Let’s talk about something that’s got a lot of parents buzzing lately: oral ties. You’ve probably heard all kinds of opinions—should we laser them? Clip them? Ignore them and hope for the best? Are they even real? With so much chatter (and misinformation) out there, it’s no surprise parents are left scratching their heads.
Let’s clear the air and bust one common myth: oral ties don’t just affect feeding. They can impact your baby’s overall development in ways you might not expect. If you’ve ever wondered how something as small as that little band of tissue under your baby’s tongue or lip could cause such a stir, let’s break it down together.
What Are Oral Ties?
An oral tie is when the tissue that connects your baby’s tongue, lip, or cheek to their mouth—called a frenulum—is tighter or thicker than it should be. Sometimes, this doesn’t cause any issues, but other times? It can make even basic tasks, like eating, feel like running a marathon for your baby
Oral ties can show up in many ways, and it’s not always easy to tell what’s normal and what might need attention.
Here are some signs to look out for:
• Feeding Fatigue: Does your baby act like feeding is a full workout? Falling asleep halfway through or taking forever to finish could be a sign that feeding is harder than it should be.
• Clicking and Spit-Up: Hearing a clicking sound during feeds? Seeing more spit-up than usual? Your baby might be swallowing extra air because they can’t get a good seal, leading to tummy troubles.
• Gas and Fussiness: That swallowed air has to go somewhere—and it’s not fun for your baby (or you). If they’re extra gassy or fussy after feeds, it might be connected to how they’re eating.
• Slow Weight Gain: When feeding takes too much effort, babies may not get the milk they need, which can lead to slower weight gain.
• Milk Dribbling: If more milk ends up on their chin (or on you) than in their tummy, poor suction and seal could be the issue.
• Tongue Limitations: Watch for a heart-shaped tongue tip, trouble sticking out their tongue, or difficulty moving it side to side or up and down
• Pacifier Problems: Newborns are born with a strong reflex to suck. When babies have difficulty taking a pacifier it can indicate limitations in their tongue movement and oral motor strength.
If these signs sound familiar, it doesn’t automatically mean your baby has a tie. But if you’re seeing several of them, it’s worth chatting with an infant feeding specialist or pediatric provider for a closer look.
How Oral Ties Affect Infant Development
Oral ties don’t just stop at feeding—they can ripple out into other areas of your baby’s growth and development.
• Body Tension
When the tongue can’t move freely, your baby’s body may compensate, creating tension in the jaw, neck, and shoulders. This tension can lead to body imbalances and head-turn preferences, potentially resulting in flat head syndrome if not addressed.
• Motor Milestone Challenges
Babies need a strong, balanced body to roll, crawl, and eventually walk. Tension caused by oral ties can throw a wrench in those early motor skills. The tongue is connected to the body through a network of fascia, so if it’s restricted, it can affect how other muscles work, too.
Here’s how tension can impact specific milestones:
Tummy Time: Instead of enjoying tummy time, babies with these restrictions may feel stiff or stuck in their neck, shoulders, and back, leading them to cry, arch their back, or avoid tummy time altogether. Over time, this discomfort can delay critical head and neck strength development, which is foundational for other motor milestones like rolling, sitting, and crawling.
Rolling: Rolling requires a balance of core strength, head control, and smooth coordination between the upper and lower body. If a tongue tie causes tightness in the neck, shoulders, or back, babies may struggle to shift their weight or rotate their body effectively. This tension can also make them prefer lying on one side, creating asymmetry and making rolling harder to achieve.
Sitting: Independent sitting requires a stable core and the ability to balance upright. When oral ties lead to body tension or compensatory movement patterns, babies may find it harder to engage their core muscles evenly. They might slouch, lean to one side, or struggle to maintain a steady sitting posture.
Crawling: In order to crawl, babies need good coordination between their arms and legs, as well as strength and stability in the shoulders, hips, and trunk. If the tongue is restricted, it can create tension that limits how freely a baby moves their head, shoulders, and torso. This can result in delayed or inefficient crawling patterns, like scooting instead of crawling on all fours.
• Delayed Speech
The tongue plays a huge role in forming sounds and speech. As your baby grows, a restricted tongue can make it harder for them to pronounce certain letters or develop clear speech patterns.
• Difficulty with solids
A tongue tie can make eating solid foods a real challenge for babies because the tongue plays a key role in safely and effectively managing food. When tongue movement is restricted, it can impact essential feeding skills like lateralizing food (moving it side to side), chewing, and swallowing.
Lateralizing Food: To successfully eat solids, babies need to move food from the center of their mouth to the sides, where their gums or early molars can mash it. When tongue mobility is limited, this lateralization becomes difficult. As a result, food may stay stuck in the center of the mouth or get pushed out altogether, turning mealtimes into a source of frustration for both baby and parent.
Chewing and Tongue Strength: The tongue’s ability to press food against the roof of the mouth is essential for breaking it down into manageable pieces. If a baby’s tongue is weak or tethered, they may struggle with textured or chunkier foods, making eating more difficult and less enjoyable.
Safe Swallowing: A mobile tongue is crucial for safely moving food toward the back of the mouth for swallowing. When the tongue can’t properly control the food, it may linger in areas that trigger the gag reflex, leading to frequent gagging or difficulty progressing to solids.
➡️ These challenges can lead to picky eating, aversion to textures, or delayed progress with solids. That’s why addressing a tongue tie isn’t just about breastfeeding—it’s about setting your baby up for success in all stages of feeding.
When To Seek Help
If you’re noticing ongoing feeding struggles, body tension, or delays in milestones, it’s time to reach out for support. Here’s how to get started:
• Consult a Lactation Specialist: They’re pros at spotting feeding challenges, addressing latch positions, and identifying whether a tie might be involved. They're also experts at preserving your milk supply if your baby is having trouble feeding at the breast.
• Visit a Dentist or ENT: These providers can confirm whether an oral tie is present and discuss treatment options, like a frenectomy (a quick procedure to release the tie).
• Work with a Pediatric Physical Therapist (like me!): Working with a pediatric PT, OT, or ST who specializes in infant feeding and oral ties can make a world of difference for your baby. These professionals help improve your baby’s mobility, ease body tension, and support oral motor function both before and after a release.
They will also address any other body restrictions that might be holding your baby back, helping them move more comfortably and thrive. It’s not just about feeding—it’s about giving your baby the tools they need to feel their very best from head to toe!
Check out these local Charlottesville providers
Before jumping into any procedure, I always recommend a functional assessment. Not every oral tie needs to be released! Many babies can make great progress with therapy alone. If you decide a frenectomy is the right path for your baby, pre and post-procedure therapy can dramatically improve outcomes and make feeding easier for both of you.
And if you want to dive deeper into the research around tongue ties, take a look at these articles.
You’ve Got This!
If you think oral ties might be affecting your baby, trust your instincts - you’re the expert on your baby. You’re not alone, and there’s a team of professionals ready to help you navigate this journey.
Your baby’s development deserves the best start possible. Addressing oral ties is one way to help them thrive beyond the feeding stage. You’ve got this, and I’m here to support you every step of the way.
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