Tongue-Tie

Tongue-tie happens when the tissue that attaches the tongue to the bottom of the mouth (lingual frenulum) is too short. This problem is present at birth. It can limit the movement of the tongue. Some children don't have problems. For others, it may cause problems with feeding, speech, and social interactions.

Many children with tongue-tie don't have symptoms. The tissue either stretches as the child grows, or the child adapts to the tongue restriction. But some children may have:

• Trouble latching and sucking during breastfeeding. Bottle-fed babies often don't have feeding problems. That's because drinking from a bottle uses different mouth movements than breastfeeding.
• Gaps or spaces between the front lower teeth.
• Speech problems. This may happen when the tip of the tongue cannot rise high enough to make some sounds clearly. These sounds may include t, d, z, s, th, n, and l.
• Personal or social problems. The limited tongue movement can make it hard to do certain things, such as clean food off the teeth with the tongue.

Your doctor will do a physical exam of your child's mouth and ask about any symptoms. If you are trying to breastfeed, your doctor may also examine your breasts and watch your child trying to breastfeed. In an older child or adult, the doctor may check the shape and movements of the tongue.

If your baby has tongue-tie and is feeding okay, you may choose to wait and see if their lingual frenulum stretches on its own. You can also:

• Talk to a lactation consultant. They can help if you or your baby is having trouble breastfeeding.
• Consult a speech therapist if your toddler is having speech problems.

If tongue-tie causes problems with eating, speech, or social interactions, the doctor may release the tissue. This procedure is called a frenotomy or a frenuloplasty. The doctor clips the lingual frenulum and closes the wound with stitches. The doctor may teach your child how to do tongue exercises. These can help with tongue movement.

• If you are breastfeeding your baby, talk with your doctor. They can help you find a lactation consultant who can help your baby latch on and suck well.
• If your child has speech problems, ask your doctor about speech therapy.
• If eating or speech problems don't improve, you may want to think about surgery to release the tissues under the tongue.

After surgery

• After surgery, your child's tongue may bleed a little. You can give your child acetaminophen (Tylenol) for any discomfort.
• Do not give your child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful. Read and follow all instructions on the label.
• Do not give aspirin to anyone younger than 20. It has been linked to a serious illness called Reye syndrome.
• You may need to help your child with tongue exercises many times a day for 4 to 6 weeks. Stretching may help improve tongue movement. It also may help prevent scar tissue.
• If a more complicated surgery is done, your child will have stitches under the tongue.