it is worth getting it checked rather than guessing.
5 Common Signs Your Baby May Have a Tongue-Tie
Recognising tongue-tie early — when it is causing problems — can make a real difference to feeding and to a mother’s comfort. Here are the five signs most worth watching for.
1. Difficulty Breastfeeding
Breastfeeding difficulty is the earliest and most common sign. A restricted tongue can’t extend over the lower gum and cup the breast the way it needs to, so the baby struggles to form and hold a deep, comfortable latch. Watch for:
- Trouble latching, or slipping off the breast repeatedly
- Clicking or smacking sounds while feeding (a sign the seal keeps breaking)
- Seeming hungry again very soon after a feed
- Long feeds that leave the baby tired but unsatisfied
- Fussiness, pulling off, or frustration at the breast
Feeding difficulty has many possible causes, so these signs point to “worth assessing,” not a guaranteed diagnosis.
2. Poor Weight Gain
When a tongue-tie makes feeding inefficient, some babies simply don’t transfer enough milk, and weight gain can lag. Pediatricians track weight against growth charts precisely because it’s an objective signal that feeding may not be working well. Consistently slow weight gain — especially alongside the feeding signs above — is a reason to have your baby reviewed rather than wait and see.
3. Difficulty with Bottle Feeding
Tongue-tie is often thought of as a breastfeeding issue, but it can affect bottle-fed babies too. A tongue that can’t move freely struggles to seal around the teat and control the flow, which can lead to:
- Taking in extra air, then gassiness and discomfort
- Dribbling milk during feeds
- Gagging, coughing, or spluttering
- Difficulty coordinating suck, swallow, and breathe
- Frustration or tiring quickly during a bottle
If bottle feeding is also a struggle, it strengthens the case for an assessment.
4. Speech Development Concerns (Later On)
Some tongue-ties cause no obvious trouble in infancy and only raise questions later, when speech develops. A significantly restricted tongue can make certain sounds harder to form — commonly those that need the tongue to lift or reach, such as “l,” “r,” “t,” “d,” “s,” “z,” and “th.” It’s important to keep this in perspective: many children with a mild tongue-tie speak perfectly clearly, and most speech delays are not caused by tongue-tie. But if your child has persistent difficulty with specific sounds, it’s reasonable to have a clinician check whether tongue mobility is a contributing factor.
5. Visible Physical Signs
Finally, there are physical clues you may notice yourself:
- A heart-shaped or notched tip when the baby extends or lifts the tongue
- Limited ability to lift the tongue toward the roof of the mouth or move it side to side
- The tongue appearing tethered or anchored low in the mouth
- Difficulty extending the tongue past the lower gum or lip
These don’t appear in every case — a posterior tongue-tie in particular may show none of them — which is exactly why function matters more than appearance.
Signs to Notice in the Breastfeeding Mother
One set of signs is easy to overlook because they show up in mum, not the baby. A poor, shallow latch caused by tongue-tie can lead to cracked, pinched, or persistently sore nipples, pain throughout feeds rather than just at latch, blocked ducts or recurrent mastitis, and a feeling that the breast never empties properly. If feeding hurts and isn’t settling with positioning support, that’s a meaningful clue worth mentioning at an assessment.
Important: Not Every Tongue-Tie Needs Treatment
This is worth stating plainly, because it’s easy to assume that a diagnosis automatically means a procedure. It doesn’t. Treatment is guided by symptoms, not by the presence of a tie alone. If a baby has a tongue-tie but is feeding well, gaining weight, and comfortable — and mum is comfortable too — then often the right answer is simply to monitor, with no intervention needed. The decision to treat is made when the tie is genuinely interfering with feeding or development, and it’s always made together with parents after weighing the likely benefit. A good assessment is as much about identifying the babies who don’t need anything as those who do.
What to Expect at a Tongue-Tie Assessment
Knowing what happens can take a lot of the worry out of booking. An assessment is gentle and unhurried.
Before the Appointment
It helps to come with a short feeding history: how feeds are going, how long they take, any pain you’re experiencing, how nappy output and weight gain look, and what you’ve already tried. If you can, note the specific moments that feel difficult — it gives the clinician useful detail.
During the Assessment
The clinician will talk through that history, then carefully examine your baby’s mouth — looking at the frenulum and, importantly, gently feeling and watching how the tongue actually moves and lifts. Where helpful, they’ll observe a feed to see the latch in action. This functional check is what separates a tongue-tie that needs attention from one that doesn’t.
After the Assessment
You’ll leave with a clear explanation and a plan. That might be reassurance and monitoring; it might be a referral for feeding or lactation support to try first; or, if the tie is clearly affecting feeding, a discussion of a simple release procedure and what it involves. Whatever the path, the aim is a decision you understand and feel comfortable with.
Treatment Options for Tongue-Tie
When treatment is the right choice, several approaches may be used — often in combination.
Frenectomy (Tongue-Tie Release)
A frenectomy is a quick procedure to release the tight band of tissue restricting the tongue. Using careful technique — including laser or other modern methods — the restrictive frenulum is divided, freeing the tongue to move. In young babies it is typically very brief, and many can feed soon afterwards, often with an immediate improvement in latch. As with any procedure, your clinician will explain the benefits, the small risks, and the aftercare before anything is decided.
Aftercare and Gentle Exercises
After a release, your clinician may show you simple, gentle movements to encourage healing and help prevent the area from reattaching as it heals. These take only moments and are done a few times a day, following the specific instructions you’re given.
Lactation and Feeding Support
For breastfeeding mothers, support around positioning and latch is often valuable — sometimes on its own, and sometimes alongside a release. Good feeding support can improve comfort and milk transfer, and helps you and your baby settle into an easier routine.
Speech Therapy (When Relevant)
In the smaller number of cases where tongue-tie has affected speech in an older child, a speech and language therapist can help build tongue mobility, strength, and clear articulation as part of the plan.
Ongoing Monitoring
Whether or not a procedure is done, follow-up matters — checking that feeding, comfort, weight gain, and development are all on track, and adjusting the plan if needed.
Caring for Your Baby While You Wait for an Appointment
If feeding is a struggle and you’re waiting to be seen, a few things can help in the meantime: try different feeding positions to find one where the latch feels deeper and less painful; feed a little more often if your baby tires quickly and takes less each time; keep an eye on wet and dirty nappies as a rough guide to intake; and look after your own comfort — sore nipples need gentle care. If your baby seems to be feeding very poorly, isn’t producing enough wet nappies, or is unusually sleepy and hard to wake for feeds, don’t wait — seek medical advice promptly.
Myths and Facts About Tongue-Tie
“If there’s a tongue-tie, it has to be cut.” Not true — treatment depends on whether the tie is actually causing problems. Many are simply monitored. “You can always see a tongue-tie.” Posterior ties can be hidden; function tells you more than appearance. “Tongue-tie causes most speech delays.” It doesn’t — most speech delays have other causes, though a significant tie can occasionally contribute. “The procedure is dangerous.” A release in a young baby is a minor, quick procedure when done by an experienced clinician, with aftercare explained in advance. “It will sort itself out, so there’s no point checking.” Some mild ties do stretch with time, but if feeding is suffering now, an assessment helps you act early rather than persist with painful, inefficient feeds.
How myPediaclinic Can Help
At myPediaclinic in Dubai, our team assesses tongue-tie and lip-tie thoroughly — focusing on how your baby actually feeds and moves, not just how the frenulum looks. We’ll tell you honestly whether treatment is likely to help, talk you through the options, and support you and your baby through whatever path you choose, including feeding support and follow-up. Our priority is the right decision for your family — which sometimes means a simple release, and sometimes means reassurance that nothing needs doing.
When to Take Action
Tongue-tie is common and very manageable. If your baby is feeding well and thriving, a tongue-tie may need no more than an occasional check. But if feeding is painful or inefficient, weight gain is lagging, or you’re simply unsure, an assessment gives you clarity and, where needed, an early, effective fix. Trust what you’re seeing at feeds — you know your baby best.
Concerned about your baby’s feeding or a possible tongue-tie? Book a tongue-tie assessment at myPediaclinic in Dubai — or message us on WhatsApp and we’ll help you take the next step.
Frequently Asked Questions
How do I know if my baby has a tongue-tie?
The most reliable clues are feeding-related: trouble latching, clicking sounds, long unsatisfying feeds, poor weight gain, or sore nipples for mum. You might also see a heart-shaped tongue tip or limited tongue movement. Because some ties are hidden, a functional assessment is the only way to be sure.
Does every tongue-tie need to be treated?
No. Treatment depends on whether the tie is actually affecting feeding, comfort, or development. Many babies with a tongue-tie feed well and simply need monitoring rather than any procedure.
At what age should a tongue-tie be treated?
When a release is needed for feeding difficulties, it can often be done in the early weeks, sometimes within days of birth. The timing depends on your baby’s symptoms — your clinician will advise what’s right for your child.
Is a tongue-tie release painful for my baby?
A release in a young baby is a quick, minor procedure. Discomfort is usually brief, and many babies can feed soon afterwards. Your clinician will explain the procedure, any small risks, and the aftercare before you decide.
Can a tongue-tie resolve on its own?
Some mild ties stretch over time. However, if feeding is suffering now, waiting can mean prolonged feeding difficulty — so it’s better to have it assessed than to assume it will resolve.
What is the difference between tongue-tie and lip-tie?
Tongue-tie restricts the tongue via the band beneath it; lip-tie restricts the upper lip via the band connecting it to the gum. Both can affect the seal during feeding, and they sometimes occur together, so an assessment usually checks for both.
Can tongue-tie affect bottle-fed babies?
Yes. A restricted tongue can struggle to seal around a teat, leading to extra air intake, dribbling, gagging, or difficulty coordinating feeding — not only breastfeeding problems.
Will tongue-tie cause my child to have speech problems?
Usually not. Most children with a mild tongue-tie speak clearly, and most speech delays have other causes. A significant tie can occasionally make some sounds harder, so persistent speech difficulty is worth checking.
How is a tongue-tie diagnosed?
Through a hands-on assessment: reviewing the feeding history, examining the mouth, and — most importantly — checking how the tongue actually moves and lifts, sometimes while observing a feed. Appearance alone isn’t enough, especially for posterior ties.
How long does recovery take after a tongue-tie release?
Recovery is generally quick, with healing over a short period and gentle aftercare movements as advised. Many parents notice feeding improvements soon after, though every baby adjusts at their own pace.
My nipples are very sore — could my baby’s tongue-tie be the cause?
It can be. A shallow latch from a restricted tongue is a common cause of persistent nipple pain. If positioning support isn’t fixing it, mention it at an assessment so feeding and any tie can be evaluated together.
Should I see a doctor urgently?
Routine feeding concerns can be assessed at a normal appointment. But seek prompt advice if your baby is feeding very poorly, not producing enough wet nappies, losing weight, or unusually sleepy and difficult to wake for feeds.
Tongue-Tie & Lip-Tie: Related Guides
- 6 symptoms of tongue-tie in children
- Does tongue-tie hurt your baby?
- How tongue-tie affects speech in children
- Lip-tie and breastfeeding: how early diagnosis helps
- Is tongue-tie surgery the right choice for your baby?
- Before, during & after tongue-tie surgery: what to expect
Concerned about tongue-tie or lip-tie? Book a tongue-tie assessment at myPediaclinic in Dubai.
