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 usual. This prevents the baby from having full motion of their tongue. This is sometimes identified by the pediatrician during an early well-baby check. However, it can be hard to see and it may not become apparent until your baby has difficulty with 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 actually notice that the baby’s tongue may look heart-shaped as the frenulum pulls the tip of the tongue back.
Approximately 2-4% of all babies are tongue tied. Some studies indicate that it runs in families. As the newborn baby grows, it is possible that tongue tie can get better on its own as the baby’s mouth grows, and the frenulum recedes.
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 foods.
How do I know if my baby’s feeding issues are related to tongue tie?
If you suspect tongue tie, listen closely while feeding for a clicking sound with each swallow. Your baby may also break suction often and have difficult time latching on to the bottle nipple or breast. Pay attention to if she is sucking or “chomping.” If she is chomping, she may not have a coordinated suck that is 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 rectify itself within the first year. If it doesn’t, a simple procedure of snipping the frenulum called a “frenectomy” can be performed. This is typically done in the doctor’s office and it requires no anesthesia. Because it is such a thin piece of skin, it barely even bleeds. The baby usually is able to breast feed 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 out occupational therapy or physical therapy after a frenectomy. The baby might have tight neck muscles in association with the tongue tie because the range of motion of the tongue was limited and all the musculature in the mouth and neck are connected. Usually a few sessions of stretching will have her as good as new.
If you have any suspicion that your baby may be tongue tied, just ask your pediatrician and they can check her with a simple visual inspection.