Is There a Link Between Tongue Tie and Reflux?

Photo by Craig Adderley

If your baby is struggling with feeding, seems unusually gassy, or has been showing signs of reflux, you might be wondering if there’s any cause for concern. One possible culprit that’s often overlooked is tongue tie. While it's commonly associated with breastfeeding challenges, research suggests it could also play a role in reflux symptoms.

What is Tongue Tie?

Tongue tie, or ankyloglossia, is when the little piece of skin under the tongue (called the frenulum) is too tight, restricting the tongue’s movement. It can affect feeding, speech, and even how a baby breathes or swallows. The tongue tie can be anterior (where the frenulum extends towards the front of the tongue) or posterior tongue tie, which extends towards the back.

And What About Reflux?

Infant reflux, or gastroesophageal reflux (GER), is super common and often linked to swallowing too much air during feeds (aerophagia). This trapped air can lead to spit-up, discomfort. There are different types of reflux, such as silent reflux, which is not always as easy to diagnose.

So…Are Tongue Tie and Reflux Connected?

In short, yes. A growing body of evidence suggests a strong link between tongue tie and reflux. Babies with tongue ties often struggle to latch properly, whether breast or bottle-fed. This poor latch can lead to them gulping air, contributing to reflux and gas.

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As a quick side note: I breastfed my daughter Olympia when she was born and had all the symptoms of a poor latch caused by tongue tie: sore and misshapen nipples, clicking when feeding and mastitis (twice!). I wish I had been more informed and had her checked for tongue tie and my breastfeeding journey might not have ended so early.

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A 2022 study led by Dr Bobby Ghaheri found that releasing a posterior tongue tie significantly improved reflux symptoms in babies. In the study, infants who had the tie released showed better feeding coordination, faster tongue movement, and (drum roll...) less reflux. So yes, fixing a tongue tie can help with reflux, especially if the cause is related to air swallowing during feeds.

Tongue Tie and Reflux in Bottle-Fed Babies

If you’re bottle feeding, you might also notice symptoms like clicking sounds during feeding, leaking milk, or persistent wind. This is often due to a poor seal and air intake—another clue that a tongue tie might be involved. Tongue tie gas and reflux in bottle-fed babies is one of the more overlooked issues in the early weeks, so it's important to look out for this too.

What Can You Do About Tongue Tie and Reflux?

You don’t have to rush into anything, but it’s worth having your baby assessed by someone trained in tongue ties, like a lactation consultant or specialist midwife. You should contact your local birth team or HV (look for the number on your red book) to direct you to the best point of contact. If treatment is needed, a simple procedure called a frenotomy can divide the tie in seconds. It's a quick and painless procedure that can bring immediate relief for both babies and parents.

If it's not having a huge effect on your baby, you may opt to wait and see, and in some cases, the tie may stretch or tear naturally. But if you're dealing with persistent reflux, feeding issues, or unsettled behaviour, it might be worth getting assessed. As I've mentioned, I regret not getting my daughter checked out in those initial days of breastfeeding as this procedure may have helped me continue my breastfeeding journey pain-free.

Final Thoughts

While not every case of reflux is caused by a tongue tie, recent research suggests that tongue ties and reflux often go hand-in-hand. Getting support and asking the right questions early on can make all the difference for you and your baby.