In infants, tongue ties can affect their ability to breastfeed and lead to poor latch, nipple pain and trauma, decreased milk intake and a decline in milk supply over time. Babies with a lip tie often have difficulty flanging their lips properly to feed and cannot create a proper seal at the breast. This improper seal can cause babies to take in excess air during breastfeeding, which often makes these babies gassy and fussy.

In toddlers or older children, tongue ties may affect speech, feeding or sleep.  Speech problems include speech difficulty or delay, or struggles with articulation, especially with producing the L, R, T, D, N, TH, SH, and Z sounds.  Feeding challenges may manifest as choking, gagging, or having difficulty swallowing certain textures, only eating small amounts of food, slow eating, packing food in the cheeks like a chipmunk, and pickiness with textures.  Soft, mushy foods and meats are typically the most difficult, but children can struggle with other foods as well. Lastly, TOTs may cause sleep disturbances due to grinding or sleep disordered breathing.