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A tongue-tie is easy to treat — but you need to know the signs.

Does your baby have trouble latching during feedings? You might want to check for a tongue-tie. It’s a common condition, and once treated can make life easier for both of you.

What is a tongue-tie?

Also called ankyloglossia, a tongue-tie happens when a baby’s tongue is connected to the bottom of the mouth by a band of tissue called a frenulum. It’s more common in boys than in girls.

“Because it restricts movement of the tongue, a tongue-tie can interfere with breastfeeding,” says Dr. Joseph Romeo, pediatrician at Geisinger. 

It can also impact your child’s speech, eating or swallowing. 

Tongue-tie symptoms

If your baby has a tongue-tie, they may:

  • Have trouble latching
  • Gain weight slowly
  • Be fussy during feedings
  • Make clicking sounds while nursing

Your baby’s tongue-tie can affect you, too. You may have some or all of the following:

  • Low milk supply
  • Pain during nursing
  • Cracked or bleeding nipples
  • Mastitis

Other challenges

A tongue-tie can make it hard for your child to do other things like:

Speak clearly. A tongue-tie can restrict tongue movement. This can lead to difficulty with making certain sounds.

Eat certain foods. The tongue plays a vital role in chewing. It helps move food to the sides of the mouth. When the tongue can’t move as well as it should, chewing can be challenging, especially with foods like meat or crunchy veggies. It may also make it hard to lick an ice cream cone.

Breathe properly. Having a tongue tie can cause the roof of the mouth to narrow, which can lead to mouth breathing and snoring. This can dry out the mouth, impacting dental health.

Practice good oral hygiene. A tongue-tie may make it harder for your child to move their tongue around their mouth and remove food particles after eating.

If your child has a mild tongue-tie, it may not impact their daily life. But, Dr. Romeo notes, it can be serious enough to need treatment.

Treatment for a tongue-tie

A lactation consultation or your child’s pediatrician will determine if your child has a tongue-tie. They’ll look at the underside of your child’s tongue to see if it’s attached to the bottom of their mouth.

Once they’ve determined that your child has a tongue-tie, they’ll work with you to find the best treatment option. Common treatments include lactation training and speech therapy. They may also choose to monitor their condition over time.

“Because some children grow out of a tongue-tie, their pediatrician may suggest a wait-and-see approach,” Dr. Romeo says.

And if your child’s is more serious, surgical tongue-tie treatments are available, including:

Frenotomy — During this minimally-invasive procedure, a surgeon makes a small incision in the lingual frenulum, the thick band connecting the tongue to the bottom of the mouth. This incision frees the tongue, restoring proper movement. It’s often done before your newborn leaves the hospital.

Frenectomy — This procedure is similar to a frenotomy. But instead of just cutting the frenulum, a surgeon reconnects it to the bottom of the mouth.

Frenuloplasty — If your child’s frenulum is too thick to treat with a frenotomy, their pediatrician may recommend a lingual frenuloplasty. During this procedure, a surgeon removes the lingual frenulum entirely. This procedure is typically done on older children. 

Your pediatrician can explain each treatment and help create the best course of action for your baby.

Next steps:

There’s more than one way to breastfeed
Dads: Here’s how you can participate in breastfeeding
Meet Joseph Romeo, MD

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