What is tongue-tie?

In tongue-tie, the tissue that connects the tongue to the bottom of the mouth is too short. This problem often runs in families.

Your child may not be able to fully move their tongue. But this may not cause problems. In some cases, the tissue stretches as the child grows. Or your child may adapt to less tongue movement.

Some children have trouble latching while breastfeeding. They may have speech and social problems. If symptoms are bad enough, surgery may be needed to release the tissue.

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.

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.

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.

A lactation consultant can help with breastfeeding problems. A speech therapist can help if your child has problems with speech.

If your child has their tongue-tie released, try comforting them with cuddling and plenty of time together. Give medicines as needed, and follow all instructions. Tongue exercises may help improve tongue movement.

The cause of tongue-tie isn't always known. It can run in families or may occur in babies who have other problems that affect the mouth or face, such as cleft palate.