Manual Therapy and Lactation Support for Tongue Tie and Breastfeeding Babies
Written by Kylie Walsh, MHSc (Osteo) and Dr Shervin Yazdi, DDS.
Tongue ties are highly controversial, inspiring widespread research among pediatricians, lactation consultants, dentists, ENT specialists, and osteopaths. The goal of such research is to explore the condition’s impact on short- and long-term health, feeding function, airway development, and even overall well-being.
If you are searching for treatment for tongue tie, it’s important to understand that every baby is unique. A comprehensive, team-based approach that considers feeding, body tension, and development often provides the best outcomes.
Although babies have natural reflexes that help them latch, breastfeeding is a learned skill for both the nursing parent and the baby. And support from an International Board-Certified Lactation Consultant (IBCLC), midwife, or pediatrician is often necessary to facilitate this process.
In this article, we'll explain how oral ties, including tongue and lip tie, may affect an infant's ability to breastfeed or chestfeed and what can be done about it. We’ll also answer common questions and offer guidance to support you and your baby.
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What is a Tongue Tie in Breastfeeding?
Ankyloglossia, better known as “tongue tie,” refers to a condition where the band of tissue that tethers the tongue to the floor of the mouth (lingual frenulum) is too short or tight. This restriction limits mobility and can interfere with latch, suck coordination, and milk transfer.
When restrictions occur in the upper lip (a lip tie) or elsewhere in the oral cavity, they may collectively be referred to as oral ties. These restrictions can influence the baby's mouth function, affecting feeding mechanics and comfort for both baby and parent.
Types of Tongue Ties
Not all tongue ties are created equal. There are several presentations:
• Anterior tongue tie – a short or tight frenulum located toward the front of the tongue.
• Posterior tongue tie (mid-tongue restriction) – a tighter frenulum positioned further back, often less visible but equally impactful.
In some cases, a lip tie may also be present, further restricting mobility within the baby's mouth and affecting latch.
Symptoms of Tongue Tie in Babies
Tongue ties may present with a range of symptoms, or none at all.
Tongue Mobility Issues
The hallmark sign is a reduced range of motion, including limited lift and lateralisation. These restrictions may reduce the baby's ability to maintain suction and feed efficiently.
Muscular Tension in the Face
A restricted tongue can affect the entire facial and cervical system. Tension in the jaw, neck, and head may contribute to feeding challenges and even encourage compensatory patterns such as mouth breathing over time.
Challenges for the Nursing Parent
When tongue mobility is compromised, the nipple may be compressed instead of drawn deeply into the mouth. This can lead to nipple pain, tissue damage, and reduced milk transfer.
Inefficient feeding may also impact milk supply and overall feeding confidence.
Additional Signs to Look Out For
In some babies, the following signs may indicate feeding dysfunction related to oral ties:
• Clenched fists
• Head asymmetry
• Limited neck range of motion
• Arching of the back
• Pulling off the breast
• Persistent fussiness
• Painful nursing
• Digestive irregularities
These signs may reflect broader tension patterns affecting feeding and development.
What to Do if Your Baby Has a Tongue Tie
If your baby is diagnosed with a tongue tie, the next steps depend on:
• Severity of restriction
• Functional tongue movement
• Presence of symptoms
• Feeding goals
• Airway and facial development considerations
Early support is key. In many cases, conservative tongue tie treatment, such as lactation guidance and osteopathic care, can significantly improve function before considering tongue tie surgery.
Because feeding challenges may also affect oxygenation and breathing patterns, supporting nasal breathing early in life can positively influence long-term development, including
Lactation Support for Tongue Tie in Breastfeeding
If you're seeking treatment for tongue tie, a lactation consultation is typically the first step. An IBCLC will assess milk transfer, positioning, latch quality, and suck coordination.
Even after tongue tie surgery, continued lactation support is essential. Babies often need guidance to relearn effective feeding patterns once mobility improves.
Follow-up within a few days of release is strongly recommended to optimise outcomes.
How Can Osteopathic Manual Therapy Fix Tongue Tie?
Osteopathic Manual Therapy aims to relieve tension affecting the tongue, jaw, neck, and diaphragm. Addressing fascial and muscular strain can improve feeding mechanics and sometimes reduce the need for surgical intervention.
Targeted tongue exercises may also be recommended before and after release to improve coordination, strength, and integration of new movement patterns.
When symptoms persist after several sessions of conservative care, referral for tongue tie surgery may be appropriate.
How Tongue Tie is Diagnosed
Diagnosis involves:
A full health history
Feeding assessment
Structural and functional oral exam
Providers evaluate tongue mobility, suck quality, palate shape, airway considerations, and overall tension patterns. If multiple oral ties are suspected, including lip tie, these will be assessed together to determine the most appropriate tongue tie treatment plan. Photographic documentation may assist with collaborative care between providers.
What Happens During Tongue Tie Surgery?
If conservative approaches are insufficient, tongue tie surgery (also called a frenotomy or frenectomy) may be recommended.
The procedure typically involves:
• Swaddling for comfort
• Protective positioning
• Numbing the release site
• Releasing the restrictive tissue using appropriate surgical equipment
After the procedure, post-release care often includes tongue exercises to prevent reattachment and support optimal function of the baby's mouth during feeding.
Frequently Asked Questions About Treatment for Tongue Tie
What is the best treatment for tongue tie?
The best treatment for tongue tie depends on your baby’s symptoms and functional challenges. Many families begin with lactation support and osteopathic care. If needed, tongue tie treatment may include surgical release combined with bodywork and feeding support.
Can a lip tie affect breastfeeding?
Yes. A lip tie may limit flange mobility, making it harder for babies to maintain a deep latch. When combined with other oral ties, this can contribute to nipple pain and reduced milk transfer.
Will tongue tie affect my baby long-term?
Untreated restrictions may influence feeding, speech, oral development, and breathing patterns, such as mouth breathing. Early assessment ensures that the baby's ability to feed, grow, and thrive is fully supported.
Do all babies with tongue tie need surgery?
No. Not all babies require tongue tie surgery. Some respond well to conservative tongue tie treatment, including lactation support and manual therapy.
Get Started with an Initial Consultation Today
If you are looking for support during your postpartum journey and related to breastfeeding/chestfeeding, contact Nourish Osteo & Wellness for a free 15-minute phone consultation or book an initial treatment online.
This article was also gracefully contributed to by Dr Shervin Yazdi, DDS. Click here to make a dental appointment with Dr Yazdi and his team at Castro Valley Pediatric Dentistry and Orthodontics in Castro, California.
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