In recent years, there has been considerable interest growing among new parents around tongue ties, oral health, and the ability of a new baby to breastfeed or bottle feed.

The mouth is a critical component for the breast and bottle feeding for the new mother and newborn baby, and it’s incredibly stressful when new parents discover that their baby isn’t feeding well—or that breastfeeding is painful.

One common cause of this feeding struggle is tongue ties or lip ties—which simply means that excess oral tissue remained in your baby’s mouth through fetal development. This small tissue attaches to the underside of the tongue or the upper lip and inhibits its free movement. And despite how relatively tiny these bands of tissue are, they can cause a lot of stress for families.

If the baby’s mouth and oral structures do not function properly, he or she will not be as efficient at latching for breast and bottle feeding. This causes feeding struggles in early life for the child—stressful for the newborn trying to eat, and a source of great heartache for any new breastfeeding mother or parent trying to help their baby eat and gain weight.

This can also be challenging for bottle-feeding families, as not all mothers elect to or can breast feed, and tongue or lip ties can impact a baby’s ability to bottle-feed as well.

So what are the symptoms of tongue tie? There are some key signs: In baby, infant reflux (spitting up through nose and/or mouth), poor weight gain, and on-demand but unsatisfied feedings are a few signs. Mothers can also identify an underlying issue with tongue tie if they find that breastfeeding is painful: This can manifest as nipple damage, breast shape changes such a compression and lipstick shaping, bleeding or mastitis.

The only way to find out for sure is a comprehensive symptom intake and a physical exam. Ideally, there should also be a comprehensive evaluation by a tongue and lip tie trained IBCLC or feeding specialist for breast and/or bottle feeding.

When the tongue tie accompanies a lip tie

There are times when the lip alone or a combined tongue and lip tie do prevent the proper ability of the mouth to open and for baby to feed. Signs can include baby snorting, bobbing on and off of the breast in frustration, lip blisters, noisy breathing, puffiness under baby’s eyes due to restricted tear duct flow into the nose, among others.

Baby can even have a lip tie when a mother has minimal to no breastfeeding symptoms and baby’s weight gain is “fine” because she has such a great milk “letdown” that an efficient latch is not necessary. Yet in many of these cases, there are still baby symptoms like spitting, gagging and fussiness.

Yet another reason for a thorough evaluation by the appropriately trained professional.

Both tongue ties and lip ties can be stressful on parents, but in many cases have fairly simply remedies. The best thing you can do it advocate for yourself, and see a trained medical professional as quickly as possible.