Everything You Need to Know About Tongue Tie and Lip Tie in Dubai

Is your newborn struggling to breastfeed effectively? Does your baby seem to have difficulty latching, causing pain during nursing or poor weight gain? These may be signs of tongue tie or lip tie—common but often overlooked conditions that can significantly impact feeding and development.

At myPediaClinic in Dubai, our pediatric specialists have extensive experience diagnosing and treating tongue tie and lip tie in infants and children. Early identification and appropriate treatment can resolve feeding difficulties and prevent future complications.

Understanding Tongue Tie (Ankyloglossia)

Tongue tie, medically known as ankyloglossia, occurs when the lingual frenulum—the thin strip of tissue connecting the tongue to the floor of the mouth—is unusually short, thick, or tight. This restricts the tongue’s range of motion and can interfere with feeding, speech, and other functions.

Types of Tongue Tie

Tongue ties are classified by their location and severity:

Anterior tongue tie (Class 1 and 2):

• Attachment is visible at the front of the tongue
• Often easier to identify
• Tongue may appear heart-shaped when extended

Posterior tongue tie (Class 3 and 4):

• Attachment is farther back, near the base of the tongue
• May be hidden under mucous membrane
• Often harder to diagnose
• Can still cause significant feeding problems

How Common Is Tongue Tie?

Tongue tie affects approximately 4-11% of newborns, though some studies suggest it may be more common when posterior ties are included. Boys are more commonly affected than girls. The condition sometimes runs in families, suggesting a genetic component.

Understanding Lip Tie

Lip tie occurs when the labial frenulum—the tissue connecting the upper lip to the gum above the front teeth—is unusually thick, tight, or attached too low. This can prevent the upper lip from flanging outward properly during breastfeeding.

Types of Lip Tie

• Class 1: Minimal attachment, mucosal only
• Class 2: Attachment inserts at the gum line
• Class 3: Attachment inserts in the area of future front teeth
• Class 4: Attachment extends into the hard palate

Relationship Between Tongue Tie and Lip Tie

Many babies with tongue tie also have lip tie, and both conditions can contribute to feeding difficulties. When evaluating an infant with breastfeeding problems, it’s important to assess for both conditions.

Signs and Symptoms of Tongue Tie and Lip Tie

Symptoms in Breastfed Babies

Baby’s symptoms:

• Difficulty latching or staying latched during feeding
• Clicking or smacking sounds while nursing
• Sliding off the breast repeatedly
• Poor weight gain or failure to thrive
• Feeding for very long periods without satisfaction
• Falling asleep quickly during feeding (fatigue from inefficient sucking)
• Excessive gassiness or colic symptoms
• Reflux or frequent spitting up
• Persistent drooling
• Frustration during feeding

Mother’s symptoms:

• Painful breastfeeding despite proper positioning
• Cracked, blistered, or bleeding nipples
• Creased or flattened nipples after feeding
• Plugged ducts or mastitis
• Low milk supply (from inadequate breast emptying)
• Frustration and exhaustion from feeding struggles

Symptoms in Bottle-Fed Babies

While tongue tie often causes fewer problems with bottle feeding, some babies still experience:

• Difficulty forming seal around bottle nipple
• Milk leaking from corners of mouth
• Excessive air intake causing gas and fussiness
• Prolonged feeding times
• Preference for fast-flow nipples

Symptoms in Older Children

If tongue tie is not addressed in infancy, symptoms may appear later:

• Speech difficulties: Problems with sounds requiring tongue elevation (l, r, t, d, n, th, s, z)
• Eating difficulties: Trouble with certain food textures, messy eating, difficulty licking ice cream or lollipops
• Oral hygiene challenges: Difficulty cleaning teeth with tongue
• Dental issues: Gap between front teeth, orthodontic problems
• Social concerns: Inability to stick tongue out, kiss, or play wind instruments

Diagnosing Tongue Tie and Lip Tie

Diagnosis involves careful clinical examination by an experienced healthcare provider:

Physical Examination

• Visual assessment of frenulum appearance
• Evaluation of tongue movement and elevation
• Assessment of tongue shape during extension
• Examination of lip flanging ability
• Observation of feeding when possible

Functional Assessment

• Evaluation of feeding effectiveness
• Assessment of weight gain patterns
• Discussion of mother’s symptoms if breastfeeding
• Speech evaluation in older children

Challenges in Diagnosis

Tongue tie and lip tie can be missed because:

• Posterior tongue ties are not always visible
• Not all healthcare providers are trained to assess them
• Symptoms may be attributed to other causes
• Severity doesn’t always correlate with appearance

If you suspect your baby has tongue tie or lip tie, seek evaluation from a provider experienced in these conditions.

Treatment Options for Tongue Tie and Lip Tie

Conservative Management

For mild cases, conservative approaches may be tried first:

• Lactation support: Working with a lactation consultant on positioning and techniques
• Feeding therapy: Exercises to improve tongue and lip function
• Monitoring: Some mild ties improve as baby grows
• Bottle feeding modifications: Different nipple types for bottle-fed babies

Frenotomy (Frenectomy)

Surgical release is recommended when conservative measures fail or symptoms are significant:

What is frenotomy?

• Simple procedure to release the restrictive tissue
• Can be performed in clinic setting for young infants
• Takes only seconds to perform
• Minimal bleeding
• Baby can feed immediately after

Techniques used:

• Scissors or scalpel: Traditional method using sterile instruments
• Laser: Uses laser energy to release tissue with minimal bleeding

The Procedure Process

Before the procedure:

• Evaluation and diagnosis confirmation
• Discussion of risks and benefits
• Assessment of feeding baseline
• Planning for post-procedure care

During the procedure:

• Baby is swaddled and positioned
• Topical numbing may be applied (varies by provider)
• Frenulum is visualized and released
• Procedure typically takes seconds to minutes
• Minimal discomfort—babies often cry briefly then calm quickly

After the procedure:

• Immediate feeding is encouraged
• Wound stretching exercises may be recommended
• Follow-up to assess healing and function
• Continued lactation support if breastfeeding

Post-Procedure Care and Exercises

Wound Stretching

To prevent reattachment (the wound healing back together), stretching exercises may be recommended:

• Gently lift tongue or lip to keep wound open
• Performed several times daily for 2-4 weeks
• Technique demonstrated by your provider
• Brief discomfort is normal

What to Expect After Release

Immediate period:

• Small white patch at release site (normal healing)
• Mild fussiness for a day or two
• Some feeding improvement may be immediate
• Others require time and practice to improve feeding

Recovery timeline:

• Full healing typically occurs within 1-2 weeks
• Feeding improvements may continue over weeks to months
• Some babies require additional therapy

When to Seek Follow-Up

• Signs of infection (increasing redness, swelling, fever)
• Excessive bleeding
• No improvement in feeding after 2-4 weeks
• Concern about reattachment

Importance of Lactation Support

Releasing a tongue tie doesn’t automatically fix breastfeeding. Many babies and mothers need ongoing support:

• Retraining proper latch and sucking patterns
• Building milk supply if it has decreased
• Addressing any breast tissue damage
• Emotional support for frustrated parents

Working with a lactation consultant before and after frenotomy optimizes outcomes.

Common Myths About Tongue Tie Debunked

Misconceptions about tongue tie can lead to delayed treatment or unnecessary worry. Here are facts parents in Dubai should know:

Myth: Tongue Tie Is Rare

Truth: Tongue tie is relatively common, affecting 4-11% of newborns. With increased awareness, more cases are being identified, including posterior tongue ties that were previously underdiagnosed. If your baby has feeding difficulties, tongue tie should be considered as a possible cause.

Myth: If You Can See the Tongue, There’s No Tongue Tie

Truth: Posterior tongue ties can significantly restrict tongue function while still allowing the tongue to extend somewhat. The key is not just tongue extension but tongue elevation and the ability to move the tongue properly for effective feeding. A functional assessment is more important than appearance alone.

Myth: Tongue Tie Only Affects Breastfeeding

Truth: While breastfeeding difficulties are often the first sign, tongue tie can also affect bottle feeding, introduction of solid foods, speech development, dental health, and oral hygiene. Some impacts may not become apparent until the child is older, making early identification and treatment valuable.

Myth: Babies Will Just Grow Out of Tongue Tie

Truth: Unlike some infant conditions, tongue tie doesn’t resolve on its own. The frenulum doesn’t stretch or disappear with time. While some mild ties cause fewer problems as the baby grows stronger, significant tongue ties continue to cause issues and may lead to speech or dental problems later in childhood.

Myth: Frenotomy Is Major Surgery with Significant Risks

Truth: For young infants, frenotomy is a quick, simple procedure with minimal risks. It typically takes seconds, involves minimal bleeding, and allows immediate feeding. While no procedure is without risk, frenotomy in trained hands has an excellent safety profile. Complications like significant bleeding or reattachment are uncommon.

Myth: If My Baby Is Gaining Weight, Tongue Tie Doesn’t Matter

Truth: Weight gain is important but isn’t the only measure of feeding success. Babies with tongue tie may gain weight adequately while the mother experiences significant pain, supply issues, or feeding takes excessively long. The mother’s experience and the baby’s feeding efficiency both matter. Additionally, adequate weight gain in infancy doesn’t prevent future speech or dental issues from tongue tie.

Choosing a Provider for Tongue Tie Assessment and Treatment

Not all healthcare providers have training in tongue tie diagnosis and treatment. Consider these factors when seeking care in Dubai:

Provider Experience Matters

• Look for providers who regularly diagnose and treat tongue tie
• Ask about training and experience with both anterior and posterior ties
• Inquire about how many procedures they perform
• Ask about their assessment approach—functional assessment is key

Multidisciplinary Approach

The best outcomes often come from providers who work as part of a team:

• Collaboration with lactation consultants
• Access to speech therapy for older children
• Integration with pediatric care
• Comprehensive pre- and post-procedure support

Questions to Ask Before Choosing a Provider

• How do you diagnose tongue tie, including posterior ties?
• What technique do you use for frenotomy?
• What is your post-procedure protocol?
• Do you work with lactation consultants?
• What follow-up care do you provide?

Supporting Breastfeeding Success

Addressing tongue tie is often just one part of the breastfeeding puzzle. Comprehensive support maximizes success:

Before Frenotomy

• Work with a lactation consultant to optimize positioning and latch
• Document current feeding patterns and challenges
• Address any breast tissue damage
• Build milk supply if it has decreased
• Consider bodywork for baby if muscle tension is present

After Frenotomy

• Continue lactation support to retrain proper feeding
• Be patient—improvement may be gradual
• Perform wound care exercises as directed
• Address any remaining challenges with professional guidance
• Attend follow-up appointments

Emotional Support for Parents

Feeding difficulties can be emotionally draining for parents:

• Acknowledge that feeding struggles are not your fault
• Seek support from other parents who have been through similar experiences
• Celebrate small improvements
• Remember that fed is best—whatever method works for your family
• Don’t hesitate to seek mental health support if needed

Tongue Tie and Lip Tie Resources in Dubai

Dubai offers various resources for families dealing with tongue and lip tie:

Where to Find Help

• Pediatric clinics with tongue tie experience: myPediaClinic and other specialized pediatric practices
• Lactation consultants: Many work independently or through hospitals and clinics
• Support groups: Online communities connect Dubai parents facing similar challenges
• Speech therapists: For older children with speech concerns

Insurance Considerations

• Check if your insurance covers tongue tie assessment and treatment
• Lactation consultant visits may be covered separately
• Pre-authorization may be required
• myPediaClinic can help with insurance coordination

Controversies and Considerations

When Treatment May Not Be Needed

Not all tongue ties require treatment:

• Ties without functional problems
• Babies feeding and gaining weight well
• Mild ties that may stretch with growth
• When conservative measures are successful

Questions to Ask Your Provider

• Is the tie causing functional problems?
• Have conservative measures been tried?
• What improvement can I expect from treatment?
• What are the risks of treatment versus waiting?
• What is your experience with this procedure?

Long-Term Outcomes

With Appropriate Treatment

• Most babies show significant feeding improvement
• Maternal symptoms typically resolve
• Speech development proceeds normally
• Dental issues are prevented or reduced

Without Treatment

Untreated significant tongue tie may lead to:

• Continued feeding struggles and early weaning
• Nutritional concerns from feeding difficulties
• Speech articulation problems
• Dental and orthodontic issues
• Challenges with eating certain foods
• Social concerns in older children

Frequently Asked Questions About Tongue Tie and Lip Tie

How do I know if my baby has tongue tie?

Common signs include difficulty latching during breastfeeding, clicking sounds while feeding, poor weight gain, and maternal nipple pain or damage despite proper positioning. You may notice your baby’s tongue cannot extend past the lower lip or looks heart-shaped when extended. If breastfeeding is painful or ineffective despite lactation support, have your baby evaluated by a provider experienced in diagnosing tongue tie. Posterior tongue ties can be harder to see and may require expert assessment.

At what age should tongue tie be treated?

If tongue tie is causing significant feeding problems, treatment can be performed within the first few weeks of life. Early treatment (before 2-3 months) is often simpler, as the procedure can be done in-office with minimal discomfort. Older infants and children may require different approaches, sometimes with sedation. However, treatment can be beneficial at any age when functional problems exist. The ideal timing depends on the severity of symptoms and your provider’s recommendations.

Is the frenotomy procedure painful for babies?

For young infants, frenotomy causes brief discomfort similar to a quick pinch. Babies typically cry momentarily but calm quickly, often nursing immediately after the procedure for comfort. The frenulum tissue has few nerve endings, and bleeding is minimal. Some providers use topical numbing. After the procedure, babies may be slightly fussy for a day or two but are typically back to normal quickly. Pain medication is usually not needed.

Will my baby’s tongue tie affect their speech later?

Untreated tongue tie can potentially affect speech development, particularly sounds that require the tongue to touch the roof of the mouth or lift (l, r, t, d, n, th, s, z). However, many children with mild tongue tie develop normal speech. If tongue tie is released in infancy due to feeding issues, speech problems are typically prevented. Children with speech difficulties from tongue tie may benefit from release combined with speech therapy.

Can tongue tie reattach after treatment?

Yes, the wound can heal back together (reattachment) if stretching exercises aren’t performed properly. This is why post-procedure wound care is important. Your provider will demonstrate stretching exercises to perform several times daily for the first few weeks. If reattachment occurs, a second release procedure may be needed. Following aftercare instructions carefully minimizes this risk.

Should lip tie be treated at the same time as tongue tie?

If both conditions are present and contributing to feeding difficulties, releasing both simultaneously is often recommended. This addresses all restrictive tissue in one procedure. However, lip tie alone may not always require treatment if it’s not causing significant problems. Your provider will assess both conditions and recommend whether one or both should be treated based on functional impact.

How long after frenotomy will I see improvement in breastfeeding?

Improvement timelines vary significantly between babies. Some mothers notice immediate improvement in latch and comfort during the first feeding after the procedure. Others see gradual improvement over days to weeks as the baby relearns proper feeding patterns. Factors affecting recovery include the baby’s age at treatment, severity of the tie, whether bodywork is needed for muscle tension, and ongoing lactation support. Patience and continued work with a lactation consultant optimize outcomes.

Can tongue tie cause reflux in babies?

Yes, tongue tie can contribute to reflux symptoms. Babies with tongue tie often swallow excess air during feeding due to poor seal and inefficient sucking. This excess air can cause increased spit-up, gas, and discomfort that mimics or worsens reflux. Additionally, the prolonged feeding times common with tongue tie mean more opportunity for air swallowing. Treating tongue tie may reduce reflux symptoms in some babies, though other causes of reflux should also be evaluated.

Is there an age limit for tongue tie treatment?

There is no strict age limit for treating tongue tie. While early treatment in infancy is often simpler, older children, teenagers, and even adults can benefit from frenotomy when tongue tie causes functional problems. The procedure approach may differ for older patients, sometimes requiring sedation or different techniques. Speech therapy is often beneficial alongside treatment for older children with speech impacts. If tongue tie is causing problems, it’s never too late to consider treatment.

What is the difference between laser and scissors frenotomy?

Both methods effectively release tongue tie. Traditional scissors or scalpel frenotomy uses sterile instruments to cut the frenulum. Laser frenotomy uses laser energy to vaporize the tissue. Laser may cause less bleeding and potentially less discomfort, though this is debated. Both methods have excellent outcomes when performed by experienced providers. The choice often depends on provider training and preference. Ask your provider about their experience with their preferred technique.

Will treating my baby’s tongue tie guarantee successful breastfeeding?

Frenotomy significantly improves feeding in most cases, but it’s not a guaranteed solution. Breastfeeding success depends on multiple factors including proper latch technique, milk supply, baby’s oral motor skills, and maternal anatomy. Some babies need time and practice to develop new feeding patterns after release. Ongoing lactation support is essential. While frenotomy removes one barrier to successful breastfeeding, comprehensive support addresses the complete picture.

My baby has a tongue tie but is bottle-fed. Should we still have it treated?

Even for bottle-fed babies, tongue tie can cause issues worth addressing. Bottle-fed babies with tongue tie may experience excessive air intake, milk leakage, feeding fatigue, and preference for very fast flow nipples. Additionally, tongue tie may affect speech development and dental health later regardless of feeding method. If your bottle-fed baby has symptoms or you’re concerned about future impacts, evaluation is worthwhile. Treatment recommendations consider current symptoms and potential future concerns.

Schedule an Evaluation in Dubai

If you’re concerned about tongue tie or lip tie in your baby, our experienced pediatric team at myPediaClinic in Dubai can provide comprehensive evaluation and treatment. We work closely with lactation consultants to ensure the best outcomes for feeding success.

Contact myPediaClinic:

• Location: Dubai Healthcare City, Dubai, UAE
• Book online: Schedule a Consultation
• Phone: +971-4-430-5926

Don’t let tongue tie or lip tie interfere with your baby’s feeding and development. Early evaluation and appropriate treatment can make a significant difference for your baby and your breastfeeding journey.