“Tongue-tie” refers to a condition also known as ankyloglossia. It exists in children and adults who have an unusually tight segment of tissue that causes the tip of the tongue to be attached to the bottom of the mouth. While the condition can look unusual and cause some difficulties, a tongue-tied baby is not necessarily a rare occurrence, and concerned parents need just a little education and understanding to learn how to manage it, if necessary.

Is my baby tongue-tied?
The first step is securing a qualified medical opinion. You might suspect your child is tongue-tied if you notice that there is a thick, tight band of tissue, called the lingual frenulum, that appears to restrict the movements of your baby’s tongue. This tissue is actually normal and is part of your baby’s development process. It guides the development of structures within the mouth, including the teeth and tongue. However, in some children, the tissue is particularly tight, or it stays in place rather than naturally receding like it is supposed to. That is when you end up with a tongue-tied baby, which could require some form of treatment. A good place to start is to obtain a referral to an otolaryngologist, a doctor who specializes in the ear, nose, and throat area.

What are the difficulties that occur with a baby tongue-tie?

One of the most common complications that occurs for parents of a tongue-tied baby is with feeding. The tongue is a necessary component in establishing the suction a baby needs to breastfeed, or even bottle feed, correctly. Babies with this condition may not gain weight fast enough due to difficulty in feeding.

Another sign to watch for is pain or difficulty from the mother’s perspective when breastfeeding. Ankyloglossia is often an overlooked cause of a baby’s failure to latch, and can also result in the mother experiencing significant pain when the baby feeds.

As a child gets older, unresolved tongue-tie can cause trouble in learning how to speak in certain cases. While this difficulty is rare, normal speech can require some work with a speech therapist to compensate for the shortened frenulum. Generally, the difference is particularly noticeable when speaking quickly, as the condition can make articulation less precise. Sounds that a child with tongue-tie might struggle with include the letters T, D, L, TH, and ST, due to their increased involvement of the tongue.

Parents of a baby who has this condition should also take extra care in their child’s dental health routine. Limited tongue mobility reduces the mouth’s ability to spread saliva, and can also make it harder to brush the teeth and mouth fully. You should get your child in the habit of brushing her teeth frequently and carefully to make up for this limitation. This includes brushing the gums to prevent gingivitis.

The most challenging issue children with tongue-tie often face as they get older is self-consciousness socially. They often view their condition as more apparent than it may, in fact, be, as it can interfere with their ability to do things like eat ice cream or other messy foods that require them to lick their lips. The condition can also become more apparent when children play about and stick out their tongues.

Children with tongue-tie also can face difficulty participating in common student activities, such as playing an instrument, due to the reduced tongue mobility. If it continues to be an issue as the child gets older, it can also affect their ability to kiss.

What treatment options exist for a baby with tongue-tie?

How and when to treat a baby who has this condition should be discussed thoroughly between the parents and the medical professionals involved in the baby’s health care. There are some professionals who recommend correcting the condition while the child is still a newborn. This approach is often due to concerns about avoiding malnutrition early on, and to assist mothers so that they do not have to experience pain with breastfeeding, which might discourage them and cause them to switch to a bottle prematurely.

It is worth discussing with your baby’s doctor whether this option is best for you and your child. Generally, tongue-tie that is left untreated will either resolve due to the frenulum loosening on its own, or will simply exist without any notable problems or complications.

If your child’s tongue-tied condition is severe enough that you are concerned, either regarding breastfeeding issues or potential speech complications, a simple procedure is available. This procedure is called a frenotomy, or frenulectomy, which usually takes less than fifteen minutes to perform. A surgeon excises the frenum using a scalpel or a laser, releasing the tip of the tongue from the floor of the mouth and allowing free range of motion. Often, the procedure can be performed using local anesthesia and a sedative, though younger children may require general anesthesia. It usually causes very little bleeding and does not require stitches afterwards, and frequently does not even cause discomfort once the procedure is finished.

A baby who has undergone a frenotomy can usually breastfeed right away. Few complications arise from this procedure, but parents should keep an eye out for signs of infection or indications that there has been damage to the tongue or salivary glands.

Sometimes, additional repair can be required due to the frenulum being too thick for the simple frenotomy procedure. This repair typically occurs in older children and adults, and is referred to as frenuloplasty. The procedure is more serious than a frenotomy, requiring general anesthesia and surgical tools, and typically involves sutures afterwards. A longer recovery time is expected.

Conclusion

While ankyloglossia can present some complications, it is typically a highly treatable condition that parents can discuss with their medical professionals. It commonly is not serious, but should be cause for concern if an infant stops feeding or suffers from malnourishment due to difficulty latching. At that point, parents should talk to their pediatrician to discuss the best course of action for their particular child.

Has your child been affected by ankyloglossia? What treatment option did your family end up selecting? Let us know your experiences in the comments.