Source: and Dr. Kotlow

These are the guidelines set by the Academy of Breast Feeding Medicine.

Infant symptoms

• No latch
• Un-sustained latch
• Slides off nipple
• Prolonged feeds
• Unsatisfied after prolonged feeds
• Falls asleep on the breast
• Gumming or chewing on the nipple
• Poor weight gain or failure to thrive
• Unable to hold pacifier

Maternal symptoms

• Creased or blanched nipples after feeding
• Flattened cracked, bruised or blistered nipples
• Bleeding nipples
• Severe pain with latch
• Incomplete breast drainage
• Infected nipples
• Plugged ducts
• Mastitis & nipple thrush

Potential problems as baby grows:

• Reflux/colic/gassy baby.
• Clicking noises while sucking, more notable during bottlefeeding
• Loud gulping noises
• Choking on milk or gasping for air mid-feed
• Noticeably strong suck
• Decreased saliva production
• Inability to effectively remove milk
• Milk dribbling out of the mouth during feeds
• Disruption of normal oral development
• Difficulty eating solid foods
• Difficult or delayed speech development
• Severe tightness of the tongue and jaw may lead to restriction of joints and muscles in other areas of the body

If you want to know more about treatment of a tongue tie, read here.