Normal breastfeeding infants use different zones of the tongue in different ways – the anterior tongue ‘rides’ on the mandible and the mid tongue and posterior tongue follow a wave of depression from the front of the mouth to the back, facilitating both milk removal (negative pressure) and swallowing (Elad et al, 2014). Children with posterior tongue-tie (ankyloglossia that affects the mid and/or posterior tongue) show a disorganized pattern of tongue mobility before frenotomy and a more organized wave of tongue movement after.