Tongue-tie

What is tongue-tie?

Tongue-tie is a condition that causes babies to have difficulty moving their tongue properly. This is because their frenulum is too short – the strip of skin that runs between the bottom of the tongue and the bottom of the mouth. 

In severe cases, babies can struggle to feed as they find it hard to suck.

What are the key symptoms of tongue-tie?

Babies with a mild tongue-tie might not have any symptoms, but others may find it difficult to feed. If this is the case, the symptoms to look out for include: 

• Their mouth is unable to attach or stay attached to the breast or bottle for long

• They take a long time to feed or have to feed several times

• They may be hungry all the time

• It’s difficult for them to gain weight

If a parent is breastfeeding they may also have symptoms caused by the baby’s tongue-tie, including:

• Sore or cracked nipples

• Low milk supply

• Pain and inflammation of the nipple, also known as mastitis

In some cases, tongue-tie might not become a problem until adulthood. With adult tongue-tie, there can be other problems that weren’t as obvious as a baby:

• Speech problems

• Cavities

• Bad breath

• Gum inflammation and problems

• Difficulty swallowing

• Snoring and waking up out of breath, also known as sleep apnoea

How common is tongue-tie?

About 1 in every 20 babies is born with some form of tongue-tie, but in most cases, it's not bad enough to cause any problems.

What causes tongue-tie?

Tongue-tie is caused by a random growth defect. Having a short frenulum may also be passed down from the parent to child.

How is tongue-tie diagnosed?

Even though tongue-tie is usually found during newborn checks, some are missed, as they may be more difficult to spot. If this is the case, a doctor can still help to diagnose tongue-tie by:

• Asking a few questions about your baby’s feeding habits

• Looking in your baby’s mouth – a heart shaped tongue that’s difficult to stick out, lift or move from side to side may be tongue-tie

How is tongue-tie treated?

Mild tongue-tie can resolve by itself as the baby grows. So, if the baby doesn’t have any problems feeding, treatment isn’t necessary. 

But if the baby is experiencing symptoms, they may need treatment. A procedure called tongue-tie division or frenotomy, can help. This is where the baby’s frenulum is cut with a pair of scissors. In very young babies, there is no need for an anaesthetic as it causes no pain. This only takes a few minutes and can improve feeding straight away.

In older babies or children a general anaesthetic is generally required. 

Other support is available, including:

• A lactation consultant can help improve feeding 

• A paediatrician may also recommend supplementing with formula to help your baby gain weight

• A speech therapist may help if tongue-tie is causing a speech impediment

When should I speak to a doctor?

Talk to a doctor if:

• Your baby is having any symptoms of tongue-tie

• Breastfeeding your baby is painful

• You suspect that you may have an undiagnosed tongue-tie

• Your older child has difficulty moving their tongue or speaking