Tongue-Tie

What is tongue-tie?

Tongue-tie is when the tongue cannot move properly because the band of tissue under the tongue is tight. A newborn has an abnormally tight tongue if the band under the tongue attaches near to the tip of the tongue. A child older than 1 year has an abnormally tight tongue (or tongue-tie) if:

• The tip of the tongue can’t be protruded past the teeth or gums.
• The end of the tongue becomes notched when it is protruded.
• The tongue cannot touch the roof of the mouth.
• The tongue cannot easily move from side to side (to the corner of the lips).

Tongue-tie is a rare condition.

What are the symptoms?

Sometimes a baby with a tight tongue has trouble sucking, latching on, and breastfeeding. This can cause inadequate milk transfer and poor weight gain for the infant. It also causes sore nipples and painful breast-feeding for the mother because the shortened tongue cannot cover the lower gum line and protect the areola from chewing.

A tongue with less movement than normal usually does not cause delay or difficulty with speech. If your child is 3 years of age, however, and more than half of his speech is not understood outside of the family, he should be evaluated.

How is it treated?

The treatment for tongue-tie that interferes with nursing is to clip (cut) the tight band under the tongue (called frenulum release). This is usually done in the first 3 months of life. Otherwise, clipping is rarely done because it is usually unnecessary. Clipping also carries a small risk of bleeding, infection, and tight scar tissue.

Call your healthcare provider during office hours if breast-feeding is painful.