Ankyloglossia, or “tongue-tie,” is a condition when the tiny piece of skin called the frenulum that connects the baby’s tongue to the bottom of their mouth is shorter than usual1. This prevents the baby from having the full motion of their tongue. The pediatrician sometimes identifies this during an early well-baby check. However, it can be hard to see and may not become apparent until your baby has difficulty feeding. Some babies are more tongue-tied than others if the frenulum is longer and extends closer to the tip of the tongue. You can notice that the baby’s tongue may look heart-shaped as the frenulum pulls the tip of the tongue back.
Approximately 4-11% of all newborns are tongue-tied2. Some studies indicate that it runs in families1. As the newborn baby grows, it is possible that the tongue-tie can get better on its own as the baby’s mouth grows and the frenulum recedes4.
What are the potential issues?
Tongue-tie could interfere with feeding. It makes it difficult for the baby to flatten the tongue under the nipple to suck adequately. It also makes it hard to move her tongue in the wave-like motion to suck and swallow. Tongue-tie could also cause problems down the road with speech and eating solid foods1.
How do I know if my baby’s feeding issues are tongue-tie related?
If you suspect tongue-tie, listen closely while feeding for a clicking sound with each swallow3. Your baby may also break suction often and have difficulty latching on to the breast or bottle nipple. Pay attention to if she is sucking or “chomping.” If she is chomping, she may not have a coordinated suck needed to flatten the tongue and press the nipple against the roof of the mouth to express milk. If you notice these things, you can ask your pediatrician to check for tongue-tie.
What is the treatment?
Sometimes, the tongue tie is not severe and may resolve naturally as the baby’s mouth develops4. If it doesn’t correct on its own, a simple procedure of snipping the frenulum called “frenectomy” can be performed5. This is typically done in the doctor’s office and requires no anesthesia. Because it is such a thin piece of skin, it barely even bleeds. The baby usually can breastfeed immediately with much greater ease. Of course, you could also make an appointment with an oral surgeon or ENT specialist for the frenectomy procedure.
Sometimes it is helpful to seek occupational therapy or physical therapy after a frenectomy6. The baby might have tight neck muscles associated with the tongue tie because the tongue’s range of motion is limited, and all the musculature in the mouth and neck are connected. Usually, a few stretching sessions will have her as good as new.
If you suspect your baby may be tongue-tied, ask your pediatrician, and they can check her with a simple visual inspection.
