The tongue portion is held in place at the front of the mouth by a band of tissue called the lingual frenulum. If the frenulum is short, it can restrict tongue movement. This is often called a tongue tie.
Children with a short tongue-tie are unable to stick their tongue out of their lower lip or reach the tops of their upper teeth when they open their mouth. When they stick their tongue out, it looks like a notch or heart shape. Because babies typically don’t stick out their tongues, your baby’s tongue may become tied if you can’t get your fingers under the tongue.
How common is tongue tie?
Tongue-tie is common. It’s hard to say exactly how common it is because people define the condition differently. About 8% of babies under one year old may have at least a mild tongue tie.
Is tongue-tie a problem?
This is very important: a tongue-tie is not necessarily a problem. Many babies, children and adults have glossoglossus, which does not cause them any difficulties.
There are two main ways that a tongue tie that is too short can cause problems:
- They may cause breastfeeding problems Makes it difficult for some babies to latch on to their mother’s nipple well. This can lead to difficulty feeding the baby and sore nipples for the mother. Not all babies with tongue-tie develop this condition. Many of them can breastfeed successfully. In breastfed babies who are gaining weight well, gas or fussiness is not caused by a tongue-tie that is too short. Babies with short tongue ties have no problem with bottle feeding.
- They can cause speech problems. Some children with tongue-tie may have difficulty pronouncing certain sounds, such as t, d, z, s, th, n, and l. A tongue tie that is too short does not cause speech delay.
What should you do if you think your baby or child has tongue-tie?
If you think your newborn won’t latch well because his tongue tie is too short, talk to your doctor. There are many, many reasons why a baby may not latch on to the breast well. Your doctor should take a closer look at what’s happening and examine your baby carefully to better understand the condition.
You should also see a lactation specialist for help with breastfeeding—both because there are many reasons why babies have difficulty latching on, and because many babies with tongue-tie can nurse successfully with the right technique and support.
If you think a short tongue-tie may be causing problems with your child’s speech, talk to your doctor. Many children just need some time to learn how to pronounce certain sounds. Before jumping to conclusions about a tongue-tie problem, it’s best to get an evaluation by a speech therapist.
What can be done about a short tongue tie?
If necessary, doctors can use a procedure called a frenotomy to loosen a tongue tie. A frenotomy can be done by simply cutting the frenulum, or it can be done using a laser.
However, no action should be taken for a tongue tie that is too short and is not causing a problem. Although a frenotomy is a relatively minor procedure, complications such as bleeding, infection, or feeding difficulties can sometimes occur. So it’s never a good idea to do this just to prevent future problems. This surgery should only be considered if tongue-tie is clearly causing a problem.
It’s also important to know that cutting your tongue tie won’t always solve the problem, especially if you’re breastfeeding. Research does not show clear benefits for all babies or mothers. That’s why it’s important to work with a lactation specialist before considering a frenotomy.
If a newborn with a tongue-tie cannot latch well despite strong support from a lactation specialist, a frenotomy should be considered, especially if the baby is not gaining weight. If this is required, it should be done at the earliest opportunity by someone who is trained and experienced in the procedure.
What else should parents know about tongue-tie surgery?
Although the evidence for the benefits of frenotomy is unclear, many providers are quick to recommend them. If someone recommends a product for your child, ask these questions:
- Make sure you know exactly why it is recommended.
- Ask if there are other options, including waiting.
- Talk to other health care providers on your child’s care team, or get a second opinion.