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Baby has posterior toungue tie
My 2-month-old daughter has been diagnosed with a posterior tongue tie. She takes expressed breast milk by bottle because she was unable to latch due to my flat nipples.
Our feeding therapist has suggested doing oral exercises for one month, and if there is no improvement after that, they may consider a tongue tie release procedure.
My baby usually drinks only 20–40 ml at a time and wants feeds every 45–60 minutes. Sometimes I hear clicking sounds during feeding, she cries in the middle of feeds, arches her back while feeding, and seems gassy all the time.
Even though she takes very little milk at a time, she has good wet diapers. Her birth weight was 2.7 kg, she dropped to 2.5 kg initially, and at 58 days she weighs 4.2 kg.
I want to know if doctors has seen improvement with therapy alone. Should we consider tongue tie release or not? Has anyone benefited from a tongue tie release procedure?
Answers (6)
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Dr Faisal Zoheb
MBBS , MD PAEDIATRICS , PGPN (BOSTON), FELLOWSHIP IN NEONATOLOGY ( Newborn and vaccination specialist )
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If the the baby had no problems while feeding then we can wait for 6 months . The baby had good weight gain no need to worry
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Dr. Venkatesh Badugu
Pediatrician
9 yrs exp
Hyderabad
Consult Pediatric surgeon urgently
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Dr. Bhatt Vivek Prafulchandra
Pediatrician
5 yrs exp
Rajkot
Consult with Pediatrician physically for further evaluation and treatment
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Dr. Shebin C E
Pediatrician
10 yrs exp
Kanyakumari
Greetings
Your daughter’s daily weight gain is excellent, but her feeding routine is highly exhausting.
Her clicking, gassiness, and frequent feeding indicate inefficient milk transfer and rapid muscle fatigue.
She fills her stomach with excess air, causing her abdominal pain and back arching.
Doctors frequently see feeding improvements through structured oral therapy and specialized muscle exercises.
However, therapy alone cannot physically lengthen a severely restricted posterior tissue band.
A tongue-tie release is worth considering because her current routine is unsustainable.
The procedure can immediately stop the clicking sounds by restoring a secure bottle seal.
It drastically reduces swallowed air, which eliminates the painful gas and crying.
Most babies can then pull larger volumes, extending sleep and feeding intervals.
Completing the one-month therapy trial ensures surgery is only used as a necessary last resort
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Dr. Jay Gajjar
Pediatrician
6 yrs exp
Surat
Posterior tongue tie can sometimes improve with feeding therapy/oral exercises alone, especially if weight gain is adequate. In your baby’s case, weight gain from 2.5 kg to 4.2 kg by 2 months is reassuring and wet diapers are a good sign.
However, symptoms like:
• clicking sound while feeding
• very frequent small feeds
• crying/arching during feeds
• poor latch efficiency
• excessive gassiness
can be seen in babies with significant tongue restriction.
Usually, tongue tie release (frenotomy) is considered only if:
• feeding difficulties continue despite proper lactation support/exercises
• baby struggles to transfer milk effectively
• mother has persistent breastfeeding difficulty/pain
• weight gain becomes suboptimal.
Many babies do show improvement after frenotomy when symptoms are clearly related to tongue tie, but not every feeding issue is due to tongue tie alone. Reflux/air swallowing can also contribute.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.