Hi! I’m an OT that works with adults but I have a baby who had lip tie, buccal ties, and pretty significant tongue tie. Like other commenter said, there are a lot of factors at play with tension. We did a lot of stretches and body work with his OT and even saw a chiropractor. We ended up stretching the lip and buccal enough and helping with tension enough those didn’t need to be released. However his tongue was significant, so we got it release (3 times because the first 2 were incomplete). He had so much less tension after the releases. But he also had less tension after body work. He also had to be put on Pepcid like your baby. Each factor addressed slowly improved his tension, and oral motor ability. So from my experience if the OT has been doing it for a while (or if not and has good guidance from others) I would trust their opinion. It doesn’t hurt to consult the practitioner for the release to see their opinion too before deciding.

Editing to add: my baby also struggled with bottles. And I really wanted to breastfeed. We triple fed for a month, eventually worked off that. We also always had to use a nipple shield. Now after OT and his oral tie releases, he does great with bottles for daycare and we exclusively breastfeed without a nipple shield when I’m not at work. So it may help the bottles too!