How do I know if my 1 year old child has a tongue tie or lip tie, and can it be treated?

You are right to suspect that a tongue and lip tie may be responsible for the feeding behaviours you have noticed. As these oral restrictions are present at birth, you may also have experienced challenges with breastfeeding during the newborn period. Nursing difficulties may continue to translate into challenges with solids as you have experienced. However, it is worth noting that there may be many other reasons for the feeding behaviour you have noticed e.g. food aversions.

In order to determine if there are oral restrictions affecting your child, first you have to decide who to consult with. You may wish to speak to your child's paediatrician or look for a paediatric dentist/ ENT/surgeon. While all these paediatric specialists should be able to do the assessments, in my experience, paediatricians are likely to refer you to see a paediatric dentist/ENT/surgeon for the actual treatment.

At the appointment, I would ensure 2 important steps are done during your consultation:

1. Your doctor/dentist looks at the structures: A detailed oral assessment which will include a look into your child's mouth to evaluate the oral structures.

2. Your doctor/dentist assesses function : Not all tongue and lip ties cause issues. Hence diagnosis is only complete with an assessment of your child's current level of oral competence. Just like walking and crawling are motor development milestones your paediatrician looks for, there are similar oral developmental milestones I would look for in our discussion. Nursing history would be one part of our discussion.

How urgent is this assessment?

Although you have not mentioned, it has been my experience that many parents who come to see me are also most concerned about the impact of such oral restrictions on future speech development. I suspect that may be on your mind as well. Thus, it is important that an oral assessment be made to rule out the presence of such restrictive oral ties soon. We do not want oral ties to negatively affect speech development. 


Early diagnosis is also advantageous for your child due to the surgical nature of the treatment. While the procedure to loosen the tongue and lip tie is simple (the surgical procedure is commonly known as frenectomy or frenotomy), it does get more complex with age owing to his ability to cooperate. Parents know how difficult it is for a toddler to stay still even for a diaper change. In the same way, it can be challenging to do a surgical procedure safely in toddlers.

Thus, for some children, this procedure has to be conducted in a hospital setting under some level of sedation or general anaesthesia (children are asleep during the treatment). The earlier the treatment can be done, the less likely sedation or general anaesthesia will be required.

Hope this tidbit of information has helped! I certainly hope you will be able to find some answers soon for your son for I know how frustrating it can be when each meal time is a challenge!

You can lift your baby's tongue to see if the frenulum, a thin membrane that connects the tip of the tongue to the floor of the mouth, is tight. It may be easier for a doctor to check this for you though, as the doctor would be able to draw on past experience to determine what is considered tongue tie - it can be rather relative. The doctor would need to consider the whole picture, on how the baby is feeding, the actual examination, and the speech sounds, even at this age. In an older child who can stick his tongue out, it would be obvious there is a tongue tie if the tip of the tongue shows a "W" shape.

An upper and lower lip tie is also possible, and can result in the lips not closing properly. In severe cases, these can interfere with speech and feeding. Again, a doctor would be able to assess this better when examining the baby.

However, I note that your baby is fussy and colicky. That may mean he has other issues that need to be excluded. For example, there may be reflux of milk and solids during or after feeds, or food sensitivities. Usually, I would like to exclude those first in the examination and perhaps with a simple allergy test, as the problem may not be due to a lip and tongue tie.

Hope baby gets better!

Kind regards,

Dr Lynne Lim

Tongue ties are pretty common: basically they are bands of soft tissue which tether the tongue down to the floor of the mouth. They don’t usually cause much of a problem but if t then the baby may have some problems feeding/breastfeeding, or the younger child may have a slight speech impediment in the form of a lisp or difficulty pronouncing certain consonants which require the tongue to extend forwards.

If your child sticks his tongue out and his tongue appears forked shape (with a divot at the tip), then he has a tongue tie. Tongue ties which are not affecting speech or feeding don’t need to have anything done. But from experience, my patients with tongue ties who have chosen to have the tongue tie divided in a minor daycase procedure, did so because they either felt it was restricting their pronounciatjon of certain sounds, perhaps more obvious when speaking languages with different tones, or because they felt there was some issue licking eg ice cream. Babies may have their tongue ties snipped safely under the age of 6 weeks old when they have been fed and are asleep. Some patients who are older will need some form of light sedation and/or local anaesthetic to have their tongue tie divided. Sometimes, stitches are placed to prevent recurrence of the tongue tie.

One of my adult patients decided to have her tongue tie divided because she thought it was affecting her kissing ability! Strange but true! After her tongue tie was divided, she (and her boyfriend) reported an improvement……;)

Upper lip ties don’t tend to cause that much of a problem as the tongue ties but again if it is really bothering the patient, then it can be easily and safely divided.

Your child is 1 year old so you can choose to wait till he starts to speak properly and then assess his speech articulation which might not be till age 2.

Every patient is different but a tongue tie condition that is causing problems is easily treated by dividing it safely in a minor daycase surgery procedure. Hope the above info helps!