“Our pediatrician says she’s gaining weight.”
“Everyone tells me she’s doing great.”
“But I just know something isn’t right.”
If you’ve had these thoughts, you’re not alone.
In fact, this is one of the most common conversations I have with parents who come to see me.
Many arrive feeling confused.
Their baby is gaining weight.
Their pediatrician isn’t worried.
Perhaps they’ve already worked with a lactation consultant.
They’ve even asked whether their baby could have a tongue-tie and were told, “No, I don’t think that’s the problem.”
Yet feeding continues to feel incredibly difficult.
If this sounds familiar, I’d like to reassure you of something:
Good weight gain is wonderful – but it doesn’t always tell the whole story.
Weight Gain Is Important…But It’s Only One Piece of the Puzzle
One of the biggest misconceptions about infant feeding is the idea that if a baby is gaining weight, feeding must be going well.
Sometimes that’s true.
Many babies gain weight beautifully while feeding comfortably and efficiently.
However, after evaluating thousands of babies with feeding difficulties, I’ve learned that some babies gain weight despite significant feeding challenges.
They’re growing.
But they’re working incredibly hard to do it.
Weight gain tells us whether your baby is getting enough nutrition.
It doesn’t always tell us how difficult it is for your baby – or for you – to get there.
Babies Can Compensate Surprisingly Well
One of the amazing things about babies is how adaptable they are.
Many babies compensate for inefficient feeding by:
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Nursing almost constantly
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Staying at the breast for 45 to 60 minutes
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Feeding every hour or two
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Working much harder to transfer milk
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Waking frequently because they never seem completely satisfied
Eventually, many of these babies gain weight.
From the outside, everything appears normal.
But parents know otherwise.
They see the feeding sessions that never seem to end.
They hear the clicking.
They notice the gas.
They experience the nipple pain.
They watch their baby fall asleep from exhaustion, only to wake up hungry again a short time later.
These families often tell me:
“Everyone says everything is fine…but it doesn’t feel fine.”
Every Feeding Tells a Story
If long feeds, clicking, or nipple pain sound familiar, it may be time for a closer evaluation.
“I Asked About a Tongue-Tie…”
Another sentence I hear almost every day is:
“I asked if it could be a tongue-tie, but they told me that wasn’t the problem.”
Sometimes that’s absolutely correct.
However, many of the families who come to our office have already received one or more opinions before coming to see us.
In some cases, the tongue-tie simply wasn’t recognized.
In others, the evaluation focused primarily on what the frenulum looked like rather than how the tongue functioned during feeding.
That’s an important difference.
A baby can have a tongue-tie that significantly limits tongue movement – even if the frenulum isn’t immediately obvious.
That’s why I believe a comprehensive functional feeding evaluation is so important.
The question isn’t simply:
“Is there a frenulum?”
The better question is:
“Is the tongue functioning normally during feeding?”
Other Signs That Feeding May Not Be Going Well
Weight gain is only one part of the picture.
I also ask parents about questions like these:
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Does your baby click while nursing?
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Does breastfeeding hurt?
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Does feeding take 45 minutes or longer?
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Does your baby seem hungry shortly after eating?
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Does your baby swallow a lot of air?
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Is your baby unusually gassy or fussy?
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Does milk leak from the corners of your baby’s mouth?
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Do feedings leave both of you exhausted?
When several of these symptoms occur together, they often suggest that feeding isn’t as efficient as it should be – even if your baby is growing well.
One of the most common reasons I see for this pattern is restricted tongue movement from a tongue-tie.
The encouraging news is that when a tongue-tie is truly contributing to these symptoms, treatment is often very rewarding. Parents frequently tell us their baby feeds more efficiently, seems satisfied after eating, swallows less air, and that breastfeeding finally becomes enjoyable.
Still searching for answers?
If your baby is gaining weight but feeding still doesn’t feel right, trust your instincts. Many of the families we care for have already been told everything looks normal before coming to our office.
We regularly welcome families from across the United States and around the world who are looking for a comprehensive evaluation focused on tongue function – not simply whether a frenulum is present.
Send us a message or call 205-419-4333 to schedule a consultation. Our team is happy to answer your questions, discuss travel if you’re coming from outside the area, and help you determine the best next step for your family.
It’s Not Always a Tongue-Tie But It’s Often Worth Evaluating
Not every baby who struggles with feeding has a tongue-tie.
Feeding difficulties can also be related to:
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Low milk supply
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Prematurity
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Torticollis
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Body tension
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Oral motor challenges
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Neurologic conditions
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Other feeding disorders
However, after evaluating thousands of babies with feeding difficulties, I’ve found that tongue-ties are one of the most commonly overlooked causes of poor milk transfer.
That’s why I believe persistent feeding problems deserve a comprehensive evaluation.
The goal isn’t to recommend a procedure for every baby.
The goal is to understand why feeding is difficult so we can recommend the treatment that’s most likely to help your baby.
Why We Look Beyond the Tongue
One of the things I’ve learned over the years is that successful feeding involves much more than just the tongue.
That’s why we frequently work alongside:
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IBCLCs (International Board Certified Lactation Consultants)
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Pediatricians
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Physical therapists
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Occupational therapists
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Speech-language pathologists
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Chiropractors experienced in caring for infants
When appropriate, these professionals can help address body tension, positioning, oral motor coordination, and other factors that may affect feeding.
Treating the whole baby – not just the tongue – often produces the very best outcomes.
Also Read: Speech Therapy for Toddlers After Tongue-Tie Surgery: What Parents Should Know
What Happens During a Comprehensive Evaluation?
One of the questions we hear most often is:
“What makes your evaluation different?”
A comprehensive tongue-tie evaluation is about much more than simply looking under your baby’s tongue.
We evaluate how your baby:
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Moves the tongue
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Latches during feeding
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Transfers milk
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Coordinates sucking and swallowing
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Maintains suction
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Compensates during feeding
We also discuss the symptoms you’re seeing at home because those often provide some of the most valuable clues.
Parents spend hours feeding their babies every day.
You notice things that no one else sees.
Those observations matter.
The Good News
One of the reasons I’m so passionate about caring for these babies is because the results can be incredibly rewarding.
When a tongue-tie is truly contributing to feeding difficulties, treatment often leads to meaningful improvements.
Parents frequently tell us:
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“He’s finally satisfied after eating.”
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“She’s nursing in half the time.”
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“The clicking stopped.”
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“I’m no longer dreading every feeding.”
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“Breastfeeding finally feels enjoyable.”
Watching those transformations never gets old.
When Should You Schedule an Evaluation?
Consider scheduling a comprehensive evaluation if your baby:
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Is gaining weight but feeding still feels unusually difficult
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Nurses almost constantly
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Takes 45 minutes or longer to feed
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Never seems completely satisfied
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Clicks while nursing
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Swallows excessive air
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Is unusually gassy after feedings
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Causes ongoing nipple pain
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Continues struggling despite excellent lactation support
Early answers can prevent weeks – or even months – of unnecessary frustration.
Don’t ignore your instincts.
If feeding continues to feel harder than it should, it’s okay to seek another opinion. Many of the families we see have already been told everything looks normal before coming to our office.
We welcome families from across the United States and around the world who are searching for a comprehensive functional tongue-tie evaluation.
Send us a message or call 205-419-4333 to schedule a consultation. Our team is happy to answer your questions, discuss travel if you’re coming from outside the area, and help you determine whether an evaluation is the right next step.
Continue Reading
You may also enjoy these related articles:
You Know Your Baby Best
One of the most important messages I hope parents take away from this article is this:
Trust your instincts.
Healthy weight gain is something to celebrate, but it doesn’t always mean feeding is easy or efficient.
If breastfeeding continues to feel painful, exhausting, or unusually difficult, don’t assume you simply have to push through it.
Many of the families we meet have spent weeks – or even months – searching for answers before finding us. One of the greatest joys of my practice is helping those families finally understand why feeding has been such a struggle and watching both baby and parents thrive after the right treatment.
If you feel something isn’t right, we’d love the opportunity to help you find answers.
Send us a message or call 205-419-4333 to schedule a consultation. We look forward to helping your family.
FAQ’s
Q1. If my baby is gaining weight, could a tongue-tie still be causing problems?
Yes. Some babies compensate remarkably well and continue to gain weight despite inefficient feeding. Weight gain is important, but it doesn’t always reflect how difficult feeding has become for your baby – or for you.
Q2. Why would my baby gain weight if feeding isn’t going well?
Many babies compensate by feeding more often, nursing longer, and working much harder to transfer milk. They eventually receive enough nutrition to grow, but the process can be exhausting for both baby and parents.
Q3. We’ve already been told there isn’t a tongue-tie. Is another evaluation worthwhile?
It certainly can be.
Many of the families who come to our office have already received one or more opinions. A functional tongue-tie evaluation is different from simply looking at the appearance of the frenulum. If feeding continues to be difficult, another evaluation is often worthwhile.
Q4. Can a tongue-tie cause nipple pain even if my baby is growing well?
Absolutely.
Restricted tongue movement can create an inefficient latch, leading to nipple pain while your baby continues to gain weight.
Q5. Can poor milk transfer eventually affect milk supply?
Yes.
If milk isn’t removed effectively, your body may eventually produce less milk over time. Addressing poor milk transfer early can help support breastfeeding.
Still looking for answers?
You don’t have to continue wondering whether feeding should be this difficult.
Whether you live nearby or are considering traveling to Birmingham, our team would be honored to help evaluate your baby’s feeding concerns.
Find Clarity. Find Confidence.
