5 Reasons for Feeding Challenges That Are Not a Tongue Tie

When a baby struggles with feeding, many parents immediately wonder if it's a “tongue tie.” And while tethered oral tissues (like tongue, lip, or buccal ties) can absolutely impact feeding, they aren’t the only reason a baby may have difficulties. Feeding is a whole-body, whole-baby process, and many different factors can make nursing or bottle feeding harder than expected.

Here are five common reasons for feeding challenges that are not related to tongue ties:

1. Muscle Tension or Body Imbalances

Babies who experienced malpositioning in the womb, have a difficult birth, use of forceps or vaccum, have a head turn preference or torticollis may develop tightness in their neck, jaw, and shoulders. That tension can limit how they open their mouth, latch, or make latching difficult. Tension can make also cause breastfeeding parent to experience a painful latch. A IBCLC Lactation Consultant can help with positioning, while releasing body tension through therapy and bodywork often makes feeding more efficient and comfortable.

2. Reflex Integration Difficulties

Feeding relies on primitive reflexes like rooting, sucking, and swallowing. If these reflexes are under-responsive, overactive, or not well organized, feeding can feel uncoordinated. A baby might struggle to find the nipple, chomp instead of suck, or have a weak suck. Babies born via cesarian may have more difficulty utilizing reflexes for feeding. Therapy strengthens use of feeding reflexes.

3. Airway or Breathing Challenges

Feeding is a workout for babies. It requires core stability, head control, jaw strength, and tongue coordination. A baby who can’t breathe well won’t feed well. Impaired posture can impact feeding, a head turn preference, poor core strength, tension through the ribcage, or prematurity can cause babies to pop off, gulp, or have a weak suck. Supporting posture, body strength, nasal breathing and safe airway development is key to helping babies feed with ease.

4. Prematurity or Early Term

Babies considered early term, 37 to 38+6 weeks, face more difficulties establishing breastfeeding due to lower stamina, more latch issues, lack of suck pads, immature suck-swallow-breathe coordination, and a weak suck. They generally require early lactation support in order to get breastfeeding off to a strong start.

5. Reflux

While all babies spit up, if baby is having discomfort with spit-up, it may be reflux. When baby is uncomfortable, they pop off more frequently, cry, arch, and end feedings early. This could lead to weight gain and milk supply challenges over time. Reflux may also cause a hypersensitive gag reflex, interfering with a deep latch, lead to torticollis (most often the head turn preference is to the RIGHT), and impact oral motor development, such as progression to solid foods.

Why This Matters

It’s important for families to know that a tongue tie isn’t always the root cause of feeding issues. A thorough assessment should look at the whole baby—their body, airway, reflexes, and environment. Sometimes multiple factors overlap, and addressing them together brings the most relief.

✨ If you’ve been told “it might be a tongue tie” but something doesn’t quite add up, don’t lose hope. Feeding challenges are complex, but with the right support, babies can (and do!) learn to eat, breathe, and thrive. While a IBCLC lactation consultant can assess factors impacting feeding, a feeding therapist (Occupational or Speech-Language Pathologist) can treat them. Feeding therapy encompasses whole body strengthening, sensory processing, and reflex activation, in addition to direct oral exercises. Nourish Therapy specializes in infant feeding, lactation, and tongue ties. Whether it is a tongue tie or not, we can support you through whole body feeding therapy. Schedule a phone consult to get started.