Tongue-tie: All you need to know

August 11, 2017

Becoming a new parent is a joyous, but stressful moment in our lives. From bottles to diaper changes, our daily routine evolves. Our time becomes enriched with baby cuddles and other sweet surprises that follow as they grow and develop. Providing our little ones with the best nutrition to grow is our number one focus. Feeding can be challenging if our infant is unable to accomplish a good latch. At times, this can be the result of ankyloglossia or tongue-tie. Below is information to guide you if you are concerned your child suffers from this.

What is ankyloglossia?

Ankyloglossia, or tongue-tie, is a condition present at birth where the lingual frenulum (attachment between the tongue and the floor of mouth) is short, tight and thick. It is often connected close to the tip of the tongue and prevents its movement. Tongue-tie can contribute to poor breastfeeding and maternal nipple pain. 

Which signs indicate your child might have ankyloglossia?

The most common signs of tongue-tie are the inability to protrude the tongue more than 2 mm past the lower gums, and the impairment of tongue movement. You may 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 cannot be rolled under the tongue

How does ankyloglossia 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. 

Is speech affected by ankyloglossia? 

Speech attainment itself is unaffected, but certain articulation 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 siblants and lingual sounds such as t, d, z, s, th, n and l. 

What is the treatment for ankyloglossia?

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 previosly 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. 

If you are concerned your child is suffering from ankyloglossia, please contact our Otolaryngology clinic at 832-822-3250.

Post by:

Deepak Mehta, MD

It's a privilege a parent lets me take care of their most precious asset--their child. It's my duty to provide them the best of care.

My clinical interests are complex airway surgery, pediatric swallowing disorders and head and neck masses,along with general otolaryngology.


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Jessie Marcet-Gonzalez, CPNP

I’m a Nurse Practitioner in the Pediatric Otolaryngology Department at Texas Children’s Hospital main campus and I take care of patients with multiple ear, nose and throat concerns. My past clinical experience involves pediatric Intensive care, adult intensive care, outpatient surgery and...

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