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Our Services > Tongue Tie Program

At Agave Pediatrics, we believe feeding your child should be a calm, pleasant experience. Unfortunately, the presence of a tongue tie and/or lip tie can pose a major obstacle for healthy breast and bottle feeding. Tongue tie treatments have been routinely performed for generations, by doctors and midwives all over the world. However, in more recent times, medical providers are not routinely evaluating for, or correcting, tongue and lip ties. Our tongue tie team specializes in diagnosing and treating children of varying ages with tongue ties and lip ties. We have a website dedicated to tongue and lip ties as well as a dedicated Facebook group. We have performed thousands of corrective procedures with astounding success, facilitating healthier feeding for infants and toddlers, and improved speech and dental health for older children.

Frenectomy procedure on infant at agave pediatric clinic

Many of the parents that seek our help come to us after experiencing breastfeeding difficulties. At Agave Pediatrics, our providers are strong advocates of breastfeeding. We have seen that tongue ties and lip ties can impede breastfeeding and cause extreme pain for mothers. Because we believe in the concept that “less is more” with procedures involving children, we usually perform a tongue tie procedure first followed by close observation of mother and baby. One procedure alone may be all you need for successful breastfeeding. However, we are able to do both tongue and lip frenectomies at the same appointment, if the situation calls for it.

What Is a Tongue Tie?

Tongue tie or “ankyloglossia” occurs when the lingual frenulum is too tight, too short, or too thick. The lingual frenulum is the small band of tissue that connects the underside of the tongue to the floor of the mouth. When this tissue restricts the tongue’s movement and function, an infant may not be able to properly latch when breastfeeding, often causing pain for mother. Bottle feeding may also be affected. In toddlerhood, some children with tongue ties may have trouble with solid foods, articulating certain sounds, or with dental hygiene. Although research varies, some medical professionals estimate that as many as 1 in 10 babies suffer from tongue tie.

Infant symptoms of a tongue tie may include:

  • Clicking sounds at the breast

  • Gumming/chomping the nipple

  • Frustration/fussiness at breast or bottle

  • Overly-frequent and/or long-lasting feedings

  • Inability/difficulty latching and/or staying latched

  • Curled in upper/lower lip when at the breast

  • Poor weight gain

  • Difficulty eating solids

  • Spitting up frequently

  • Trouble bottle-feeding

  • Digestive issues (constipation, reflux, gassiness, etc.)

  • Poor sleep

  • Colic and/or excessive fussiness

  • Excessive sleepiness at the breast


Older children’s symptoms may include:

  • Difficulty with solids

  • Speech issues

  • Dental issues

  • Sleep issues


Mother’s symptoms related to their infant having a tongue tie may include:

  • Poor breastmilk supply

  • Severe pain when breastfeeding

  • Bleeding, cracked, or blanched (white) nipples

  • Nipple flattening or misshaping post-breastfeeding

  • Clogged ducts and/or mastitis

  • Nipple thrush

  • Frustration and/or anxiety associated with breastfeeding

  • Difficulty bonding with the baby

Child having tongue function assessment
Frenectomy Procedures at Agave Pediatrics

Lingual frenectomies and labial frenectomies are both quick and simple corrective procedures that Rajeev Agarwal, MD has performed thousands of times. The procedure involves little to no pain or discomfort for the child, and in most cases results in substantial improvement in associated symptoms. The multidisciplinary tongue tie team at Agave Pediatrics is committed to remaining advocates of infant health and nutrition as well as leaders in procedures and treatments that facilitate healthy breastfeeding.

If you are concerned that your child may have a tongue and/or lip tie and would like to schedule a consultation, Agave Pediatrics is here for you. Early diagnosis and treatment of a tongue tie makes a difference. We serve patients from all over the United States and are proud to be one of the largest tongue tie programs currently in practice. We routinely have clients drive from neighboring cities and adjacent states. Dr. Agarwal is recognized as one of the top authorities of oral restrictions. 

To schedule an appointment, please contact us today.

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