If you've been told your baby has a tongue tie, lip tie, or cheek tie, you may be considering a release. Perhaps breastfeeding is painful, your baby struggles to maintain a latch, or feeding seems to require an extraordinary amount of effort.
Maybe you've already seen a pediatric dentist or another provider who has recommended a frenotomy (the procedure used to release restrictive oral tissue).
But before you schedule that procedure, there's something important I want you to understand:
Releasing a tie is only one part of the process. What happens before and after the procedure matters just as much.
At GROW, we believe that successful outcomes begin with understanding how your baby moves, feeds, and compensates for restricted mobility. Preparing the oral motor system before a release and supporting the development of new movement patterns afterward are essential parts of a comprehensive feeding plan.
Let's talk about why.
First, what are tongue, lip, and cheek ties?
A frenulum is a band of connective tissue that connects one structure to another inside the mouth.
Babies have several frenula, including:
Lingual frenulum: Connects the underside of the tongue to the floor of the mouth.
Labial frenulum: Connects the upper or lower lip to the gum tissue.
Buccal frenula: Connect the inside of the cheeks to the gum tissue.
These structures are normal anatomical features. The concern arises when the tissue is restrictive enough to interfere with the movement and function of the surrounding structures.
A tongue tie, clinically known as ankyloglossia, can limit the tongue's ability to extend, elevate, lateralize, or cup.
Restrictions involving the lips or cheeks may also affect oral mobility, depending on their location and functional impact.
But here's an important distinction: the appearance of a frenulum doesn't tell us everything we need to know about how a baby feeds.
Two babies can have very similar anatomy but completely different feeding experiences. One may feed beautifully, while the other struggles with latch, suction, milk transfer, and coordination.
That's why we look at function, not just anatomy.
What does a baby actually need to do to feed well?
Feeding is a surprisingly complex neuromuscular process. Whether your baby is breastfeeding or bottle feeding, they must coordinate several movements to successfully transfer milk.
A baby needs to be able to:
Position comfortably with appropriate head and neck extension.
Breathe comfortably through their nose.
Open their mouth wide.
Extend their tongue out and low, beyond the lower gum line.
Accept the nipple into the mouth without gagging.
Cup their tongue around the nipple.
Establish an effective seal with their lips.
Initiate a suck that elevates the tongue toward the palate.
Coordinate sucking, swallowing, and breathing.
That's a lot of work for a tiny human!
When a baby struggles with one or more of these steps, feeding can become inefficient, uncomfortable, or downright exhausting.
Sometimes the problem is a restrictive frenulum. Sometimes it's muscular dysfunction, postural instability, or an oral motor skill that hasn't developed appropriately. And sometimes it's a combination of these things.
This is why a comprehensive functional feeding assessment should happen BEFORE making a decision about a release.
Signs that your baby may have an oral restriction
Oral restrictions can contribute to a variety of feeding challenges. Some of the things we look for include:
Pain during breastfeeding.
Difficulty achieving or maintaining a latch.
Popping on and off the breast.
Clicking sounds during feeding.
Having to hold the breast in your baby's mouth to maintain a latch.
Damaged or misshapen nipples after feeding.
Milk leaking from the corners of the mouth.
Lips consistently curling inward.
Difficulty maintaining suction.
Low milk transfer or prolonged feeding sessions.
Chronic clogged ducts or engorgement.
Poor weight gain or the need for frequent supplementation.
Fussiness after feeds, reflux-like symptoms, or difficulty settling.
Excessive muscular tension or difficulty finding comfortable feeding positions.
Not every baby with these symptoms has a tongue or lip tie. However, persistent feeding challenges deserve a closer look.
Why a functional feeding assessment comes first
This is where we do things a little differently at GROW.
Our IBCLCs have completed advanced training in oral motor habilitation, which allows us to evaluate not only the anatomy of your baby's mouth but also how their muscles and structures work together during feeding.
During a comprehensive assessment, we evaluate:
Oral motor function
We look at tongue extension, elevation, lateralization, cupping, lip mobility, jaw stability, and the ability to maintain an effective seal.
Postural stability
Your baby's head, neck, shoulders, and trunk all contribute to feeding. We evaluate positioning, mobility, and muscular tension that may interfere with comfortable and coordinated feeding.
Feeding reflexes
We assess the reflexes involved in feeding, including rooting, gape, and the coordination of sucking and swallowing.
Actual feeding performance
We observe your baby at the breast or bottle. We want to understand what happens when your baby attempts to latch, maintain suction, and transfer milk.
The whole picture
We also consider your milk production, breast and nipple anatomy, feeding history, weight gain, and other factors that may be contributing to the challenges you're experiencing.
This process helps us distinguish between an anatomical restriction and muscular dysfunction that can look remarkably similar.
Sometimes a baby has a restriction that is clearly interfering with feeding. Sometimes they need support developing better movement patterns. And sometimes both are happening.
The goal is to understand exactly what your baby needs rather than jumping straight to a procedure.
Not every feeding problem is caused by a tongue tie
Here's something I really want families to understand: many of the symptoms associated with tongue ties can also be caused by things that have absolutely nothing to do with a restrictive frenulum.
A baby can have difficulty elevating their tongue, maintaining suction, achieving a deep latch, or coordinating their suck without having an actual tongue tie.
Why? Because oral motor function depends on more than anatomy. It also depends on the muscles surrounding those structures and how well they work together.
Muscular tension can sometimes create the appearance of a tongue restriction, even when the frenulum itself is functioning normally.
Think about the lingual (tongue) frenulum. It's surrounded by muscles and connective tissue that contribute to tongue movement. If those surrounding structures have excessive tension, they can limit the tongue's available movement and create a functional restriction.
A baby may demonstrate limited tongue elevation, difficulty extending their tongue, or an inability to maintain an effective seal. Those findings can look remarkably similar to what we see with a restrictive frenulum.
But there's an important difference.
If we address the surrounding muscular tension and the baby's tongue mobility improves, that tells us something significant: the frenulum itself may not have been the problem.
A normally functioning frenulum doesn't become a tongue tie simply because the tongue isn't moving well.
This is one of the reasons I feel so strongly about comprehensive functional feeding assessments with an experienced and trained IBCLC before recommending a release.
We need to understand:
Is the frenulum actually restricting movement?
Is surrounding muscular tension limiting mobility?
Are there postural or neuromotor challenges contributing to feeding dysfunction?
Is the baby using compensatory movement patterns?
Can we improve function through conservative oral motor support without releasing tissue?
Sometimes addressing muscular tension, improving postural stability, and supporting more coordinated oral motor movement can make a tremendous difference in feeding.
And sometimes, after addressing those contributing factors, we still identify a genuine anatomical restriction that is interfering with function.
That's an important distinction because we don't want to release tissue to solve a problem that could have been addressed another way.
The goal isn't to find a tie. The goal is to understand why your baby is struggling to feed and identify the most appropriate way to help.
Timing the release matters
Here's where I really want families to pay attention.
A tongue or lip tie release is not something we should approach as a standalone fix. Timing the procedure appropriately and preparing your baby beforehand can make a meaningful difference in the feeding journey that follows.
Think about it this way:
Imagine spending six months walking around a track with your shoes tied together.
Your body would figure out how to compensate. You'd develop different movement patterns, recruit muscles differently, and find ways to accomplish the task despite the restriction.
Now imagine someone unties your shoes.
Does that automatically mean you'll know how to walk better?
Of course not!
Your body has become conditioned to those compensatory movements. You still need to develop new movement patterns.
Releasing a tie is similar.
A release may provide your baby with improved range of motion, but it doesn't automatically teach them how to use that mobility.
That's why we believe in two important parts of the process:
Pre-hab before the release.
Post-Release Oral Motor Support afterward.
Let's talk about each.
What is pre-hab, and why does it matter?
Pre-hab is short for pre-habilitation. It's the functional preparation we do before a release to help your baby develop the skills and movement patterns needed for feeding.
Rather than waiting until after the procedure to begin working on oral motor function, we want to understand what your baby can and cannot do beforehand.
Depending on your baby's individual needs, pre-hab may include:
Addressing excessive muscular tension.
Helping your baby learn to activate and use muscles that have struggled with in the past
Supporting postural stability and comfortable positioning.
Addressing GI contributors to poor feeding
Developing tongue extension and elevation.
Encouraging tongue lateralization and cupping.
Supporting jaw stability and coordination.
Improving oral organization and feeding reflexes.
Working on latch mechanics and effective milk transfer.
Addressing maternal supply concerns
Addressing maternal contributors to infant positioning
Why do this before the release?
Because we want to establish a baseline of your baby's abilities and begin addressing any functional challenges that may exist independently of the restriction.
We also want your baby to have some familiarity with the movements we're hoping to improve.
Pre-hab helps us understand what we're working with, what needs attention, and what improvements we're hoping to see after the procedure.
It's not about making the baby perform a prescribed list of exercises. It's about preparing the oral motor system based on what your baby actually needs.
Pre-hab doesn't replace a release. It prepares for one.
I want to make one thing very clear: pre-hab is not intended to replace a tongue or lip tie release when a genuine anatomical restriction is present and interfering with function.
If we've identified a frenulum that is too short, thick, or stiff to allow appropriate mobility, working on surrounding muscular tension isn't going to magically change the structure of that tissue.
The restriction still exists.
But that doesn't mean we should skip the preparation.
Even when we know a release is necessary, we still want to prepare the mouth and body beforehand. We want to address excessive muscular tension, establish better movement patterns, improve postural stability, and help your baby develop the skills they'll need to use their newly available mobility.
Think of it this way: We aren't trying to avoid the release. We're trying to help your baby get the most functional benefit from it.
In our clinical experience at GROW, the infants who seem to be at the highest risk of needing a revision (returning to the release provider to have the release performed again) are often the infants who had little or no pre-hab beforehand.
Why might that be?
A release creates a wound that heals as the tissue repairs itself. If the surrounding structures are still excessively tense and the baby continues using the same compensatory movement patterns, the functional outcome may not be what we hoped for. Healing and tissue reattachment can also be influenced by individual factors.
Preparing the oral motor system beforehand gives us an opportunity to address some of those contributing factors and establish a baseline for what we want to improve.
It also gives parents a chance to become familiar with the movements and support strategies they'll be using after the procedure.
Pre-hab doesn't guarantee that a revision won't be needed. No approach can make that promise. But we believe that going into a release with a prepared mouth, a more organized feeding system, and a clear plan for post-release support is a much better approach than treating the procedure as the entire solution.
If a release is necessary, don't skip the preparation. Your baby deserves more than just a procedure.
What happens during a tongue or lip tie release?
A release, sometimes called a frenotomy or frenectomy depending on the procedure, involves dividing restrictive tissue to improve mobility.
The procedure is performed by a qualified provider experienced in infant oral restrictions. Providers may use different techniques, including scissors or laser.
The appropriate technique, pain management, risks, and aftercare should be discussed directly with your procedural provider.
A few things families should understand before proceeding:
A release is a procedure, not a guarantee of improved feeding.
Some babies may experience temporary feeding changes during healing.
The newly available mobility still needs to be integrated into functional movement.
Follow-up support should be part of the plan before the procedure takes place.
We want you to know what to expect and have a clear plan for the days and weeks that follow.
What is Post-Release Oral Motor Support?
This is the part of the process that often gets overlooked.
Once the restriction is released, your baby has the opportunity to explore a greater range of movement. But remember our analogy about walking with your shoes tied together?
We still need to help your baby develop new movement patterns.
Post-Release Oral Motor Support helps your baby learn to use their newly available mobility in a functional way.
Depending on your baby's needs, this may include:
Supporting tongue elevation and extension.
Developing tongue lateralization and cupping.
Improving suction and oral seal.
Supporting jaw stability and coordination.
Encouraging more effective lip mobility.
Improving suck-swallow-breathe coordination.
Practicing functional feeding at the breast or bottle.
Monitoring milk transfer and feeding efficiency.
The goal isn't simply to get your baby to demonstrate a particular movement during an oral assessment.
We want those movements to translate into meaningful improvements during feeding.
That might mean a more comfortable latch, better milk transfer, less clicking, improved suction, or a more coordinated feeding experience.
Post-release support should be individualized. Your baby doesn't need a generic exercise routine. They need support based on their functional assessment and progress.
How long does the process take?
This is one of the most common questions we hear, and the honest answer is that it depends on your baby.
Some babies make noticeable progress relatively quickly. Others need more time to develop new movement patterns and integrate those skills into feeding.
The timeline can depend on:
The degree of functional restriction.
How long your baby has been compensating.
Their existing oral motor skills.
Postural and muscular challenges.
Their feeding history.
How consistently the family is able to participate in the recommended support.
We don't want families to feel rushed through the process. We also don't want them to assume that the procedure itself marks the finish line.
The goal is functional improvement, not simply a healed release site.
Questions to ask before scheduling a release
If you're considering a tongue, lip, or cheek tie release for your baby, here are some questions I encourage you to ask:
Has my baby had a comprehensive functional feeding assessment?
Do we understand which specific movements are restricted?
What pre-hab will help prepare my baby before the procedure?
Who will provide Post-Release Oral Motor Support?
How will we measure improvements in feeding function?
What is the plan if feeding doesn't improve as expected?
If no one has discussed pre-hab or post-release support with you, I would encourage you to seek additional guidance before proceeding.
A procedure without a functional plan leaves too much to chance.
How GROW supports families through the process
Navigating a possible tongue or lip tie can feel overwhelming. You may have received conflicting opinions, visited multiple providers, or spent hours researching symptoms and procedures.
We want to make the process feel a little less complicated.
At GROW Lactation Services, we provide comprehensive functional feeding assessments and oral motor habilitation to help families understand what's happening and determine the next steps.
Our approach includes:
Before the release:
Comprehensive oral motor and functional feeding assessment.
Evaluation of postural stability and feeding mechanics.
Individualized pre-hab recommendations.
Support for latch, milk transfer, and milk production.
Collaboration with trusted bodyworkers and release providers when appropriate
After the release:
Individualized Post-Release Oral Motor Support.
Continued assessment of oral motor function.
Support for developing new movement patterns.
Breastfeeding and bottle-feeding adjustments.
Monitoring feeding progress and milk transfer.
Collaboration with other providers when additional support is needed.
We believe families deserve coordinated care. That may mean working alongside pediatric dentists, chiropractors, bodyworkers, physicians, and other feeding professionals to address the whole picture.
We also believe that not every feeding challenge requires a release. Our job is to help you understand what is happening, what options are available, and what makes the most sense for your family.
The bottom line: Don't release a tie without a plan.
A tongue or lip tie release can be an important intervention for a baby whose oral restriction is interfering with functional feeding.
But the procedure is not the entire solution.
Pre-hab prepares the foundation. The release provides an opportunity for improved mobility. Post-Release Oral Motor Support helps your baby develop and integrate new movement patterns.
All three deserve attention.
If you're considering a release for your baby, we encourage you to start with a comprehensive functional feeding assessment. Understand what is happening, identify what needs to improve, and make sure you have a plan for both before and after the procedure.
At GROW, we're here to help you navigate that process with confidence, clarity, and support.
Concerned about a possible tongue or lip tie? Schedule a functional feeding assessment with GROW Lactation Services in Lakeland, Florida. We'll help you understand the whole picture and determine the next best steps for your baby.
