By Dr. Alli Chisholm, PT, DPT

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As a lactation-informed pediatric physical therapist, I sometimes worry that I come across as “anti-tongue tie release.” And if you’ve ever felt that way, I want to pause and say—I’m sorry. That’s not who I am, and it’s certainly not what I believe.

What I am cautious about is when parents aren’t given the full story: the root cause of their baby’s symptoms isn’t fully explored, or they aren’t told both the benefits and risks of a tongue tie release. Too often, a provider offers a release as a “quick fix” without digging deeper. And sometimes that leaves babies (and parents) struggling more than they were before.

This is not about being against the procedure. It’s about being for informed decisions, for whole-baby care, and for parents feeling empowered—not pressured—when making choices for their child.

My Experience as a Mom With Tongue Tie Recommendations

Both of my babies had feeding struggles in those early weeks (which is part of why I became so passionate about tethered oral tissues and newborn feeding in the first place).

With my second baby, we were told she would likely need multiple releases: her upper lip tie, buccal (cheek) ties, and tongue tie. The reasoning was that she wasn’t gaining weight fast enough, she had reflux, and her oral motor skills seemed limited.

At first, that felt overwhelming. The thought of putting my tiny newborn through not one, but several releases at once? My mom-heart ached.

But I also knew to pause. We began sessions with an occupational therapist, and I worked with my daughter at home. Within weeks, she was transferring plenty of milk during breastfeeding sessions, no longer causing me pain, and barely clicking at the breast or bottle.

She also thrived with the Ninni pacifier, a tool designed to support oral motor skills (if you’d like to take a peek at other oral motor toys I recommend for babies, check them out here!). One day during a therapy appointment while my baby was doing tummy time, she sucked on it to the left, in midline, and to the right. The OT looked at me and said, “I’ve never seen a baby suck on a pacifier so well.”

And yet—tie releases were still being recommended.

That was the moment I had to lean on not only my knowledge as a lactation-informed pediatric PT myself, but also on my mama intuition. I thanked the providers, but I said no. And my daughter continued to thrive without surgery - and still is today over two years later!

But Sometimes, Tongue Tie Release Is the Right Choice

That doesn’t mean it’s always wrong. In fact, sometimes it’s exactly what a baby needs.

I recently worked with a mom (who happens to be a physical therapist herself). Her baby had made beautiful progress with therapy, but she was still refusing bottles, which meant Mom could only work half days. The reflux continued, too, even after months of trying everything.

She sought opinions from multiple providers — early intervention, ENTs, pediatric dentists, and me. And ultimately, she made the informed decision to schedule a tongue tie release.

And I fully supported her.

Because here’s the truth: not every baby responds to therapy alone. Sometimes, despite pre-hab, bodywork, and feeding strategies, the improvement of a baby’s symptoms plateau. In those cases, a release can provide the extra help a baby needs.

P.S. If your baby is refusing a bottle or experiencing reflux, sometimes making a switch to a different, “oral motor approved” bottle can make all the difference. Check out my top bottle recommendations in the 0-6 Month Infant Feeding section of my website!

Why I’ll Never Judge a Parent Who Chooses Release

If you decide your baby needs a tongue tie release, you’ll never hear judgment from me. Here’s why:

There’s so much conflicting information. Navigating oral ties, reflux, and feeding is confusing. You’re bombarded with opinions from every direction.
Some providers push for release too quickly. This can leave parents feeling guilty if they don’t move forward.
It feels “trendy.” Right now, tongue tie releases are more common than ever. That doesn’t mean they’re always the answer—but it does mean more parents are facing the pressure.
Sometimes it truly is the best option. When you’ve tried therapy, feeding support, and bodywork, and your baby is still struggling, a release can be life-changing.
Weight gain matters. If your baby is experiencing failure to thrive, providers and parents alike want the fastest, safest, most effective way forward. Sometimes, that’s an oral tie release.

How to Decide If a Tongue Tie Release Is Right for Your Baby

Here are steps I encourage families to take before making the decision:

Learn what to look for. Start with resources like my post: Does My Newborn Have a Tongue Tie?.
Get multiple opinions. See an OT, PT, or SLP with feeding experience, plus a pediatric dentist or ENT trained in airway-focused care.
Evaluate progress with therapy. Has your baby improved with feeding therapy, or have things plateaued?
Rely on your mama intuition. What is your gut telling you? While not an “objective measure”, tuning in to what your own body is telling you when it comes to making any decisions for your baby should never be discredited.
If you decide yes, choose wisely. Research reputable providers with experience in infant oral ties.
Plan for post-release care. Healing isn’t just about the procedure—it’s also about aftercare. There are different approaches, from “active wound care” to gentle functional oral activities (I cover this in my blog post on gentle aftercare).

You’re Already Doing Your Best

Here’s what I want every parent to know: whether you choose release or not, you are a good parent.

Your baby is loved. You are advocating for them. And you’re making the best choices you can with the information you have.

Even if you look back and second-guess, there are always options for support and care moving forward. Nothing is ever “too late” when it comes to helping your little one.

Ready for Support?

If you’re wrestling with this decision—or any feeding, reflux, head shape, or milestone concerns—I’d love to walk alongside you.

👉 Book your 60-minute virtual assessment today. We’ll dig into your baby’s symptoms, look at the whole picture, and create a clear plan that feels doable for your family.

👉 Not quite ready? Schedule a free 15-minute inquiry call. You’ll get a safe space to ask your questions and see if my approach feels like the right fit.

Tongue Tie Release in Babies: Why I’ll Never Judge a Parent’s Choice (and How to Know What’s Best for Your Baby)