Sailboat with mast up on blue ocean

How are anterior and posterior tongue-tie different?

Not all tongue-ties are the same. We will look at the difference between a posterior and an anterior tongue-tie with how they affect breastfeeding and speech in the future.

What is a posterior tongue-tie?

A posterior tongue-tie is located deeper in the mouth, further underneath the tongue. 

It is harder to see to the average eye due to being located UNDER the tongue. The best time to look is when the baby is upset and crying during diaper change. When you look at the middle of your baby’s tongue tip it will look dimpled. This type of tongue-tie is at times misdiagnosed as a short tongue.

If a posterior tongue-tie is in the back, what is the problem?

Even though your child’s tongue tie is in the back of the tongue and they can move their tongue tip freely. It will still cause issues, let me explain. 

The middle of the baby’s tongue is still stuck to the bottom of its mouth. A baby needs the ENTIRE tongue for effective feeding and swallowing. The middle of the tongue also needs to touch the roof of its mouth.  This is how your baby will get enough milk out of your breast.  Otherwise, your baby is not squeezing your breast enough to get all of the milk out to empty your breast completely.  Therefore, you might experience engorgement, clogged ducts, or mastitis, etc.

Are you new here? I also have the following posts to help you with other breastfeeding information!

To Clip or Not to Clip? That is the questions.
Are Tongue Ties real?
Are Lip Ties real?

Do you feel your milk supply is low due to your improper latch, mastitis, clogged duct, bleeding nipples or thrush? Check out my new Ebook that you can download right away with lots of tips and tricks to help along with a lot of printables to help with daily trackers, pain trackers, breastfeeding planner and more. There is a special bonus that comes with a FREE call with me. Check out my Ebook: How to Deal with Pain while Breastfeeding.

Ebook Cover: How to deal with pain while breastfeeding

What is an anterior tongue-tie?

An anterior tongue-tie is easy to locate and see due to the frenulum (extra skin that is attached to the tongue and bottom of the mouth) is extended “to the tip” of the tongue. Most babies’ tongues will look like a heart shape. This was my own son who had a severe Type 1 heart shaped tongue.

Are there different degrees of tongue-tie?

YES, there are different types of classification systems doctors can use. 

Usually they use a four type system called the Coryloss Ankyloglossia grading scale. Anterior tongue ties may be referred to as type 1 and type 2. A posterior tongue-tie may be referred to as a type 3 or type 4.  If you’d like to know more about the different degrees of tongue-tie from Johns Hopkins Medicine, click here.  Here is a website with good pictures of baby’s with different tongue ties.

Will I see a difference in breastfeeding with a posterior or anterior

NO, The symptoms will be the same for both posterior or anterior tongue ties. 

Here are a few of the symptoms you will see in your baby.

  • Trouble latching to breast
  • Popping on and off breast
  • Colic
  • Fussiness
  • Poor weight gain or in the 1%

Here are a few symptoms you will see in yourself.

  • Sore Nipples
  • Nipples that are cracked and bleeding
  • Decreasing milk supply.

If this sounds like you, you should register for my freebie Do You Have Pain When Breastfeeding Your Baby? Where I share signs and symptoms of both Mama and Baby where your baby might have a tongue-tie.

Who can treat a tongue tie?

A pediatric dental office who specializes in tongue and lip ties or an ENT can take care of this for you. 

The procedure can be done in their office, called a frenectomy. The procedure will be done with either a laser or surgically. This is a fast, 90-second procedure by laser that releases the tension.

Will my child’s tongue-tie result in language delay?

NO, this will not affect your child’s future language development. 

Language development means expressing their wants, needs, thoughts, and ideas as well as understanding what you say, Mama. Even if your child is a late talker, this does not mean it is related to a tongue-tie.

Will my baby’s tongue-tie affect their development?


Research has shown a very close correlation between a tight, restricted frenulum aka tongue-tie and difficulty with breastfeeding, poor sleep, mouth breathing, reflux, poor weight gain, and overall forward posture.

Will my baby’s tongue-tie affect how they talk in the future?

It might.

As a Speech Language Pathologist, I look at talking in the physical movements of coordinating the lips, teeth, tongue, jaw, vocal cords and palate to produce spoken words aka talking. However, speech includes more than how we talk. It includes articulation, voice and fluency according to ASHA the governing body over Speech Therapists. 

When a child has a severe tongue-tie you can hear they have trouble with specific sounds such as /t/ /d/, /z/, /s/, /th/, /l/ and /r/. All of these sounds need the tip of your tongue to move, mostly right behind your teeth to produce the sound correctly. If your tongue is too short for right behind your teeth to make a /l/ such as in the word LOVE it will sound more like ‘wove” which is cute at the age of two but not at the age of thirteen.

Final Thoughts!

I will leave you with this visual that a pediatric dentist stated to me. An anterior tongue tie is more like a sail boat when the sail is visible. However, behind the sail, there is a mast that also needs to be taken care of. A posterior tongue-tie is where the sail of the sailboat is down but the only thing you will see is the mast. Just because the sail is gone does not affect the presence of the mast. Therefore, they both have a mast that will affect your breastfeeding journey.

Sailboat with mast up on blue ocean


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