Tongue Tie Symptoms Newborns May Show From Our Conversation With Lisa Paladino, MS, CNM, IBCLC
If you’re asking yourself, does my baby have tongue tie, something likely doesn’t feel right.
Then again, perhaps you’re listening to this episode because you’re anticipating an upcoming breastfeeding journey!
Unfortunately, breastfeeding may be more painful than you expected. Maybe your baby clicks while feeding. Maybe they nurse constantly but never seem satisfied.
This is a common question new parents ask. And the confusion makes sense.
Tongue tie is everywhere right now – social media, parenting forums, even routine hospital screenings. Some providers say it’s over-diagnosed. Others say it’s frequently missed. That leaves parents stuck in the middle, trying to make the right decision for their baby without clear guidance.
In our episode of the Fourth Trimester Podcast with IBCLC and Certified Nurse Midwife Lisa Paladino, who has decades of clinical experience supporting breastfeeding families, we talk about how to unpack this topic calmly and clearly.
Because this is not a decision that benefits from urgency. It benefits from thoughtful evaluation.
You can listen to the full episode here: Apple, Spotify.
Tongue Tie Is About Function, Not Appearance
One of the most important clarifications from our conversation is this:
Tongue tie is a functional diagnosis.
Many babies have a visible frenulum, the small band of tissue under the tongue. A visible frenulum does not automatically mean there is a problem.
What matters is whether the tongue can move well enough to:
- Lift
- Extend
- Cup the breast
- Maintain suction
- Transfer milk effectively
As Lisa explains in the episode, diagnosing tongue tie from a photo alone is not appropriate. Feeding needs to be observed. Symptoms need to be understood in context.
That distinction alone can change how parents approach this question.
Does My Baby Have Tongue Tie? Signs That Deserve Evaluation
If you’re searching this question, here are patterns that warrant professional support.
Persistent Nipple Pain
Breastfeeding can feel intense in the early days. But sharp, ongoing pain that does not improve deserves evaluation.
Research supports tongue tie release for reducing nipple pain when restriction is clearly affecting feeding. But pain can also stem from positioning issues, latch challenges, or milk supply concerns.
In the episode, Lisa explains how she differentiates between these possibilities in her own clinical practice.
Clicking Sounds During Feeds
Clicking can indicate suction loss. This sometimes happens when the tongue cannot maintain a stable latch.
But clicking alone does not confirm tongue tie.
Milk transfer, latch depth, maternal comfort, and overall feeding efficiency all matter.
Lisa walks through what she looks for during a full feeding assessment and it is far more detailed than most parents are led to believe.
You can listen to the full episode here: Apple, Spotify.
Constant Feeding Without Satisfaction
Some babies nurse for long stretches, fall asleep quickly, and wake soon after still hungry.
This may suggest inefficient milk transfer.
However, low milk supply can present similarly.
One of the strongest themes from our conversation is this: both sides of the feeding relationship must be evaluated. Releasing a tongue without addressing milk supply or maternal recovery will not necessarily resolve the issue.
That nuance is important.
Who Should Evaluate Tongue Tie?
If you suspect tongue tie, a thorough evaluation by an IBCLC (International Board Certified Lactation Consultant) is often the most appropriate first step.
IBCLCs are specifically trained in breastfeeding function. They assess:
- Latch
- Milk transfer
- Maternal health factors
- Infant oral function
- Positioning
- Feeding patterns
Many pediatricians are supportive of breastfeeding, but most receive limited training in lactation mechanics. That does not diminish their expertise as physicians. It simply means that feeding dynamics require a specialized lens.
In the episode, Lisa explains why treating breastfeeding – not just the tongue – leads to better long-term outcomes.
What Is a Tongue Tie Release?
If a functional restriction is confirmed, a frenotomy (tongue tie release) may be recommended.
The procedure is typically quick and performed in-office, using scissors or laser.
But this is where nuance matters.
It is not always an immediate fix.
Some families experience noticeable improvement right away. Others see gradual progress over days or weeks. Many require continued lactation support and post-procedure exercises to prevent reattachment.
Lisa speaks directly to the most common complication she sees in practice – reattachment – and how preparation and aftercare significantly influence outcomes.
She also discusses when tongue tie release may be urgent, and when it is appropriate to slow down.
If you are considering this step, hearing that explanation directly is valuable.
When Might It Make Sense to Wait?
Not every tongue tie requires immediate release.
Sometimes the better first step is:
- Improving positioning
- Supporting milk supply
- Addressing maternal recovery
- Exploring bodywork for infant tension
In the episode, Lisa shares a detailed case study of a mother recovering from a difficult birth with significant medical complications. Waiting, stabilizing maternal health, and building milk supply first ultimately led to a smoother and more successful outcome.
That story illustrates why individualized care matters more than trends.
The Emotional Side of This Decision
Breastfeeding challenges are not just physical.
They can bring guilt, fear, urgency, and conflicting advice. Social media can amplify pressure to “fix” something quickly.
One of the most grounding moments in the episode is Lisa’s reminder to follow your instincts.
If you feel dismissed, seek a second opinion.
If something feels off, investigate.
If you need time, take it.
You deserve providers who see both you and your baby, together. Ideally going beyond speech alone.
A Calm Framework for Deciding
If you are still asking, does my baby have tongue tie, here is a measured approach:
- Notice consistent patterns, not isolated moments.
- Seek a thorough IBCLC evaluation.
- Rule out positioning and milk supply concerns.
- Ask detailed questions before consenting to a procedure.
- Make a decision that feels informed, not pressured.
Tongue tie is real. Breastfeeding pain is real. But urgency is not always necessary and there’s a lot you might be able to achieve without a procedure.
In the full conversation with Lisa, you will hear far more detail, including:
- Lisa’s decades of clinical perspective
- How she navigates overdiagnosis and underdiagnosis
- What she says to families in her own office
- A real-world case study
- Practical preparation guidance
- A closing reflection on slowing down in the fourth trimester
If you are navigating this decision, hearing the full conversation will likely provide more clarity than reading summaries alone.
Listen to “Does My Baby Have Tongue Tie? How to Know and What to Do Next” here: Apple, Spotify.
Please check with your medical provider on what is best for you and your family.
The content provided in this article(s) is provided for informational purposes only and does not constitute medical or other professional advice. Neither Sarah Trott nor Fourth Trimester Media Group LLC are liable for claims arising from the use of or reliance on information contained in this article.