My baby has a tongue tie. What can I do to help her latch better, besides getting the release procedure?
First of all, great job working through the challenges of having a baby with a tongue or lip tie! While some moms choose to have a release procedure performed, others may not have access to it or prefer not to do it. It’s important to know that even if your baby is having trouble latching, you can protect your milk supply while working to improve feeding skills. Latching techniques, suck training exercises, and other options may help your baby achieve a deeper latch—and help you to be more comfortable.
Protect Your Milk Supply While Baby Learns to Latch
Frequent and effective milk removal is necessary to maintain a healthy milk supply. While your baby is learning to latch well, protect your milk supply by pumping after feedings to fully empty your breasts. Pump at least 8 times a day, and watch for signs that your baby is getting enough milk.
You can give pumped milk using a supplemental nursing system or by using paced bottle-feeding, which makes it easier for baby to go back and forth between breast and bottle.
It’s a good idea to hold off on pacifiers for now. They can satisfy your baby’s need to suck without improving breastfeeding—and may confuse her sucking pattern.
Before Latching
Soften Your Breast: Babies with oral ties may latch easier if the breast is soft. Avoid engorgement by breastfeeding frequently. If your nipple is too firm, hand express a little milk to soften the area.
Try reverse pressure softening: Place your five fingertips around the base of your nipple and apply gentle, steady pressure for about one minute. This helps move fluids away from the nipple area and makes it easier for baby to latch.
Encourage Tongue Movement: Let your baby lick milk off your nipple or her own lips before or after a feeding. This encourages tongue extension. Stick your tongue out at your baby during playtime—she may copy you, which helps strengthen tongue movement.
Stimulate Let-Down: Hand express or pump until your milk starts to flow. This makes it easier for your baby to get milk right away without needing to work as hard at the breast.
Do Suck Training Exercises: Suck training can strengthen your baby’s tongue and mouth muscles, which is important for babies with oral ties, especially when a release procedure (frenotomy) isn’t performed. A lactation consultant or doctor can guide you on exercises tailored to your baby’s needs.
Suck Training 101
Make sure your hands are clean and your fingernails are smooth and trimmed short before doing these exercises. Suck training works best when your baby is alert and calm—not overly hungry. Follow her cues. If she becomes upset or resists, stop and try again later.
Tug-of-War: Stroke your baby’s lower lip to encourage her to open wide. Place your finger (nail side down) in her mouth. If she doesn’t suck, gently press your finger up toward the roof of her mouth to trigger the sucking reflex. When she begins to suck, slowly try to pull your finger out, allowing her to suck it back in. Repeat three times or until you feel her tongue move forward over the gums. This helps your baby strengthen her sucking reflex and build stamina for breastfeeding.
Walking Back: Massage along your baby’s lower gums, starting in the middle and stroking toward each side. When she opens her mouth, gently press the tip of her tongue with your finger and hold for three seconds. Move your finger slightly farther back on the tongue and press again, repeating this one or two more times. Avoid going too far back to prevent gagging. Repeat this gentle “tongue walk” three or four times before latching. This helps your baby gain more control over her tongue movement and strengthens the muscles needed for breastfeeding. It encourages the tongue to stay forward and follow stimulation.
Pushing the Tongue Down and Out: Let your baby suck on your finger (nail side up) for about 30 seconds. Then turn your finger so the soft, padded side touches her tongue. While she sucks, gently press down on her tongue and slowly pull your finger forward and out of her mouth. Repeat a few times before latching. This helps the tongue move forward and trains the tongue to stay extended during sucking.
Tongue Stroking: Lightly stroke your baby’s tongue from back to front with your finger. This encourages the tongue to cup and move in a wave-like motion—important for drawing milk from the breast.
Palate Touch: Gently press the roof of your baby’s mouth just behind her gums. This stimulates the sucking reflex.
*Suck training is no longer needed when she can suck continuously and correctly for 10 minutes without the tongue changing position.
Latch & Positioning
A good, deep latch starts with good positioning—and babies with oral ties may need extra help. Your baby's ability to latch effectively can improve over time and as she grows.
Use a C-hold: Support the breast with your four fingers underneath and your thumb on top, forming a “C” or “U” shape. This helps baby get as much breast tissue in her mouth as possible.
Laid-Back Breastfeeding: Lie back in a reclined position with baby lying across your stomach, looking upward at your breast. This position works with gravity to soften the breast, as well as draw baby’s tongue forward to help her get a deeper latch. Doing skin-to-skin while in this position increases success!
Adjust Baby’s Chin: Some babies pull their tongue back when opening their mouth, instead of keeping it forward. This can make it harder to latch deeply.
Tilt your baby’s head back slightly so her chin moves away from the nipple. This helps her tongue reach the soft part of your breast behind the nipple.
Or, press gently on your breast where the areola meets your skin to make a little dent. Then guide your baby’s chin into that dent. This gives her chin a clear spot to land and helps her open wide and latch deeply.
Use Your Finger: Before latching, press your finger or thumb just above your nipple where baby’s top lip will land. This tips your nipple slightly downward so baby feels your breast first, not just the tip of your nipple. When baby opens wide, pull her in close to your body. Use your finger to guide the breast into your baby’s mouth. The nipple should be the last part to go in. It will slide in and unroll naturally once your baby is on. Once she’s latched, slide your finger out.
Provide Support During the Feeding: Apply gentle, upward pressure under baby’s chin to encourage better tongue movement. This video demonstrates this latching technique.
Use your finger to roll (flange) her lips outward for a better seal.
Do breast compressions to increase milk flow and help baby get more milk with less effort.
Additional Tools: A lactation consultant may suggest using a nipple shield temporarily. This is a silicone cover with holes on the tip that is placed over the nipple to help the baby latch on.
Other Options to Consider
Some moms find that craniosacral therapy (CST), infant chiropractic care, or massage helps release their baby’s body tension, improves latch, and makes breastfeeding more comfortable for both of them.
Speech-language pathologists (SLPs)—especially those trained in feeding and swallowing therapy—also work with infants who have oral ties. Talk to your doctor to see if these options might benefit your baby.
Soothing Sore Nipples
Your baby isn’t the only one affected by her oral tie. A shallow latch can be very painful for a breastfeeding mother. While working to improve your baby’s latch, soothe sore nipples by:
- Rubbing a few drops of breast milk on the nipple and letting them air dry.
- Applying cool packs covered in a cloth.
- Going without a bra or wearing one that’s comfy but doesn’t rub.
- Using nipple cream designed for breastfeeding mothers. (Do not use lanolin products if you have a wool allergy.)
Final Thoughts
If breastfeeding remains difficult, your baby isn’t gaining weight well, or you’re still in pain, talk to your doctor or a lactation consultant for further evaluation. Your peer counselor can connect you with an IBCLC and help monitor your progress.
A weighed feeding—where your baby is weighed before and after nursing—can help show how much milk your baby took in during that feeding. It gives a snapshot of just one feeding, not every feeding, but the information can help guide next steps and offer peace of mind.
It’s okay to choose not to have your baby’s oral tie surgically released. Many babies manage just fine with conservative care. What matters most is having support, good information, and care that fits your needs.
Sources:
https://www.bfmed.org/assets/Anklyloglossia%20position%20statement%202021.pdf
https://llli.org/breastfeeding-info/tongue-lip-ties/
https://lllusa.org/tongue-and-lip-ties/
https://laleche.org.uk/engorged-breasts-avoiding-and-treating/#rps
https://my.clevelandclinic.org/health/treatments/22130-nipple-shield
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