“Our pediatrician says it’s reflux.”
“We’ve already tried reflux medicine, but nothing seems to be helping.”
“Could a tongue-tie be causing all of this?”
These are questions I hear every week.
Reflux is one of the most common diagnoses given to babies with feeding difficulties.
Sometimes it’s exactly the right diagnosis.
However, after evaluating thousands of babies with feeding problems, I’ve found that many babies who appear to have reflux are actually struggling with something else first – inefficient feeding.
When babies aren’t feeding efficiently, they often swallow excessive air, work much harder than they should to remove milk, and become uncomfortable after eating.
The result can look remarkably similar to reflux.
The encouraging news is that when a tongue-tie is contributing to these feeding problems, treatment is often very rewarding. Parents frequently tell us their baby feeds more comfortably, spits up less, seems happier after meals, and no longer appears to be in constant discomfort.
Does My Baby Really Have Reflux?
Some babies absolutely do.
Reflux is common during infancy because the muscle between the stomach and esophagus is still developing.
Many babies spit up occasionally and remain perfectly happy.
These babies are often called “happy spitters.”
However, not every baby diagnosed with reflux is experiencing symptoms because of stomach acid.
One of the first questions I ask is:
“How is your baby feeding?”
That’s because feeding mechanics often provide important clues.
One of the Most Common Conversations I Have
One of the most common things parents tell me is:
“We’ve tried reflux medicine, but our baby still seems miserable.”
Or…
“The medicine helped a little, but feeding is still so difficult.”
Or…
“Everyone keeps telling us he’ll outgrow it.”
Sometimes babies do outgrow reflux.
But if feeding itself isn’t working properly, simply waiting may not address the underlying problem.
That’s why I spend so much time asking questions about feeding – not just reflux.
Why Feeding Mechanics Matter
When babies repeatedly lose suction during feeding, they often swallow excessive amounts of air.
That air enters the stomach along with the milk.
As pressure builds, babies may:
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Burp frequently.
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Spit up after feeding.
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Arch their backs.
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Pull away from the breast.
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Cry after eating.
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Become fussy when lying flat.
Those symptoms can look very similar to reflux.
One of the most common reasons I see babies lose suction is restricted tongue movement caused by a tongue-tie.
In some babies, a restrictive lip-tie can also make it difficult to maintain a secure seal during breastfeeding or bottle feeding, allowing even more air to enter throughout the feeding.
Rather than treating the spit-up alone, it’s important to ask:
Why is my baby swallowing so much air in the first place?
Could a Tongue-Tie Be Causing My Baby’s Reflux?
Sometimes, yes.
Not every baby with reflux has a tongue-tie.
However, after evaluating thousands of babies with feeding difficulties, I’ve found that tongue-ties are one of the most commonly overlooked causes of reflux-like symptoms.
One of the most common things parents tell me is:
“We asked about a tongue-tie, but they told us that wasn’t the problem.”
Sometimes that’s absolutely true.
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 the appearance of the frenulum rather than how the tongue functioned during feeding.
That’s an important distinction.
A baby may have a subtle tongue restriction that significantly affects feeding mechanics, even if the frenulum isn’t immediately obvious.
When feeding becomes more efficient, babies often swallow much less air.
As a result, many parents notice improvements in symptoms they previously thought were caused entirely by reflux.
Reflux Is Often Only Part of the Story
Parents often arrive believing reflux is the main problem.
As we talk, they begin mentioning other symptoms.
“He clicks during every feeding.”
“She’s always hungry.”
“He feeds for nearly an hour.”
“Breastfeeding hurts.”
“She burps constantly.”
At that point, the picture begins to change.
Instead of looking only at reflux, we begin looking at why feeding has become so difficult.
If your baby clicks during feeding, you may also enjoy reading Why Does My Baby Click While Breastfeeding?. If your baby swallows excessive air, our article Why Does My Baby Swallow So Much Air While Feeding? explains why this often contributes to reflux-like symptoms. And if your baby always seems hungry despite frequent feedings, you may also find Why Is My Baby Always Hungry? It May Not Be Low Milk Supply helpful.
Wondering whether your baby’s reflux could actually be related to feeding?
Many of the families we care for have already tried reflux medications, changed formulas, or adjusted feeding routines before coming to our office. A comprehensive functional feeding evaluation often helps identify whether tongue function, lip function, or another feeding issue may be contributing to your baby’s symptoms.
Families travel to the Alabama Tongue-Tie Center from across the United States and around the world seeking answers to difficult feeding problems.
It’s Not Always a Tongue-Tie, But It’s Often Worth Evaluating
Not every baby with reflux has a tongue-tie.
Likewise, not every baby with a tongue-tie has reflux.
Some babies truly have gastroesophageal reflux disease (GERD) that requires medical treatment. Others have food allergies, formula intolerance, or different medical conditions that contribute to their symptoms.
However, after evaluating thousands of babies with feeding difficulties, I’ve found that many babies diagnosed with reflux are also struggling with inefficient feeding.
If the underlying feeding problem isn’t recognized, reflux medications alone may not fully address what’s causing your baby to be uncomfortable.
That’s why I believe it’s important to evaluate the whole feeding picture – not just the spit-up.
Why We Evaluate Both the Tongue and the Upper Lip
Many parents are surprised to learn that we don’t evaluate only the tongue.
During every comprehensive feeding evaluation, we carefully assess both tongue function and upper lip function.
While tongue-ties are more commonly responsible for poor milk transfer, a restrictive lip-tie can also contribute to feeding difficulties by making it harder for some babies to maintain a comfortable seal around the breast or bottle.
When that seal repeatedly breaks, babies often swallow more air throughout the feeding.
The result may be:
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Frequent burping
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Gas
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Spitting up
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Milk leaking from the corners of the mouth
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Clicking sounds
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Frustration during feeding
Because tongue-ties and lip-ties frequently occur together, we evaluate both as part of every feeding assessment.
If you’d like to learn more about upper lip restrictions, you may also enjoy reading Lip-Tie in Babies: Signs, Symptoms, and Treatment.
Why We Look Beyond the Mouth
Feeding is about much more than the tongue and lip.
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
Some babies benefit from feeding therapy.
Some need help with body tension.
Some have forceful milk letdown or other breastfeeding challenges.
Some benefit from treatment of a tongue-tie, lip-tie, or both.
Every baby is different.
Our goal is to understand why feeding has become difficult so we can recommend the treatment that’s most likely to help.
What Happens During a Comprehensive Feeding Evaluation?
One of the questions parents ask most often is:
“What makes your evaluation different?”
We don’t simply look for a visible tongue-tie.
We evaluate:
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Tongue mobility
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Tongue function during feeding
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Upper lip mobility
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Suction
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Milk transfer
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Feeding coordination
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Oral anatomy
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Your baby’s symptoms
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Your feeding history
Parents spend more time feeding their babies than anyone else.
Your observations often provide some of the most important clues.
The Good News
One of the reasons I’m so passionate about treating feeding difficulties is because the improvements can be remarkable.
When a tongue-tie or lip-tie is significantly contributing to inefficient feeding, parents frequently tell us:
“She’s so much happier after eating.”
“He’s not spitting up nearly as much.”
“The constant burping has almost disappeared.”
“Breastfeeding finally feels comfortable.”
“Feedings are half as long as they used to be.”
Watching families finally enjoy feeding their baby is one of the most rewarding parts of my practice.
When Should You Schedule an Evaluation?
It may be time for a comprehensive feeding evaluation if your baby:
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Frequently spits up and seems uncomfortable
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Burps constantly
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Swallows excessive air
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Clicks while feeding
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Feeds for a long time
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Always seems hungry
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Has ongoing nipple pain during breastfeeding
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Continues struggling despite lactation support
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Has persistent feeding difficulties despite reflux treatment
Early answers often prevent weeks – or even months – of frustration.
Still wondering whether your baby’s reflux is really just reflux?
If feeding continues to feel difficult despite medication, changing formulas, or trying different feeding techniques, it may be time to look a little deeper.
Many of the families we care for have already been told their baby “just has reflux” before coming to our office. A comprehensive feeding evaluation often uncovers feeding mechanics that had previously been overlooked.
We regularly welcome families from across the United States and around the world who are searching for answers to complex feeding challenges.
Send us a message or call 205-419-4333 to schedule a consultation.
FAQ,s
Q1. Can a tongue-tie cause reflux?
Ans. A tongue-tie doesn’t directly cause stomach acid to reflux.
However, restricted tongue movement can make feeding inefficient, causing babies to swallow excessive air. That extra air can contribute to symptoms that closely resemble reflux or make reflux symptoms worse.
Q2. Can a lip-tie contribute to reflux symptoms?
Ans. Yes.
A restrictive upper lip can make it more difficult for some babies to maintain a secure seal during feeding. When babies repeatedly lose that seal, they often swallow more air, which can contribute to burping, gas, spitting up, and reflux-like symptoms. Research also suggests that tongue and lip-ties may be linked to constipation and reflux in some babies.
Q3. Does every baby with reflux need a tongue-tie release?
Ans. No.
Many babies with reflux do not have a tongue-tie.
That’s why a comprehensive evaluation is so important. The goal is to determine the true cause of your baby’s feeding difficulties before recommending treatment.
Q4. Why didn’t reflux medicine completely solve the problem?
Ans. If inefficient feeding mechanics are contributing to your baby’s symptoms, medication alone may not address the underlying issue.
Q5. Can bottle-fed babies have these problems too?
Ans. Absolutely. Tongue-ties and lip-ties can affect both breastfed and bottle-fed babies by making it difficult to maintain an efficient seal and transfer milk comfortably.
Looking for answers?
Whether you live nearby or are considering traveling to Birmingham, we’d love the opportunity to help evaluate your baby’s feeding concerns.
Send us a message or call 205-419-4333 to schedule a consultation. Our team is happy to answer your questions and discuss whether a comprehensive evaluation is right for your family.
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Finding the Real Cause of Your Baby’s Symptoms
Watching your baby struggle after every feeding is exhausting.
Whether the cause is reflux, a tongue-tie, a lip-tie, or another feeding challenge, you deserve answers.
Our goal is to understand why your baby is struggling so we can recommend the treatment that’s truly appropriate – not simply treat the symptoms.
Every Baby Deserves the Best Start
