Tongue Tie in Babies and Children
What is a tongue tie?
Tongue tie, also known as ankyloglossia, is a condition in which the strip of tissue beneath the tongue (the lingual frenulum) is shorter, tighter or thicker than usual. This can restrict the movement of the tongue.
Tongue tie is present from birth and varies in severity. Many babies with a tongue tie feed normally and never require treatment, while others experience difficulties with breastfeeding, bottle feeding or, occasionally, speech and oral function as they grow older.
At our clinic, we assess not only the appearance of the tongue tie but, more importantly, whether it is affecting your child's feeding, development or quality of life before recommending treatment.
What are the symptoms?
Many tongue ties cause no symptoms. When problems do occur, they may include:
In babies
- Difficulty latching during breastfeeding
- Frequent slipping off the breast
- Clicking sounds while feeding
- Long or very frequent feeds
- Poor milk transfer
- Poor weight gain
- Excess wind or reflux-like symptoms
Breastfeeding mothers may also experience:
- Pain during feeds
- Cracked or damaged nipples
- Recurrent blocked ducts or mastitis
- Difficulty maintaining milk supply
In older children
Occasionally, a tongue tie may contribute to:
- Difficulty moving the tongue freely
- Challenges licking foods such as ice cream
- Difficulty with oral hygiene
- Mechanical speech difficulties affecting certain sounds (although many speech concerns are unrelated to tongue tie)
When should I seek medical advice?
You should seek an assessment if your baby has persistent feeding difficulties despite support from a midwife, health visitor or lactation consultant.
Assessment is particularly important if your baby:
- Is struggling to gain weight
- Cannot maintain an effective latch
- Becomes distressed during feeds
- Has prolonged or exhausting feeding sessions
- Shows signs of dehydration
Older children may benefit from assessment if restricted tongue movement is affecting eating, oral hygiene or daily function.
How is tongue tie diagnosed?
Diagnosis involves a detailed discussion about your child's symptoms, feeding history and growth, followed by an examination of the tongue and its range of movement.
A visible frenulum alone does not necessarily require treatment. Instead, we assess how well the tongue functions and whether the restriction is responsible for your child's symptoms.
If breastfeeding is affected, we may recommend assessment alongside a lactation consultant or infant feeding specialist to ensure all contributing factors are considered.
What treatment is available?
Not every tongue tie requires treatment.
If your baby is feeding well, gaining weight appropriately and has no significant symptoms, no intervention may be necessary.
If the tongue tie is clearly contributing to feeding difficulties, a tongue tie release (frenotomy) may be recommended.
A frenotomy is a simple procedure that involves dividing the restrictive frenulum to improve tongue movement. In young babies, it is usually performed in the outpatient clinic without a general anaesthetic and takes only a few minutes.
Older infants and children may require treatment under local or general anaesthetic depending on their age, symptoms and the complexity of the tongue tie.
Following treatment, feeding support is often recommended to help babies establish an effective latch and maximise the benefits of improved tongue movement.
Recovery
Recovery following a tongue tie release is usually very quick.
Most babies feed immediately after the procedure and often return to their normal feeding pattern the same day. Mild discomfort, a small amount of bleeding or temporary fussiness may occur but usually settles quickly.
Parents will receive clear aftercare advice, and follow-up may be arranged if needed to assess feeding and healing.