Short tongue ties are not always recognizable at a glance, the symptoms are varied and can also have various other causes. If breastfeeding is not running smoothly, it is always worth looking for the cause and solutions.
In breastfeeding counseling, I have also been providing intensive support to families whose babies are affected by oral restrictions for many years.
The first port of call is often the breastfeeding consultation, as this is usually where problems first become apparent.
Oral restrictions (tongue tie)
Just look in your mouth and you know whether the tongue tie fits or not? Unfortunately, it’s not that simple.
In addition, not every specialist for babies – or for the area of breastfeeding – is sufficiently trained to be able to reliably recognize oral restrictions and treat them accordingly.
As a breastfeeding and lactation consultant (IBCLC) and co-initiator of a network on oral restrictions in the greater Munich area, I advise and support parents in diagnosing any existing tongue tie problems and having them treated professionally.
If you suspect that one of the causes of breastfeeding problems is a tongue tie that is not fully functional, make an appointment with me for an initial assessment.
- Professional initial assessment
- Discussion of possible further steps
- Contact to suitable dental practices with proven expertise in the treatment of oral restrictions
- Support throughout the entire treatment (pre-/post-treatment care)
Recognize & treat symptoms
The tongue ligament – a symptom converter!
The symptoms are varied, are not related to breastfeeding at first glance and can change again and again. Without a detailed medical history, close observation of a breast or bottle feed and a functional test, it is not possible to draw any conclusions! The decisive factor is function, not appearance.
Effects of an impaired tongue tie on the breastfeeding mother
- Pain when putting on
- Sore nipples
- Deformed nipples, lipstick or almond-shaped
- Tendency to milk stasis and mastitis
Symptoms of oral restriction in children
- Insufficient weight gain
- Continuous breastfeeding
- Flatulence, colic
- Mouth breathing
- Calluses and blisters on the lips
- White coated tongue
All of these symptoms can lead to enormous distress, and affected families need competent help quickly. However, as there may also be other reasons for these symptoms, a qualified breastfeeding advice is essential.
It is not uncommon for families to have already been through a long journey of various treatments and therapies. Once the tongue ligament has been identified as the culprit, there is hope that the situation will now improve.
However, severing the restrictive ligament is only one piece of the puzzle in the treatment of this complex problem.
Voices from the consultation
Interdisciplinary work - essential for oral restrictions
The tongue tie is still neglected in the training of medical professionals – although it is neither a new phenomenon nor harmless. Lip and cheek bands can also affect the orofacial structures and have a wide variety of consequences.
The interdisciplinary approach is crucial.
For example, pain during breastfeeding: This may first lead the woman to the gynecologist, but the cause lies with the child. In the case of oral restrictions, the situation is far more complex; no single discipline alone will achieve a satisfactory result.
As often the first point of contact, the trained Lactation Specialist differentiates which problems are present, what can be solved in the first step and what can improve the situation.
Thanks to many years of experience, numerous training courses, a large network and countless hours of supervision and shadowing, I am able to provide competent support to families. Interdisciplinary work with doctors and therapists from all disciplines involved is important to me, as is the exchange of knowledge in direct discussions and in training courses.
Further training for specialist staff
Karin Giese (Still- und Laktationsberaterin IBCLC, Heilpraktikerin)
Dr. Simone-Melanie Linder (Zahnärztin im Zungenbandzentrum München; Curriculum Kinderzahnmedizin und Kinderzahnärztliche Hypnose, Laserzahnheilkunde)
I am currently offering a basic and an advanced course in a team with Michaela Dreißig and Dr. Linder via Semifobi Rheine and Loguan on the topic of tongue ligaments for specialists from various professions (midwives, pediatricians, dentists, etc.).
New dates for 2026 will follow soon.
- WHERE? Tongue Band Center Munich in the family dental practice Dres, Max and Linder, Firkenweg 7, 85774 Unterföhring and via Zoom
- COSTS? 295 euros for midwives/breastfeeding consultants, 320 euros for therapists, 345 euros for doctors
- WHO? Michala Dreißig, Karin Giese, Dr. Simone-Melanie Linder
Frequently asked questions about oral restrictions
The issue of the tongue tie is complex and can rarely be narrowed down to conspicuous breastfeeding behavior alone. This is why it is so important that experienced medical professionals are involved in the assessment.
Here I collect typical questions and answers about the tongue tie that I am frequently asked in my counseling work.
What is a tongue tie - and are there more ties?
The lingual ligament is a membrane under the tongue that holds it in position. Everyone has a tongue ligament, but it is not always clearly visible.
A complete absence of this structure is extremely rare and indicates very rare diseases.
In addition to the tongue tie, there are also lip and cheek ties, which are almost always present and can also be too short or tight, but rarely lead to breastfeeding problems.
Who treats the (too short) tongue tie?
Please do not have them separated prematurely in any practice or clinic!
Only a few doctors take the overall picture into account, work in an interdisciplinary manner and separate completely!
This kind of latching on and a quick fix without supervision can lead to a certain improvement in the breastfeeding situation.
However, separating the structures is only part of the treatment. Due to the limited mobility of the tongue, children use compensations, i.e. substitute techniques, to be able to swallow even before birth.
The intervention then only provides the possibility of mobility, learning the correct function and reducing the compensations is not yet done.
I will be happy to put you in touch with experienced and appropriately trained specialists from my network.
Are certain foods taboo during breastfeeding?
Breast milk is made from blood and nutritional colic or sores are relatively rarely caused by anything you consume as a breastfeeding mother.
A balanced diet is important. Eat what is good for you and gives you strength. Observe your child’s reactions and make an appointment with me for a consultation if you continue to suspect intolerances. If we determine during the appointment that clarification by medical specialists is necessary, I will immediately refer you to a specialist practice.
What questions about oral restrictions are you currently dealing with?
Oral restrictions (tongue tie) and associated milk stasis or sore nipples are complex issues that can hardly be dealt with in a short answer.
Arrange a short appointment with me for an assessment and I will get back to you as soon as possible.