Medically reviewed by Dr. Yury Slepak, DDS, Board-Certified Pediatric Dentist | 20+ Years Experience | Last Updated: September 2026
If your baby struggles to latch, feeds for a very long time, makes a clicking sound at the breast, or has a tongue that looks heart-shaped when they cry, tongue-tie could be the cause. Tongue-tie is a tight band of tissue under the tongue that limits how far the tongue can move. Many babies have it. Most never need any treatment. Here is how to check at home and when to see a dentist.
Tongue-tie is a tight band under the tongue that limits its movement
The medical name is ankyloglossia. Every person has a thin strip of tissue that connects the underside of the tongue to the floor of the mouth. That strip is the lingual frenulum. When it is unusually short, thick, or attached too close to the tip, the tongue cannot lift, stretch, or move side to side the way it normally would.
Estimates from the American Academy of Pediatrics put signs of tongue-tie in roughly 1 in 10 newborns or fewer, and it shows up more often in boys. It forms before birth, when the frenulum does not thin out and pull back the way it usually does as the baby develops.
The fastest home check: look for a heart-shaped or notched tongue tip
The clearest visual sign is the shape of the tongue when your baby cries or lifts it. A restrictive frenulum tugs the center of the tip downward, so the tongue looks heart-shaped or has a small notch at the front instead of a smooth, rounded edge.
Other things you can watch for at home:
- The tongue cannot reach past the lower gum or lip.
- The tongue cannot lift toward the roof of the mouth when the baby cries.
- The tip stays flat or dips in the middle instead of pointing.
A visual check is a starting point, not a diagnosis. Some ties sit further back and are hard to see, which is why a hands-on exam matters.
Feeding signs in newborns: shallow latch, clicking, and very long feeds
Feeding difficulty is the reason most tongue-ties get noticed in the first weeks. Watch for these patterns during nursing or bottle feeding:
- A shallow latch, or a latch that keeps slipping off.
- A clicking or smacking sound, which usually means the seal keeps breaking.
- Feeds that run very long and still leave the baby unsettled or hungry.
- Falling asleep quickly at the breast from the effort of feeding.
- Poor weight gain, or fewer wet and dirty diapers than expected.
- Gassiness or reflux-like fussiness from swallowing air through a broken seal.
One of these signs alone is common in newborns and often settles on its own. Several of them together, especially with poor weight gain, is worth having checked.
Some feeding signs show up in the nursing parent, not the baby
Tongue-tie affects the person nursing too, and their symptoms are often the loudest clue. If breastfeeding brings cracked, creased, or pinched nipples, sharp pain that lasts through the whole feed, or repeated clogged ducts and low milk supply, a poor latch may be the reason. The tongue cannot cup and draw milk well, so transfer suffers and the nipple takes the pressure.
If you are in pain at every feed, that is a signal to get evaluated by a lactation consultant or dentist, not something to push through.
Lip-tie is a separate issue that shows up at the upper gum
Lip-tie is a related condition where the tissue joining the upper lip to the gums above the front teeth is thick or tight. It can make it hard for a baby to flange the top lip out for a deep latch, and later in childhood it can make the front teeth harder to brush, which raises cavity risk. A baby can have a tongue-tie, a lip-tie, both, or neither. Each is judged on its own.
Speech and older-child signs appear later, and most children never have them
Parents often ask whether tongue-tie will affect talking. For most children the answer is no. When a tie does cause trouble past infancy, it tends to look like:
- Difficulty with sounds that need the tongue to reach the roof of the mouth, such as "t," "d," "l," "r," and "th."
- Trouble licking an ice cream cone, sticking the tongue out, or clearing food off the teeth.
- A gap between the lower front teeth in some cases.
Speech is complex and has many causes. A tie is only one possibility, so a speech concern deserves a full look rather than an assumption.
Most tongue-ties do not need surgery
This is the part that gets lost online. A tongue-tie is only a problem when it causes a problem. Many babies with a visible tie feed well and gain weight, and many children with a mild tie speak clearly. The American Academy of Pediatrics has warned that tongue-tie is being overdiagnosed and that some babies undergo procedures they did not need, while the real cause of a feeding problem gets missed.
The responsible first step when feeding is hard is hands-on lactation support: adjusting positioning, latch, and technique. A large share of feeding problems improve with that alone. Surgery is considered only when a genuine restriction remains after that support and is clearly holding feeding back.
When a frenectomy is actually recommended
A frenectomy (also called a frenotomy in newborns) is the minor procedure that releases the tight tissue. It is worth considering when both of these are true:
- There is a real, examinable restriction in how the tongue moves, and
- That restriction is causing a documented problem: a baby not transferring milk or not gaining weight, ongoing nursing pain that positioning changes have not fixed, or, in an older child, a feeding or speech issue tied to tongue movement.
When a newborn does need it for feeding, it is generally best done early, often within the first weeks, so the baby can build effective feeding habits. Timing and necessity are decisions to make with a dentist or pediatrician after an exam, not from a photo on the internet.
What a frenectomy involves and how recovery works
The area is numbed with a numbing agent or local anesthesia, and most children return to normal activities the same day.
How we evaluate tongue-tie at Bite Squad Dental of NYC in Brooklyn
Our team examines how the tongue actually moves, beyond how the frenulum looks, and we weigh that against what your baby is doing at feeds. If feeding support is the right first move, we say so. If a release will genuinely help, we explain why, what it involves, and what recovery looks like before you decide.
The practice is led by Dr. Yury Slepak, DDS, a board-certified pediatric dentist with more than 20 years of experience, alongside board-certified pediatric dentist Dr. Jessica Borukhova and pediatric dentist Dr. Yelena Gofman. We care for families across Sheepshead Bay, Brighton Beach, Coney Island, Gravesend, Bensonhurst, Midwood, Flatbush, and nearby Brooklyn neighborhoods, with a front desk that speaks English, Spanish, Ukrainian, and Russian.
Worried About Your Baby's Latch or Feeding?
Our board-certified pediatric dental team will examine how your baby's tongue moves and tell you honestly whether a release is needed, in a calm setting built for the smallest patients.
Frequently asked questions about baby tongue-tie
How do I know if my baby is tongue-tied or just a slow feeder?
Look for a pattern, not a single sign. A tongue that looks heart-shaped when the baby cries, a latch that keeps slipping, clicking sounds, very long feeds, poor weight gain, and nursing pain that does not improve with position changes point toward a tie. A hands-on exam with a dentist or lactation consultant confirms it.
Does every tongue-tie need to be cut?
No. Many babies with a visible tie feed and grow well and never need anything done. A release is considered only when a real restriction is causing a real feeding, weight, or later speech problem that other steps have not solved.
At what age should a tongue-tie be treated?
When a newborn needs a release for feeding, it is usually best within the first weeks of life. Older children and even adults can have it done when there is a clear reason. Age alone does not decide it; the exam and the symptoms do.
Will a tongue-tie affect my child's speech?
Usually not. Most children with a mild tie speak clearly. When a tie does interfere, it tends to affect sounds that need the tongue to reach the roof of the mouth. Speech has many causes, so a concern should be evaluated fully rather than blamed on a tie by default.
Is a frenectomy painful for a baby?
The procedure is minimally invasive and done with a numbing agent or local anesthesia, and most children are back to normal activities the same day.
Can lip-tie cause cavities?
It can contribute. A tight upper-lip tie can make the front teeth harder to keep clean as a child grows, which can raise cavity risk in that area. Good brushing habits and regular checkups help manage it.
Talk to a Brooklyn pediatric dentist about your baby's tongue-tie
If feeding is painful or your baby is not gaining well, you do not have to guess. Call Bite Squad Dental of NYC at (718) 998-2424 or request a consultation online, and we will examine your child, tell you honestly whether treatment is needed, and lay out your options. We are at 2464 Coney Island Avenue, Brooklyn, NY 11223.
Disclaimer: This information is provided for educational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Please schedule a consultation with our team to discuss your individual needs.
