Treating tongue-tie in babies

Ankyloglossia, the medical term for tongue-tie, is a common birth defect. More common in boys than girls, it affects between 3 and 10 percent of infants, with varying degrees of severity. Tongue-tie occurs when the small piece of skin that connects the tongue to the bottom of the mouth, known as the lingual frenulum, is too tight and restricts natural movement of the tongue. Children with this condition can have feeding problems, dental issues, and possibly even speech problems down the road, depending on the severity and placement of the frenulum.

Breastfeeding, in particular, which requires a baby to latch on, can pose problems for a tongue-tied infant. Latching on with a tongue-tie condition is more difficult and may result in a baby compensating by biting on the breast or other behaviors that can hurt the mother. Incorrect latching may also result in poor weight gain and eventually failure to thrive.

The tongue is also needed to form correct speech as children enter their toddler years. While the American Speech and Hearing Association states that there is not enough evidence to support an association between tongue-tie and speech delay, in practice, some children with this condition go on to require speech therapy for speech problems. In addition, if tongue-tie is severe, dental problems might eventually develop, depending on where the frenulum is located.

Sometimes, a newborn with tongue-tie has the procedure done in the hospital nursery before being released from the hospital.

Depending on the tightness and severity of the condition, your baby’s doctor may suggest a frenulectomy, a minor surgery to separate the tongue from the floor of the mouth. This procedure may be done with or without anesthesia. Depending on the age of your child and the severity of the condition, a frenulectomy can sometimes even be performed in a doctor’s office. Typically, the baby’s tongue is held up and the frenulum is clipped quickly. The lingual frenulum does not have many blood vessels in it so bleeding is usually not a problem.

Sometimes, if your child feeds well as an infant, a frenulectomy might not be necessary until your child is a little older when other problems such as speech or dental issues become more apparent. Generally, after six months of age, a child will require general anesthesia if the procedure is performed in an operating room. In addition, a laser option is available. No general anesthesia is required for the laser procedure (numbing gel is usually used).

Sometimes, a newborn with tongue-tie has the procedure done in the hospital nursery before being released from the hospital. However, in some cases as your child gets older, the frenulectomy might need to be re-done. As your child grows, the genioglossus muscle might not develop properly, a holdover from the tongue-tie condition. This may cause language delays or impediments and so the procedure will be done a second time to achieve more permanent results. However, even in an older child, it remains a low-risk, outpatient procedure that is over in minutes.