Tongue tie, lip tie and feeding support in Delhi NCR
Feeding is not working, and someone has mentioned a tongue tie. Not every tie needs releasing. This page says plainly when it does, when it does not, and what we try first.
A tongue tie is about movement, not appearance
Every one of us has a frenulum, the small band of tissue under the tongue. A tongue tie is when that band restricts how the tongue moves enough to cause a problem. A lip tie is the equivalent band inside the upper lip. The word that matters in both is restricts. A frenulum that looks tight but works fine is not a problem to be solved.
That is why an assessment here starts by watching a feed rather than by looking in the mouth. What the tongue does is the evidence. What the frenulum looks like in a photograph is not.
Six things that bring parents in
- 1
Feeding hurts
Cracked or blanched nipples, pain that does not settle after the first week.
- 2
A clicking sound
Air getting in because the seal keeps breaking.
- 3
Long feeds that never satisfy
An hour on the breast and hungry again in twenty minutes.
- 4
Slow weight gain
The one sign that moves this from uncomfortable to urgent.
- 5
The tongue cannot lift or poke out
What we actually assess. Not how the frenulum looks.
- 6
Reflux or wind that will not settle
Common, and only sometimes connected to a tie.
Any of these is worth an assessment. None of them, on its own, means your baby has a tie. See all treatments at Tooth Tales.
When we release, and when we watch
Tongue tie is an area where treatment has grown much faster than the evidence, so here is the evidence rather than an opinion, including the parts that do not favour doing a procedure.
Most feeding pain is a tongue tie.
A release fixes breastfeeding.
The Cochrane review of five trials and 302 babies found reduced nipple pain, but inconsistent effects on the baby’s feeding, on very low to moderate quality evidence. No study followed babies long enough to report long-term breastfeeding success.[1]
The lip tie needs doing at the same time.
A study of 264 mother and baby pairs found a harmful upper lip tie was very rare and played only a minor role in feeding problems. Breastfeeding inexperience was more strongly associated with difficulty than lip anatomy.[3]
You can tell from a photograph.
What matters is how the tongue moves, not how the frenulum looks. Appearance alone is a poor guide, which is why we watch a feed before we look in the mouth.[2]
✓ We would release
- ✓ Tongue movement is genuinely restricted, tested rather than eyeballed.
- ✓ Feeding is affected and positioning and latch support has not been enough.
- ✓ Weight gain is slow, which moves this from uncomfortable to urgent.
- ✓ Nipple pain is persistent and damage is not healing between feeds.
✗ We would watch
- ✗ The frenulum looks tight but the tongue moves well and feeding is fine.
- ✗ Feeding problems that positioning and latch changes are already improving.
- ✗ An upper lip tie in a baby who is feeding well.
- ✗ Someone has diagnosed it from a photograph, without watching a feed.
Can a lip tie develop later? The frenulum does not grow in after birth. What changes is how it looks as the face grows and the front teeth arrive, so a frenulum nobody noticed at birth can look prominent at two. A change in appearance is not the same as a new problem.
Does a tongue tie release hurt a baby?
A simple release takes seconds. Most babies protest about being held still more than about the release itself, and many settle the moment they are fed, which is why we feed straight afterwards, in the room.
There is a little bleeding, usually stopped by feeding. A white or yellow patch appears where the release was made and is normal healing, not infection. Serious problems are uncommon but they are not impossible, and there is no long-term follow-up research on babies who have had this done.[1] That is a reason to be sure it is needed, not a reason to refuse it when it is.
Laser or scissors? Both release the frenulum. There is no strong evidence that either produces better feeding outcomes in babies. What matters much more is whether the release was needed at all, and what feeding support surrounds it.
Can a tongue tie release make breastfeeding worse?
This is one of the most searched questions on the subject, and it deserves a straight answer rather than reassurance.
For a few days, it can feel worse. The area is healing and your baby is relearning a movement with a tongue that now travels further than it did. Some babies latch better within hours. Some take a week or two. Both are normal.
What the evidence does not show is a lasting worsening. It also does not show a guaranteed improvement. The Cochrane review found reduced nipple pain for mothers but inconsistent effects on the baby’s feeding, on very low to moderate quality evidence, and no study followed babies long enough to report long-term breastfeeding success.[1]
So we say this plainly: a release is worth doing when function is restricted and support has not been enough. It is not a guarantee, and anyone who offers you one is overselling it.
What happens at a feeding assessment
- 1
A feed is watched, not just a mouth
The assessment starts with feeding, because that is the problem being solved.
- 2
The tongue is assessed for function
How far it lifts and extends, not how the frenulum looks in a photograph.
- 3
Feeding support comes first
Positioning and latch fix a lot of this without anyone cutting anything.
- 4
If we release, it takes seconds
A small release at the frenulum. Your baby is fed straight afterwards.
- 5
You feed before you leave
So we both see whether anything actually changed.
- 6
We follow up, because ties can reattach
A check afterwards is part of the treatment, not an upsell.
What we try, in order
Guidance is to reserve a release for babies with real functional problems, after non-surgical support has been tried.[2] That is the order we work in, and the first two rungs solve a great deal on their own.
Positioning and latch
Where most feeding pain is actually solved. No procedure, no recovery, nothing to undo.
First, alwaysLactation support over days
Milk supply, feed frequency, a plan you can follow at 3am. This is the work.
Days to weeksRelease the tongue tie
Only when function is restricted and feeding support has not been enough.
When it is neededRelease the lip tie
Rarely. The evidence here is weaker than the marketing, and we will say so.
RarelyFeeding support is led by Dr. Shivika Agarwal, an International Board Certified Lactation Consultant, who has been releasing tongue and lip ties since 2018.[4]
Questions parents ask us about tongue tie
These are the questions parents ask us most, in the words they ask them.
A simple release takes seconds and most babies cry more about being held still than about the release itself. Many settle as soon as they are fed, which is why we feed straight afterwards. There is a little bleeding, usually stopped by feeding.
It can feel worse for a few days while the area heals and your baby relearns the movement. What the evidence does not show is a lasting worsening. It also does not promise improvement: the Cochrane review found reduced nipple pain but inconsistent effects on the baby’s feeding, and no study followed babies long enough to report long-term breastfeeding success.
The frenulum does not grow in later. What changes is how it looks as the face grows and the front teeth come through, so a frenulum that seemed unremarkable at birth can look prominent at two. That change in appearance is not the same as a new problem.
Laser and scissors both release the frenulum. There is no strong evidence that one produces better feeding outcomes than the other in babies. What matters far more is whether the release was needed and what feeding support surrounds it.
Usually not. The evidence for upper lip tie release is much weaker than for tongue tie. A study of 264 mother and baby pairs found a harmful upper lip tie was very rare and played only a minor role in feeding problems, with breastfeeding inexperience more strongly associated with difficulty than lip anatomy.
No. Appearance alone is a poor guide, because the question is how the tongue moves rather than how the frenulum looks. Ask for a feed to be watched before any procedure is agreed.
References
Every clinical claim on this page is numbered and links to its source. Guideline bodies and peer-reviewed research only, including the research that does not favour treatment. All URLs checked 10 September 2026.
- 1
O’Shea JE, Foster JP, O’Donnell CPF, Breathnach D, Jacobs SE, Todd DA, Davis PG. Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews. 2017, CD011065. Five trials, 302 infants. Reduced maternal nipple pain; inconsistent effect on infant feeding; evidence very low to moderate quality; no study reported long-term breastfeeding success.
https://www.cochrane.org/evidence/CD011065_frenotomy-tongue-tie-newborn-infants - 2
Thomas J, et al. Identification and management of ankyloglossia and its effect on breastfeeding in infants. Pediatrics, American Academy of Pediatrics, August 2024. Almost tenfold rise in diagnoses 1997 to 2012, doubling again to 2016; reserve frenotomy for significant functional impairment after non-surgical support has failed.
https://www.healthychildren.org/English/news/Pages/AAP-report-addresses-rise-in-tongue-tie-diagnoses-for-breastfeeding-concerns.aspx - 3
Niemelä L, Lohi V, Aitamurto S, Lehtinen A, Aikio O. Upper lip frenulum findings and breastfeeding problems in healthy newborns. JAMA Network Open. 264 mother and infant pairs. An isolated, harmful upper lip tie was very rare and played a minor role in breastfeeding problems; maternal breastfeeding inexperience rather than lip anatomy was associated with difficulty.
https://pmc.ncbi.nlm.nih.gov/articles/PMC13184786/ - 4
Tooth Tales clinic fact base and the CV of Dr. Shivika Agarwal, BDS, IBCLC. Releasing tongue and lip ties since 2018. Internal source, not publicly linkable.
Internal source, no public URL