What is a Tongue Tie?

When most people hear the words “tongue tie”, they likely think of someone in a stressful situation who has difficulty speaking because they’re nervous or under pressure. But a tongue tie is actually a physical condition and is the common name for ankyloglossia.

As a baby develops, “a strong cord of tissue that guides development of mouth structures is positioned in the center of the mouth…called a frenulum. After birth, the lingual frenulum [under the tongue] continues to guide the position of incoming teeth” (AAO-HNS) and it recedes and thins as a baby grows. If the frenulum is tight (too short) or fails to recede it may cause difficulty with tongue mobility which in turn can affect speech and eating habits.

About .2 – 2% of babies are born with tongue ties. It is present at birth (congenital) and hereditary.

How do I know if My Baby has a Tongue Tie?

If a tongue tie is present and it isn’t noticed by the nursing staff or midwife that delivered your baby, then your family physician should notice it at the baby’s first post-natal checkup.

If you want to check for yourself, try these simple tests:

1)      Look at your baby and stick out your tongue. Babies naturally imitate what they see and will stick out their tongue. If your baby is tongue tied, he or she will not be able to stick the tongue out beyond the bottom lip or the tip of the tongue may appear heart shaped.

2)      Put your finger, pad side up, in your baby’s mouth to engage the sucking reflex. His tongue should extend over the gum line to cup the bottom of your finger. If not, then he likely has a tongue tie.

Does a Tongue Tie need to be Fixed?

In the past, a tongue tie was always snipped because it was thought that not clipping it would mean speech difficulties later. The most immediate difficulty related to limited mobility of the tongue, however, was the baby’s inability to latch on to breast feed, which would limit the baby’s intake of milk and affect weight gain. As more and more babies were bottle fed, where the nipples are softer and require less tongue movement, many doctors took a “wait and see” approach. In many minor tongue tie cases, the frenulum stretches on its own during the first year and doesn’t affect speech patterns later on.

As breastfeeding has started to become popular again, more and more mothers are affected by the tongue tie. A baby with tongue tie can cause severe damage to nipples as the baby compresses the breast tissue between his gums, instead of using his tongue to draw on the milk. This can be particularly tricky depending on the mother’s natural breast and nipple shape as well.

Unfortunately, not many family doctors are willing to treat the tongue tie themselves. A tongue tie can usually be fixed with a simple snip in a doctor’s office. Since there is no blood flow into the frenulum, there is very little pain or bleeding associated. If the “snipping” is left a little longer, beyond the age of 1, then the timing of treatment may be determined according to teething and speech development and may involve a dentist or oral surgeon. It is still a very simple procedure, usually performed under a local anesthetic. In some cases, a tongue tie may not be removed until much older until the adult central incisors (front teeth) come in, so as to aid in word and speech patterns (t, d, z, s, th, sh, ch).

In some cases, speech therapy and tongue exercises may help compensate for the tight frenulum and aid in speech development. Such therapy may also be required following the snipping to help a child get used to his new tongue movement and produce sounds properly.

Darlene Oakley is a freelance writer for EmpowHER.com.

Sources:

Fact Sheet: Tongue-tie (Ankyloglossia). American Academy of Otolaryngology – Head and Neck Surgery. Web. Feb 21, 2012. http://www.entnet.org/HealthInformation/Ankyloglossia.cfm

“Tongue-Tie” by Anne Smith, IBCLC. Breastfeeding Basics. Web. Feb 21, 2012. http://www.breastfeedingbasics.com/articles/tongue-tie

Tongue-Tie – Topic Overview. WebMD. Web. Feb 21, 2012. http://children.webmd.com/tc/tongue-tie-topic-overview

Breastfeeding a Baby with Tongue-Tie. Kellymom. Web. Feb 21, 2012. http://www.kellymom.com/babyconcerns/bfhelp-tonguetie.html