How Do We Determine If Your Baby Has a Tongue Tie? Written By: Dr. Ankita Shah, Jan 2020

Tongue Tie

The Lactation Consultant working for your baby gives me a background knowledge on your sessions with her. This helps me to gauge the baby’s nursing progress prior to my initial consultation.

If breastfeeding issues including inadequate latch, poor breast draining, painful nipples, fussiness at the breast and other possible issues have not improved and a lactation consultant is concerned about a possible tongue tie and/or a lip tie, she will refer over mom and baby for a complete functional tongue tie assessment.

1)Proper Lighting: By using proper lighting and magnification, I can freely examine the baby’s mouth with both my hands. Like many problems in life’ “When The Vision Is Clear, Strategy Is Easy.”

2)Adequate Positioning: Positioning of the infant and myself is extremely important during this examination. The parent and I face each other with our knees touching. This creates a sort of “table” for the baby to lay on. I primarily have the baby’s head towards me, laying on his/her back.

3)Gentle Examination: Our goal is to assses the level of tension in the infant’s lingual frenulum when the tongue moves up and down, in and out and right to left. I perform some exercises to measure the tongue’s range of motion and overall mobility. While doing so, I gauge the baby’s reactions to discomfort. I also assess the lip frenum which will turn white where it attaches to the upper jaw and create a dip in the upper lip if it is too tight.


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While it may be tempting to attempt this examination on your own, I highly recommend that you allow a trained professional to perform it. Why? Experience is necessary to determine what level of tension warrants a lingual frenectomy and what does not. Diagnosis of a tongue tie is not simply based upon appearance – it is largely based upon symptoms experienced by mom and baby as well as tongue function.

I conduct a thorough examination of the baby’s mouth to determine if the lingual frenulum is causing interference in the movements that are important to proper latch and tongue function. While it is certain that not all tongue ties need to be released, it is the experience I have in evaluating infants that helps me make that determination.

Do Not worry. The resulting benefits I have witnessed in improved breastfeeding make the entire procedure well worth it.