Tongue-tie 

Introduction 

The piece of skin that joins the tongue to the base of the mouth is called the frenulum 

Tongue-tie in older children and adults

Untreated tongue-tie may cause no problems as a child gets older and any tightness may resolve naturally as the mouth develops with age. However, some cases can persist and may cause problems such as speech difficulties and difficulty eating certain foods.

Speak to your GP if you are concerned that you or your child may be experiencing problems caused by tongue-tie.

Tongue-tie division can be carried out in older children and adults, although this will usually need to be done under general anaesthetic and may involve using stitches to close the resulting wound under the tongue.

Tongue-tie is a problem that occurs in babies who have a tight piece of skin between the underside of their tongue and the floor of their mouth.

The medical name for tongue-tie is ankyloglossia, and the piece of skin joining the tongue to the base of the mouth is called the lingual frenulum.

It can sometimes affect the baby's feeding, making it hard for them to attach properly to their mother's breast.

If you're concerned about your baby's feeding and think they may have a tongue-tie, speak to your infant feeding specialist, lactation consultant, health visitor, midwife or GP.

The following information explains tongue-tie and the problems it can cause, and describes a quick and painless procedure to snip the skin, known as tongue-tie division, which should be considered if your baby is affected.

What is tongue-tie?

Tongue-tie is a birth defect that affects 3-10% of newborn babies. It is more common in boys than girls.

Normally, the tongue is loosely attached to the base of the mouth with a piece of skin called the lingual frenulum. In babies with tongue-tie, this piece of skin is unusually short and tight, restricting the tongue’s movement.

This prevents the baby from feeding properly and also causes problems for the mother.

Breastfeeding problems

To breastfeed successfully, the baby needs to latch on to both breast tissue and nipple, and the baby's tongue needs to cover the lower gum so the nipple is protected from damage.

Babies with tongue-tie are not able to open their mouths wide enough to latch on to their mother's breast properly.

They tend to slide off the breast and chomp on the nipple with their gums. This is very painful and the mother's nipples can become sore, with ulcers and bleeding. Some babies feed poorly and get tired, but they soon become hungry and want to feed again.

In most cases, these feeding difficulties mean the baby fails to gain much weight.

How is tongue-tie treated?

If your baby has a piece of skin connecting the underside of their tongue to the floor of their mouth but they can feed without any problems, treatment is not necessary. If feeding is affected, the tongue-tie needs to be divided.

Tongue-tie division

Tongue-tie division involves cutting the short, tight piece of skin that connects the underside of the tongue to the floor of the mouth. It is a simple and painless procedure that usually resolves feeding problems straight away.

The National Institute for Health and Clinical Excellence (NICE) supports the use of tongue-tie division, as it is safe and there is evidence that it can improve breastfeeding. See the NICE guidelines on Division of tongue-tie for breastfeeding.

The Baby Friendly Initiative provides a list of hospitals where tongue-tie division can be carried out.

How tongue-tie division is carried out

In babies only a few months old, division of tongue-tie is usually performed without any anaesthetic (painkilling medication), or with a local anaesthetic that numbs the tongue.

general anaesthetic is usually needed for older babies with teeth, which means they'll be asleep during the procedure.

The baby’s head is held securely, while sharp, sterile scissors are used to snip the tongue-tie. This only takes a few seconds. You can start feeding your baby immediately afterwards.

Some babies sleep through it, while others cry for a few seconds. In small babies, being cuddled and fed are more important than painkillers.

There should be little blood loss, though some bleeding is likely.

A white patch may form under the tongue, which takes 24-48 hours to heal but does not bother the baby.

Page last reviewed: 04/02/2013

Next review due: 04/02/2015

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User855984 said on 17 March 2014

Tongue-tie UK is a grass-roots organisation created by parents which aims to: raise awareness of tongue-tie and lip-tie among parents, healthcare professionals, breastfeeding supporters and the general public through its website and through social media; create a hub to serve parents and others who are keen to create change and exchange stories and mutual support; and fund-raise for further research into tongue-tie and lip-tie.

It would be fantastic if all new mums knew where to access support from healthcare professionals or breastfeeding support workers who have been properly trained to recognise the symptoms of tongue-tie and either treat or refer on to someone expert in the field as appropriate. In the meantime, many mums are recognising those symptoms themselves, sometimes weeks or months after their baby is born. During that time they may have struggled with feeding their baby (whether at the breast or by bottle) with no support to find out what the underlying reason might be. Often they stumble upon information about symptoms of tongue-tie only to find that healthcare professionals aren't aware of tongue-tie and the impact it can have.

To kick off we're asking parents for their stories so that we can share on our website and via FB and Twitter - this is a crucial part of what we want to do, these testimonies are a way into understanding parents' concerns so we can work with other organisations to ensure those concerns are heard and addressed. We want to give parents a voice in this and a platform for more education, increased awareness and positive change.

http://tonguetieuk.org
https://www.facebook.com/tonguetieuk
https://twitter.com/tonguetiesuk

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