Even the little things can make a big difference when it comes to your baby’s health and happiness. Something as seemingly unimportant as the tiny tissue connecting the tongue to the bottom of the mouth could actually be causing a serious disruption to your little one’s breastfeeding now and perhaps even speaking, swallowing, and oral hygiene later on.

We’re talking about tongue-tie, or​​ ankyloglossia, a condition acquired at birth in which that little stretch of under-tongue tissue, called the lingual frenulum, is tighter, shorter or thicker than normal. As a result, babies can encounter a variety of challenges that might go away on their own, or could worsen with age. Keep reading to learn about symptoms of tongue tie, diagnosis, treatment, and more.


While it might seem like a simple peek under the tongue is enough, this syndrome can actually be difficult to spot! It might not be all that bothersome or noticeable for some babies, but it could cause more serious problems for others. In more severe conditions, restricted tongue movement can make breastfeeding more difficult and cause issues with feeding, and as a result, normal, healthy weight gain.

So, what’s going on? Typically babies need to extend their tongue beyond the line of their gums in order to properly latch on to breastfeed, and protect the nipple. If the tongue is restricted with this condition, babies might resort to using their gums to attach. This can be painful for breastfeeding parents who might develop sore or cracked nipples and can make consuming enough milk quite a challenge for little ones. For mom, this can also lead to low milk supply and even breast inflammation.


One of the most common symptoms of tongue tie in newborns is trouble latching on or attaching to the breast and staying latched for the full duration of feeding. Many tongue-tied babies feed for a longer than normal amount of time, requiring a break before feeding again. You might notice a clicking sound when feeding as a result of an improper latch (however this sound could be indicative of a separate breastfeeding problem instead). As a result of this difficulty feeding, your baby might appear hungry more of the time or seem unsatisfied or unsettled. Trouble feeding can make it difficult for your baby to get enough to eat and therefore they might not gain weight at a normal, healthy rate. 


For children and adults with this condition left unresolved, additional symptoms of tongue tie can develop and worsen, including interference with normal speech and articulation. While it does not contribute to a delay in speech, tongue-tie can impact a child’s ability to pronounce words and form sounds. Typically, this condition can affect the production of sounds that involve greater tongue movement such as “d”, “l”, “r” “s” “t”,“z”, and “th”.

Those with tongue tie syndrome are also at risk to develop improper swallowing patterns and difficulty removing food or debris from their mouths with their tongue, which can lead to problems with oral hygiene and even dental conditions such as gingivitis, jaw pain, and sleep apnea. Down the line, unresolved tongue tie syndrome can also create additional unforeseen circumstances such as inability to eat certain foods, trouble with intimacy, and problems playing certain wind instruments.


To start assessing on your own whether or not issues with breastfeeding might be related to a potentially tongue tied baby, look to see if your child has trouble sticking their tongue out, lifting it, or moving it around (up, down, and side to side). This condition can also be recognized by a tongue that appears to be shaped like a heart when stuck out.

Although, it might take more experience with feeding before the problem becomes noticeable and diagnosable, some tongue tied babies can be diagnosed during their newborn’s physical examination. Most variation in appearance of the tissue under the tongue is normal, and not a condition requiring diagnosis. However, if the variation is caused by tongue tie syndrome, your pediatrician can conduct a physical exam and make a formal diagnosis, including which type and grade of tongue tie your child might have.


Luckily, treatment is not always necessary for this condition. Many children grow out of it on their own. However, for those diagnosed and experiencing problems feeding, there is a simple procedure to resolve the condition and, hopefully, start having easier, more enjoyable feeding experiences for parent and baby. Tongue tie surgery, or frenotomy, is a minor operation in which your child’s doctor or surgeon would cut the lingual frenulum to release the pressure and restriction in your little one’s mouth. This procedure can usually be conducted in a doctor’s office without anesthesia and with a speedy recovery so that your baby can start feeding right away!

In the event of a more complicated condition, such as a thicker lingual frenulum that cannot be simply cut, a plastic surgery called frenuloplasty can be conducted with general anesthesia for a painless procedure and dissolvable stitches for a swift recovery. For non-surgical treatment options, some children might require speech therapy and additional oral-hygiene practices to keep up with communication and have a healthy mouth!


It is important to note that not all children with difficulty breastfeeding have tongue tie syndrome. There certainly can be other causes. Since tongue tie is only one of many potential reasons for trouble breastfeeding, treatment might not be the magic fit your family is seeking to make breastfeeding an easier experience.

It is crucial to get a formal diagnosis from a medical professional in order to be sure what condition your family is truly facing and how to proceed with solutions or treatment. We encourage you to work with your pediatrician and other support systems to create a plan and a feeding system that works for your family.

At Coastal Kids Pediatrics, we believe that prioritizing all aspects of your baby’s health, big and small, can be essential to helping them grow and thrive to their best potential. If you think your baby might have tongue tie syndrome, are interested in learning more about the symptoms of tongue tie, or think tongue tie surgery might be a good fit for your child, don’t hesitate to make an appointment with your passionate Coastal Kids pediatrician for a diagnosis and treatment plan. To get started, visit us at www.coastalkids.com