When a baby cannot coordinate a functional feeding action due to a tongue or lip tie, they swallow significant amounts of air with every feed. That air has to go somewhere: it comes back up as reflux, or it travels down as wind and colic-like pain.
How tongue tie causes reflux and wind
A restricted tongue cannot form an effective seal around the breast or bottle. Air enters the mouth with each suck. Added to this, the baby often needs to work harder to extract milk, increasing the duration of feeding and the total volume of air swallowed. The result is a baby who feeds for a long time, transfers milk inefficiently, swallows a large volume of air, and is uncomfortable between feeds.
- Symptoms consistently worse during or immediately after feeding
- Baby more settled after burping
- Clicking or gulping sounds during feeding
- Arching away from the breast or bottle
- Excessive posseting or vomiting
- Coincident maternal nipple pain or latch difficulty
Reflux medication is not always the answer
Many babies are prescribed antacid medication for reflux before a tongue tie assessment is offered. In some cases this is appropriate. In others, the reflux is primarily mechanical — aerophagia from an inefficient feeding action — and medication will not resolve it because it does not address the cause. If your baby is on reflux medication and still unsettled, a feeding assessment is worth pursuing.
What we look for at assessment
At our assessment, we examine the coordination of the whole suck-swallow-breathe cycle. We look at oral posture, tension patterns in the jaw and neck, the efficiency of milk transfer, and whether compensatory feeding behaviours are contributing to aerophagia. We also take a detailed history of feeding patterns, symptom timing, and previous interventions.
Our approach — Release Restrictions, Retrain Function, Relieve Tension — addresses the whole functional picture, including the tension and compensation patterns that develop alongside a restricted frenulum.
The National Tongue Tie Centre was established in 2007 as Ireland's first clinic dedicated entirely to the assessment and treatment of tongue tie. The centre treats over 1,000 patients per year and receives patients from across Ireland and internationally.
Led by Dr. Justin Roche (Consultant Paediatrician, FRCPCH, FRCPI, IBCLC), Kate Roche (Chartered Physiotherapist, IBCLC, Feeding Therapist). Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frequently asked questions
No. Tongue tie is one of several possible contributors to infant reflux and aerophagia. But when reflux exists alongside feeding difficulties, maternal nipple pain, or inefficient latch, tongue tie should be part of the diagnostic picture, not an afterthought.
Silent reflux, where the stomach contents rise but are swallowed back without visible vomiting, can be difficult to distinguish from feeding-related discomfort. If your baby has feeding difficulty alongside the reflux symptoms, a comprehensive feeding assessment is warranted.
Cow's milk protein allergy and tongue tie can coexist. If dietary modification has not fully resolved symptoms, particularly if there are coincident feeding difficulties, an oral function assessment is still appropriate.
Winding techniques address the air after it has been swallowed. If the underlying feeding mechanics are causing excessive aerophagia, winding will reduce but not eliminate discomfort. Addressing the source of the air intake is more likely to resolve the problem.
Yes. Tongue tied babies can struggle with bottle feeding too, depending on the teat and their level of restriction. They may take in more air, feed more slowly, and experience similar discomfort. We assess bottle-fed babies as well as breastfed ones.
Book a comprehensive assessment at the National Tongue Tie Centre. Our clinical team will assess your baby's tongue and lip function thoroughly, explain what we find, and give you an honest recommendation. Call us, complete our online enquiry form, or visit www.tonguet.ie. Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frenuloplasty is a surgical procedure. Risks, benefits, and individual expectations will be discussed in full at your assessment appointment before any decision to proceed is made.
