About tongue-tie

Tongue-tie is when the movement of the tongue is restricted, which leads to problems like difficulty with breastfeeding. It happens when the piece of skin that connects the tongue to the floor of the mouth (the frenum) is shorter or tighter than usual.

Many children with a short or tight frenum don’t experience any problems. These children aren’t considered to have tongue-tie.

Tongue-tie is a congenital condition. This means it’s something a baby is born with. We don’t know why tongue-tie happens in some babies, but it usually isn’t a serious problem.

Signs of tongue-tie

Here are some signs that your baby or child might have tongue-tie:

• The tip of your baby’s tongue looks heart-shaped when their tongue sticks out.
• The tip of your baby’s tongue can’t reach the roof of their mouth or further than the edge of their lower lip.
• Your baby’s tongue can’t move sideways.

If you’re breastfeeding and your baby has tongue-tie, you might notice that:

• your baby has trouble attaching or staying attached to your breast
• your baby makes a clicking sound when feeding
• your nipples look squashed after feeding and might be sore or damaged.

Does your child need to see a doctor about tongue-tie?

You should take your child to the GP if you notice any of the signs above or if you’re concerned about tongue-tie. If you’re having trouble with breastfeeding, it’s a very good idea to talk with your midwife, child and family health nurse or a lactation consultant. These health professionals will check your baby for tongue-tie.

You might see a speech pathologist if you notice problems with your child’s speech. Although it isn’t clear whether tongue-tie can affect speech development, a speech pathologist might check for signs of tongue-tie.

Treatment for tongue-tie

The aim of tongue-tie treatment is to make sure your child’s feeding, nutrition, growth and development aren’t affected by their tongue-tie.

For example, if you’re having trouble with breastfeeding, treatment might involve advice and support on your breastfeeding positioning, attachment, feed frequency and how to maintain your milk supply. If your child has speech problems, they might receive speech therapy to help develop their communication skills.

If non-surgical treatment strategies don’t work, sometimes a small surgical procedure called a frenectomy is needed. A frenectomy involves cutting the frenum with scissors or a laser.

For a newborn baby, this procedure is often done without anaesthetic. Your baby can usually feed immediately after the procedure. For older babies and children, doctors will usually use a general anaesthetic to do a frenectomy.

Your health professional can help you decide whether your child needs a frenectomy and which approach is best for your child. Only an experienced health professional should do a frenectomy.