Tongue Tie Facts You Probably Don't Know – But Should

If you’re a parent, you’ve probably heard of the term ‘tongue tie’. The condition isn’t new and has been treated since the 17th Century.

But though it’s common, it’s not just a feeding issue as many people might initially think. The condition occurs when an overly tight band of tissue restricts tongue mobility, impairing its ability to extend for proper feeding and speech, according to physician Naheed Ali, MD, PhD.

It can be distressing for babies and parents and takes some time to get a diagnosis.

Though parents may focus on tongue tie and its impact on latching on and breastfeeding, the condition can actually impact a lot of other things.

In fact, it could cause an array of issues with bottle feeding, weaning to solid foods, milestone development, breathing, sleep, dentition, poor oral health and function, weight gain and speech, says Carmelle Gentle, founder of The Tongue Tie Centre.

Are operations always necessary for tongue tie in babies?

The need for surgery for tongue tie in babies largely depends on the severity of the condition and its impact on feeding and, later in life, speech development, says Dr. Lawrence Cunningham, the medical and health contributing expert for the UK Care Guide. 

He explains that a tongue tie restricts the tongue’s range of motion, which can lead to breastfeeding difficulties, and in some cases it can affect the baby’s ability to gain weight. This is what often causes the most concern to parents.

However, not all cases require surgery, he clarifies.

“Some infants with tongue tie can breastfeed effectively without the need for surgery, and the condition may, in any case, improve as the child grows older. In some instances, simple exercises and breastfeeding techniques can alleviate the issues caused by tongue tie.

“However, when the condition severely impacts feeding or is anticipated to influence speech development negatively, a procedure known as a frenotomy might be considered, and it is something I have recommend on a number of occasions in the past.”

The procedure involves snipping the skin connecting the underside of the tongue to the floor of the mouth. Dr Lawrence says it often results in immediate improvement in breastfeeding.

Signs your child has tongue tie

According to the NHS, these are the signs to look out for if you suspect your baby has tongue tie.

- Baby may have difficulty attaching to the breast or staying attached for a full feed.

- Your child may feed for a long time, have a short break, then feed again.

- Baby may be unsettled and seem to be hungry all the time.

- Not gain weight as quickly as they should.

- Make a “clicking” sound as they feed – this can also be a sign you need support with the positioning and attachment of your baby at the breast

Risks with tongue tie operations

Treating a tongue tie with surgical interventions or with inadequate tongue space, can add ongoing feeding, weaning and longer term health implications for an infant beyond their infant feeding journey, says Carmelle Gentle.

She adds: “There is so much conflicting and misinformation around tongue tie which make it hard for parents to navigate. At the tongue tie centre we see many families who have had procedures previously elsewhere, who are left facing ongoing physical and emotional challenges that come with it.

“Unfortunately, the onus is often on the parents to ask their provider on how to prepare for a tongue tie division and around the aftercare process; they are in the best position to advocate for their infants and find a tongue tie provider that feels most aligned.”