👅Tongue Tie (Ankyloglossia): Understanding and Treatment
Learn about tongue tie, its effects, and when treatment may be needed
What Is Tongue Tie?
Tongue tie (ankyloglossia) is a condition present at birth where the thin piece of tissue (lingual frenulum) that connects the tongue to the bottom of the mouth is shorter or tighter than usual. This can restrict the tongue's range of motion.
Tongue tie affects approximately 4-11% of newborns. While some children with tongue tie have no problems, others may experience difficulties with breastfeeding, speech, eating, or oral hygiene. The severity varies, and treatment decisions depend on whether the condition is causing functional problems.
🔍Signs and Symptoms
The signs of tongue tie vary depending on the child's age and the severity of the condition:
👶In Infants
- •Difficulty latching during breastfeeding
- •Poor weight gain
- •Frequent feeding but not getting enough milk
- •Clicking sound while feeding
- •Mother experiencing nipple pain or damage
- •Cannot stick tongue out past lower front teeth
🧒In Older Children
- •Speech difficulties, especially with certain sounds
- •Difficulty moving tongue from side to side
- •Trouble sticking tongue out
- •Difficulty licking lips or cleaning teeth with tongue
- •Gap between lower front teeth
- •Problems eating certain foods
Types of Tongue Tie
1️⃣Anterior Tongue Tie
The frenulum attaches near the tip of the tongue, making it heart-shaped or notched when extended. This type is usually more visible and easier to diagnose.
2️⃣Posterior Tongue Tie
The frenulum is attached further back under the tongue and may be harder to see. The tongue may appear normal but movement is still restricted. This type can be more challenging to diagnose.
🍼Effects on Breastfeeding
Tongue tie can significantly affect breastfeeding. A baby needs to be able to move their tongue freely to latch properly and extract milk effectively:
Impact on Baby:
- •Difficulty creating proper seal
- •Insufficient milk intake
- •Poor weight gain
- •Excessive feeding time
- •Fussiness during feeds
Impact on Mother:
- •Nipple pain or damage
- •Low milk supply
- •Frustration with breastfeeding
- •Mastitis or blocked ducts
When Treatment Is Needed
Not all tongue ties require treatment. Treatment is typically recommended when:
✅Treatment May Be Needed If:
- ✓Breastfeeding problems: Baby cannot latch properly or mother experiences pain
- ✓Poor weight gain: Baby not gaining weight adequately despite frequent feeds
- ✓Speech difficulties: Significant problems with articulation, especially as child gets older
- ✓Oral hygiene problems: Difficulty cleaning teeth with tongue
- ✓Eating difficulties: Problems with certain foods or textures
💡Treatment May Not Be Needed If:
- •No functional problems: Tongue tie doesn't interfere with feeding, speech, or oral hygiene
- •Mild restriction: Tongue has adequate range of motion for necessary functions
- •Successful breastfeeding: Baby feeds well and gains weight appropriately
- •Normal speech development: No articulation problems
🏥Treatment Options
If treatment is needed, there are two main procedures:
Frenotomy (Simple Release)
A quick procedure where the frenulum is clipped with sterile scissors. Usually done in the doctor's office with local anesthesia. Recovery is quick, often same-day. Most effective for infants and anterior tongue ties.
Frenuloplasty (Surgical Release)
A more extensive procedure for thicker or posterior tongue ties. May require general anesthesia and sutures. Usually followed by tongue exercises to prevent reattachment. Used for more complex cases.
❓Frequently Asked Questions About Tongue Tie
Will my child outgrow tongue tie?
Some children may adapt to tongue tie and not experience significant problems. However, if tongue tie is causing breastfeeding difficulties, speech problems, or other functional issues, it's unlikely to resolve on its own. Early intervention is often recommended if problems are identified.
Is tongue tie release painful for babies?
Frenotomy (simple release) is usually quick and relatively painless. Babies may cry briefly, but the procedure takes only seconds. Many babies can breastfeed immediately after. Some discomfort may occur during healing, but it's typically minimal. Your healthcare provider will guide you on pain management.
Who should I consult about tongue tie?
Start with your pediatrician, who can assess the situation. For breastfeeding issues, a lactation consultant can be very helpful. For treatment, you may be referred to an ENT specialist, pediatric dentist, or oral surgeon who specializes in frenotomy procedures. The best approach depends on your child's specific needs.
What happens after tongue tie release?
After frenotomy, your healthcare provider will likely recommend tongue exercises to prevent the frenulum from reattaching. For babies, this often involves gentle stretching exercises. Healing usually occurs within a few days. You should see improvement in breastfeeding or other symptoms within days to weeks. Follow-up care is important to ensure proper healing and function.