Manuel Castillo, DDS
Board Certified Pediatric Dentist


pediatric dentist in san antonio

Breastfeeding and Tongue/Lip Ties

Having difficulty nursing your baby?  Call your Pediatric Dentist in San Antonio!


Nursing Blues

In recent times, as we have become more aware of the benefits of breastfeeding, some mothers have found that it does not always come as easily as expected. Puzzled mothers who look for answers from their PCP may often receive none. Although many breastfeeding problems are tongue or lip tie related, the reality of it is that these ties usually remain undiagnosed, leaving new parents confused and overwhelmed.


What is a tongue tie?

Tongue Tie – also known as ‘Ankyloglossia’ – is a common but often overlooked condition caused by a tight frenulum, or fold of tissue that restricts the range of motion. Tongue and lip ties are seen at birth and may run in families. Diagnosis and assessment are essential before taking any remedial action. In the past, there was little to guide us towards a decision about whether to intervene. Now, both diagnosis and an individualized physical assessment of the mouth can be made by an informed and qualified professional.


Consequences of a tongue/lip tie

A tongue or lip tie can cause a wide range of problems. Babies could lose weight and fail to thrive as they are unable to latch correctly or move their tongue appropriately to express the milk. When that happens the baby may cry in frustration or bite causing the mother pain, nipple damage, and eventually mastitis. They may also swallow excess amounts of air making them colicky, throw up or possibly develop reflux. At this point, sleep deprivation becomes a reality for both mother and child, making the maternal experience less than perfect.


As babies grow, they may develop an aversion to some solid foods and are labeled ‘picky eaters’.  In toddlers, you may notice speech issues such as difficulty articulating the sounds: t, d, z, s, th, n, and i. School-aged children may experience social, orthodontic and gum-related problems. Later in life, adults could become predisposed to certain types of sleep apnea as well as jaw pain and migraines.  The severity of these problems can vary greatly depending on the tightness of the frenulum.


What are the signs of a possible tongue and/or lip tie in babies?

  • Poor latch
  • Loss of suction while feeding
  • Lower milk supply due to baby not emptying the breast
  • Baby losing weight
  • Constant feedings (every 15 – 20 min)
  • Baby makes clicking sound while feeding
  • Painful latch (for the mother)
  • Damaged nipples
  • Recurrent blocked breast ducts
  • Mastitis


Where can I get my baby assessed?

A lactation consultant can assess whether the difficulties are tongue-tie/lip-tie related or caused by some other issues. It is also advisable to discuss this concern with your pediatrician in order to discard other medical conditions. The tongue or lip tie release surgery is usually performed by an ENT, a pediatric dentist or a pediatrician. Dr. Manuel Castillo, at Happy Pediatric Dentistry, is one of the very few specialists in the San Antonio, TX area that has the experience and qualifications to diagnose tongue/lip ties and perform the release surgery with a laser, as well as providing other services as your pediatric dentist in San Antonio.



In order to gain complete range of motion of the tongue and/or release the lip, a frenectomy (also called frenotomy or frenulectomy) is recommended. This surgery is a common surgical procedure that can be performed either with a scalpel or a laser. The advantages of using the laser method are:

– It vaporizes the tissue with almost no bleeding

– It sterilizes at touch, reducing the risk of infection

– It requires no stitches

– It minimizes post-operative discomfort

– It promotes faster recovery

– The whole procedure takes just minutes



While the frenectomy is relatively simple, it can have great results. This surgery often yields more benefit than is evident by restoring the mother-baby bonding experience, as well as ease of speech and self-esteem.


Dr. Manuel Castillo is a Board Certified Pediatric Dentist, and a Diplomate of the American Board of Pediatric Dentistry with over 25 years of experience in the dental profession. If you have any questions or would like more information, give our office a call at (210) 510-2862 today!


We understand that parents, at times, are unable to take care of their children’s dental needs during regular business hours. That’s why we are happy to offer services on Saturday morning and have an extended day on Wednesday until 7pm.