07/21/2025
Class 1? Class 4? Let’s clear it up 👅
When we talk about tongue-tie classification, we’re talking about location — not severity.
👉 The classification system (like Coryllos or Kotlow) tells us where the frenulum inserts on the underside of the tongue.
• Class 1 inserts near the tip of the tongue
• Class 2 inserts just behind the tip
• Class 3–4 are farther back toward the base
📍 But this doesn’t tell us how tight, restrictive, or impactful the tie is.
💡 So how is severity actually determined?
✔️ Function.
✔️ Mobility.
✔️ Symptoms in the infant (and often the lactating parent).
✔️ Ability to lift, extend, cup, and lateralize the tongue.
✔️ How the baby feeds, swallows, and handles milk flow.
You can have a Class 2 tie that causes no feeding issues… and a Class 4 tie that severely restricts movement.
🔍 That’s why a full functional assessment is key — not just a visual glance.
Classification = location
Severity = function + impact
If you’re not sure what your baby’s tongue-tie means for feeding, speech, or oral development — connect with a skilled IBCLC, pediatric dentist, or bodyworker who understands both structure and function.
