Remember that sticking the tongue out past the lower lip is the LEAST 
reliable sign that there's no tongue tie. Many children with posterior 
tongue tie can do this, as long as their mouth is not wide open, but you 
can see tongue retraction as they open wider, as they need to do with 
breastfeeding. ELEVATION is the most important thing to assess for 
breastfeeding. Watch the baby cry, if the tongue lifts all the way up 
and blocks the entire mouth with the mouth wide open, there is likely 
not a tongue tie.
Catherine Watson Genna, IBCLC NYC

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