Early Signs of Tongue-Tie in Newborns Every Parent Should Know

There are lots of new parents who assume that feeding a baby will be natural and easy. Nevertheless, there are infants who have difficulties either when breastfeeding or when taking a bottle, despite the best efforts of the parents. Tongue-tie is a frequently overlooked cause that may affect a baby’s tongue movement. Early identification of the signs of tongue-tie could help parents find relief at the right time and ensure that a baby feeds without discomfort and grows and thrives.

This blog will discuss the early signs of tongue-tie, the reasons for the symptoms, and the signs a parent should observe in the initial weeks after delivery.

What Is Tongue-Tie in Infants?

Some infants might have a tongue-tie (a.k.a. restrictive lingual frenulum) where the thin piece of tissue underneath the tongue is either shorter, thicker, or tighter than normal. This limits tongue movement and can disrupt feeding, swallowing, and sometimes speech development.

While some babies with a mild tongue-tie might have no issues or only mild symptoms, others (even with less obvious ties) can have significant difficulty feeding, so prompt detection of tongue-tie and awareness of common symptoms is crucial.

Why Early Detection Matters

Identification of the early symptoms of tongue-tie helps parents and health care practitioners address and improve feeding problems before they worsen or cause other complications.

Tongue-tied infants who are not treated may develop symptoms including:

• Poor weight gain (but doesn’t have to be!)
• Frustration during feeding
• Nipple discomfort in breastfeeding mothers
• Prolonged feeding sessions
• Reflux, colic, and gas from air swallowing
• Milk leaking out (messy eater)
• Clicking noises (air swallowing)

Parents should be aware of the early signs of tongue-tie and receive timely advice about their concerns from pediatricians, lactation consultants, or other professionals with advanced training in tongue-tie, such as our clinic. 

Symptoms of Tongue-Tie in Infants

These are some of the most common symptoms of newborn tongue-tie that parents should observe.

1. Baby Not Latching Properly

Among the most obvious symptoms, an inability to latch during breastfeeding or bottle-feeding is easy to identify.

A baby with tongue-tie may:

• Experience trouble with a deep latch (too shallow)
• Slip frequently off the breast
• Get frustrated when feeding
• Cough, choke, or gag when feeding
• Take a long time to feed
• Seem always hungry and not getting full

Although the latch might appear fine (visually), a baby with limited tongue movement (a tongue restriction like a tongue-tie) will have trouble maintaining the latch.

2. Clicking When Eating

Other typical symptoms of tongue and lip tie include a clicking or smacking sound during feeding.

This sound occurs because the baby is unable to maintain proper suction and seal. Because of this, the baby wants to be fed continuously, which could lead to discomfort, gas, reflux, colic, and even nasal congestion. 

3. Prolonged or Protracted Feeding Sessions

Infants who struggle with tongue-tie tend to take a long time to finish feeding. They don’t feed efficiently and can fall asleep at the breast out of exhaustion. They sometimes burn more calories than they consume, like eating while on a treadmill. 

Parents may notice:

• The baby looks sleepy before she finishes feeding.
• Babies fall asleep soon during feeding.
• Parents have to wake them up to finish a feed.
• They wake up hungry again a short time later.

This is because the baby is forced to work harder to get milk since the tongue cannot elevate properly. Poor tongue elevation comes from a restricted tongue (doesn’t have to be to the tip), which can vary in appearance from a mild restriction to a complete 100% restriction. Even a 10% restriction in some babies can cause tremendous feeding issues for mom and baby. 

4. Poor Weight Gain

A second notable early sign of the tongue-tie is the slow or insufficient weight gain.

When a baby is unable to transfer milk effectively, he or she might not receive enough nutrition, even if the baby is fed frequently. Poor weight gain in newborns with tongue-tie is common, but we have many babies who continue to gain weight well due to compensations (feeding more frequently, bottle-feeding, syringe feeding). 

So weight gain is one indicator, but typically not the best indicator of whether a tongue-tie is present. For pediatricians, this is the main symptom they look for, but focusing too much on weight gain can cause a missed diagnosis of tongue-tie for many struggling babies (and their families) who are gaining weight still. 

5. Tongue Appears Heart-Shaped

In the case of a baby with tongue-tie, when he sticks out his tongue, it might look like a heart shape or fail to extend very long past the bottom of the gums. This will only be present in the tightest tongue restrictions (90-100%), so tongue protrusion or sticking the tongue out is the least sensitive test for picking up a tongue-tie.

The best test is elevation – how high can the tongue lift? When you combine the symptoms with the tongue elevation, this is the most repeatable and easy way to diagnose a tongue-tie. 

6. Mobility Impairment: Difficulty Moving the Tongue

Parents or healthcare providers might observe that the baby is not able to:

• Tongue: Raise the tongue to the palate in the mouth.
• Stick the tongue out fully
• Cup the tongue (can’t hold a pacifier)
• Move the tongue side to side

Limited tongue or lip movement (lip curling under or not flipping out) is one of the many clues that point to a tongue-tie or lip-tie in newborns. When a tongue or lip cannot move properly and there are accompanying symptoms, it’s worth checking in with a knowledgeable tongue-tie provider like Dr. Baxter or Dr. Trego. 

7 . Gassy or Fussy Baby

Since babies with tongue-tie may ingest excess air during feeding, they may become gassy and irritable. This is called aerophagia (eating air) and is commonly mistaken for a milk protein (dairy) allergy or just “colic” when the cause is treatable and easily fixed by releasing a restricted tongue or lip. 

Parents may observe:

• Frequent burping or gas (toots)
• Fussiness after feeding
• Colic-like symptoms
• Evidence of reflux-like pain (arching the back, making faces)

These symptoms usually accompany other symptoms of tongue-tie in newborn babies.

Tongue-Tie: Signs of Tongue-Tie as the Baby Grows

Though the first symptoms of tongue-tie tend to manifest during the feeding process, there is also a possibility that the oral development will be underdeveloped as the child grows.

Potential subsequent symptoms of tongue-tie among infants are:

• Difficulty sticking out or lifting the tongue.
• Difficulty licking lips or cleaning teeth off
• Trouble with solid foods
• Trouble crawling or walking (really!)
• Difficulties with sounds or not babbling as much

These concerns can be avoided by evaluating and treating them early before they become long-term issues.

Can Tongue-Tie Affect Adults?

Even though this post discusses babies, it is worth noting that in many instances, an untreated tongue tie can persist into childhood and even adulthood. A tongue-tie does NOT stretch out, and the symptoms change over time. Certain symptoms of tongue-tie among adults are:

• Trouble with sleep – sleep apnea, snoring, mouth breathing
• Trouble with swallowing pills, meat, or certain textures
• Tension or soreness of the jaw and neck 
• Headaches or migraines 

The good news is that when treated as a baby or young child, you can, in most cases, avoid these outcomes later on. It doesn’t mean that a child treated as a baby will never have speech issues, but they are less likely to need therapy later. When a baby has symptoms, it’s worth treating early; it helps with symptoms like latching, gas, reflux, and colic, and offers continued benefits in the future. If the tongue is simply clipped, you cannot expect to see these results. When the tongue is fully released and treated by specialists with advanced training, such as laser frenectomy certification for pediatricians, ENTs, or dentists, it will very often yield the benefits that parents desire. 

Conclusion

The challenge of feeding can be a stressful experience for both the baby and the parents, particularly when the underlying cause is unclear. Knowing the symptoms of a tongue-tie early in life helps parents be aware of issues that might not be functioning as intended and can see resolution with proper treatment. If your baby is struggling, please reach out to us and we would love to help your family. We help families from all over the USA and around the world at our office in Birmingham, AL. Just call 205-419-4333 or send us a message. 

The symptoms of newborn tongue-tie are common, which include: baby not latching, clicking during feeding, lengthy feeding time, and poor weight gain.  All of these symptoms and more can indicate a tongue-tie in babies. Observing such symptoms of tongue or lip tie enables the parents to seek a consultation with a knowledgeable provider at an early stage and enable the baby to get all the help they need to not just survive, but to thrive. 

With proper education and professional attention, many babies with tongue-tie are able to feed comfortably and grow up into healthy children and later adults. 

FAQs

1. When do newborn babies have the earliest symptoms of tongue-tie?

The earliest symptom of tongue-tie is likely excessive in utero hiccups (in the womb). Excessive hiccupping can be a sign of a tongue-tie in the womb and during the first few months of life. The initial, more obvious symptoms of a tongue-tie usually include a baby failing to latch, clicking during feeding, prolonged feeding, mouth breathing, gas, reflux, and occasionally poor weight gain. Other newborn tongue-tie symptoms include difficulty lifting the tongue to the palate, poor sleep, dissatisfaction with feeds, fussiness, colic, or painful nursing. 

2. Will tongue-tie in newborn infants resolve itself?

Some babies with a mild restriction may resolve as they develop. However, if the parents observe persistent symptoms of tongue-tie in the infants, including feeding and latching challenges, it is prudent to consult a medical professional for a proper assessment and advice. Call our office at 205-419-4333 or send us a message.