Tongue-Tie and Lip-Tie in Infants and Toddlers: Signs, Effects, and Treatment

Dr Lokesh Yadav · Gurugram · Updated 2026-10-13

Many new parents in Gurugram come to us worried after a pediatrician, lactation consultant, or even a relative mentions that their baby might have a tongue-tie or lip-tie. These are common conditions, and most of the time they are manageable once properly understood. This article explains what to look for, how these conditions can affect feeding and speech, and what frenectomy treatment actually involves.

What Are Tongue-Tie and Lip-Tie?

Tongue-tie (ankyloglossia) happens when the thin band of tissue under the tongue, called the lingual frenulum, is tighter or shorter than usual. This can restrict how far the tongue moves. Lip-tie refers to a similar tight band connecting the upper lip to the gum, which can limit how well the lip flanges outward during feeding.

Both conditions are present from birth and vary widely in severity. Some babies have a mild tie that causes no problems at all, while others have a tighter restriction that noticeably affects feeding.

Signs to Watch for in Infants

• Difficulty latching on to the breast or bottle, or frequently slipping off
• Clicking sounds while feeding
• Long feeding sessions but poor weight gain
• Excessive gas, fussiness, or spitting up after feeds
• Mother experiencing pain, cracked nipples, or low milk supply due to poor latch
• A tongue that looks heart-shaped or cannot lift up to the upper gum when crying

Signs to Watch for in Toddlers

• Trouble sticking the tongue out past the lower lip
• Difficulty licking an ice cream cone or lollipop
• Picky eating or gagging on certain food textures
• Speech sounds that seem unclear, especially t, d, l, n, s, z, or r sounds
• Gaps between the upper front teeth linked to a tight lip-tie pulling on the gum

How It Can Affect Feeding and Speech

A restricted tongue cannot move efficiently to compress the breast or form a proper seal around a bottle nipple, which can lead to inefficient milk transfer. This often shows up as a baby who feeds for a long time yet still seems hungry, or one who is gaining weight slowly. For breastfeeding mothers, it can also cause significant nipple pain.

As toddlers grow, the tongue plays an important role in shaping certain speech sounds. A tight tongue-tie does not always cause speech delay, but in some children it can make specific sounds harder to pronounce clearly. Lip-tie is less commonly linked to speech but can affect lip closure and, in some cases, oral hygiene around the upper front teeth.

How Tongue-Tie and Lip-Tie Are Diagnosed

Diagnosis involves a simple clinical examination of the mouth, checking how far the tongue lifts and moves side to side, and how the upper lip flanges. The dentist will also ask about feeding history, weight gain pattern, and any speech concerns if the child is older. Not every tight-looking frenulum needs treatment, so this assessment helps decide whether intervention is actually necessary.

Frenectomy Treatment Options

When a tongue-tie or lip-tie is clearly affecting feeding, oral hygiene, or speech, a frenectomy may be recommended. This is a minor procedure to release the tight band of tissue.

Common Methods

• Scissor or scalpel frenectomy: A traditional method using small surgical scissors or a blade, usually done under local anesthesia or a numbing gel for infants.
• Laser frenectomy: Uses a dental laser to release the frenulum with minimal bleeding and often a quicker, more comfortable recovery.

Both methods are considered safe when performed by a trained dentist or oral surgeon. The choice often depends on the child's age, the extent of the tie, and the clinician's assessment.

What Happens After the Procedure

Babies are usually encouraged to feed right after the procedure, which helps with healing and comfort. For toddlers, simple stretching exercises or follow-up with a speech therapist may be suggested if speech sounds were affected before treatment.

When to Seek an Evaluation

If feeding is painful, prolonged, or your baby is not gaining weight well, or if your toddler struggles with certain speech sounds, it is worth getting a professional opinion. Early evaluation helps determine whether a frenectomy is genuinely needed or whether the tie is mild enough to leave untreated with regular monitoring.

Thinking about treatment? Oral & maxillofacial surgery at Dr Lokesh Yadav