Every day, parents walk into our office, having been reassured that their baby’s tongue-tie is “mild,” that it will “stretch out over time,” or that it’s “unlikely to cause issues.” Then we take a look, lift the tongue, and there it is—attached right to the tip or just shy of it! It’s honestly astonishing. If a tongue-tie extends to the tip, it is anything but “mild.” That level of restriction is severe. And if it’s 90-95% of the way there, some families are even told there’s “no tongue-tie at all.” But in reality, that’s still a significant restriction.
To put things into perspective, the two most widely used classification systems—Kotlow and Coryllos—categorize tongue-ties as follows:
- 75-100% attachment to the tip = Severely restricted
- 50-75% attachment = Moderately restricted
- 25-50% attachment = Minimally restricted
- Less than 25% = Typically normal mobility
However, a baby can have what’s known as a posterior or mid-tongue restriction—maybe just a 10% attachment—and still experience significant symptoms. Why? Because while the tip of their tongue may move freely, the middle remains anchored, limiting overall function.
Interestingly, some of the most painful nursing experiences for moms don’t necessarily come from the most obvious tongue-ties. Babies with tongue-ties all the way to the tip can sometimes gain weight just fine and show minimal outward signs of struggle. This is why proper diagnosis requires a three-pronged approach—considering symptoms, physical appearance, and functional restriction.
If you’ve been told your child has a “mild” tongue-tie (or even “no” tongue-tie) but they’re struggling with feeding, speech, eating, or sleep, it’s worth getting a second opinion from a knowledgeable provider. In our experience, if a healthcare professional so much as mentions a tongue-tie, it usually means the restriction is at least 75% of the way to the tip—making it severe. Many children with this level of restriction face major quality-of-life challenges that could be dramatically improved with a proper release.
Think of it this way: If a toddler was learning to walk with their shoelaces tied together, they’d eventually manage, but it would be far more difficult. Babies with tongue restrictions will adapt, but they shouldn’t have to struggle. Our goal isn’t for them to merely get by—we want them to thrive, excelling in their developmental milestones rather than barely scraping by.
If your child is experiencing difficulty with:
- Breastfeeding/Bottle-feeding (gas, reflux, colic, spitting up)
- Speech (delays, unclear articulation)
- Eating Solids (slow eater, picky, gagging, spitting food out)
- Sleep (snoring, mouth breathing, restless sleep)
…it’s time to see a provider who truly understands tongue-ties. The challenge? Many healthcare professionals, including pediatricians, ENTs, and dentists, aren’t always up-to-date on the latest research. Finding the right provider is crucial.
If you need guidance, we’re here to help. Our office treats patients from across the country and around the world. You can also check online for support groups like “[Your State] Tongue and Lip-Tie Support Group” or “Tongue-Tied Babies Support Group” to connect with other parents who’ve navigated this journey.
Want to discuss your child’s case? Send us a message or call our office at 205-419-4333—we’d love to assist your family!
