One of the most common and most frequently overlooked causes of persistent breastfeeding pain is an undiagnosed tongue tie or lip tie in your baby. At the National Tongue Tie Centre, we hear this story every day: you have been seen by midwives, PHNs, and GPs; you have been told your latch looks fine; but the pain continues. We understand. And we can help.
What does breastfeeding pain from tongue tie feel like?
Every mother's experience is different, but the most common patterns we see include nipple pain that begins immediately at latch-on; nipples that appear creased, flattened, or lipstick-shaped after feeding; sharp pain during feeding that does not settle; deep breast pain or recurrent blocked ducts and mastitis; a sensation of the baby slipping off or re-latching repeatedly during the feed; and pain that persists even after professional lactation support and repositioning.
- Nipple pain beginning immediately at latch-on
- Nipples appearing creased, flattened, or lipstick-shaped after feeding
- Sharp or burning pain during the feed that does not settle
- Deep breast pain, recurrent blocked ducts, or mastitis
- Baby slipping off the breast or re-latching repeatedly during a feed
- Clicking or gulping sounds during feeding
- Pain persisting despite good positioning and lactation support
If your baby is gaining weight but feeding is still painful, your instinct that something is not right is valid. A baby can be growing adequately while still causing significant nipple trauma with every feed.
Why does tongue tie cause breastfeeding pain?
When a baby has a tongue tie, the tongue cannot move freely to cup around the breast, create an effective seal, and draw milk with a coordinated wave-like action. Instead, the baby compensates: they may clamp, use their gums, or create excessive suction. This places enormous mechanical load on your nipple with every suck cycle — and if feeds last 20 to 40 minutes, dozens of times per day, the cumulative effect is significant.
A lip tie, where the upper lip cannot flange freely, compounds this further. The baby cannot create a wide, flanged seal, and the latch remains shallow regardless of positioning adjustments.
What if I have already tried everything?
Many of the families who come to us have already tried nipple shields, positioning adjustments, nipple creams, and multiple visits to lactation consultants. They are exhausted. We understand this. Our assessment starts from where you are now — not from what should have worked. We take a full history, observe a live feed where possible, and look at the whole functional picture.
What does our assessment include?
A full breastfeeding and feeding history; observation of a live feed; functional assessment of tongue and lip mobility and compensatory sucking patterns; assessment of oral tension, jaw tightness, and bodywork needs; and an honest conversation about whether a procedure is likely to help and what realistic outcomes look like. We do not offer a simple yes or no based on appearance alone. Function matters as much as anatomy.
If a frenuloplasty is indicated, we will prepare you and your baby before the procedure, provide hands-on bodywork, and guide you through recovery with feeding and myofunctional rehabilitation. Our approach — Release Restrictions, Retrain Function, Relieve Tension — treats not just the restriction but the whole functional picture.
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. Breastfeeding pain has many causes including positioning, flat or inverted nipples, thrush, and vasospasm. However, when pain persists despite addressing these, a tongue or lip tie should be formally assessed by a specialist who evaluates function, not just appearance.
Yes. Weight gain is not a reliable indicator of whether tongue tie is causing maternal pain. A baby can transfer enough milk to grow while still creating significant nipple trauma at every feed. Pain is a valid clinical concern in its own right.
A visual assessment of a latch can miss significant posterior or mid-tongue restrictions. Function must be assessed — how the tongue moves, whether it can cup the breast, whether the baby is compensating with jaw or gum pressure. This requires specialist evaluation, not just observation from the outside.
Some mothers notice improvement within days. For others, particularly where compensatory feeding patterns are entrenched, it takes longer and requires more involved feeding rehabilitation. We prepare you before the procedure and support you afterwards.
It is not too late. However, infants over 12 weeks require a different approach to the procedure: Functional Frenuloplasty under conscious sedation. Please contact us for an assessment regardless of age.
In most cases where supply has decreased due to inefficient transfer, supply can recover with consistent feeding and pumping support. We will discuss your individual situation and the realistic expectations for your milk supply as part of your assessment. Individual outcomes vary.
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.
