What you need to know about tongue-tie

Becoming a new parent is a joyous, yet, stressful life transition. From filling bottles to changing dirty diapers, our daily routine completely evolves; our time becomes enriched with baby cuddles and other sweet surprises to follow as they grow and develop. Providing our little ones with the best nutrition to grow is a top priority, but feeding can be challenging if your infant is unable to secure a good latch. This can sometimes be the result of ankyloglossia, or tongue-tie. 

What is ankyloglossia?

This is a condition present at birth where the lingual frenulum - the attachment between the tongue and the floor of the mouth - is short, tight and thick. It's often connected close to the tip of the tongue and prevents it from moving properly. Tongue-tie can contribute to poor breastfeeding and maternal nipple pain. 

Which signs indicate my child might have tongue-tie?

The most common indicators of tongue tie are the inability to protrude the tongue more than 2 millimeters past the lower gums and the impairment of tongue movement. You might notice your child is unable to rotate the tongue side-to-side. Sometimes it's seen as a heart-shaped appearance of the tongue. In addition, your finger can't be rolled under the tongue. 

Is speech affected by tongue-tie?

Speech attainment itself isn't affected, but certain articulations might be impacted. A tight, thick and short frenulum that begins at the tip of the tongue prevents normal movements as previously mentioned. This restriction interferes with articulation of sibilant and lingual sounds such as t, d, z, s, th, n and I. 

How does tongue-tie affect breastfeeding?

It prevents the infant from achieving optimal suction while feeding and it’s often painful for the mother. Moreover, impaired tongue mobility may be associated with breastfeeding difficulty and it could result in inadequate calorie intake and failure to thrive. Poor latch directly contributes to maternal nipple discomfort and pain. It is also challenging for you to perform appropriate oral hygiene for your child due to the restriction of tongue movement. 

What is the treatment for tongue-tie?

Frenotomy, frenulotomy or frenulectomy are terms used for the release of the frenulum. This procedure can be performed at our otolaryngology office with minimal discomfort  and your infant can be fed immediately after. For older children, or in case of thicker frenuloms, a frenotomy is performed under general anesthesia. 

What is the post-procedure care after frenulectomy?

As previously mentioned, children can be fed right after the procedure without any restrictions. The site of release will have a white patch for up to a week which is normal healing and will clear up on its own. 

To learn more about Otolaryngology at Texas Children’s Hospital, click here.

Deepak Mehta, MD

Jessie Marcet-Gonzalez, CPNP