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Tongue tie

Definition

Tongue tie is when the bottom of the tongue is attached to the floor of the mouth.

This makes it hard to freely move the tip of your tongue.

Alternative Names

Ankyloglossia

Causes, incidence, and risk factors

The exact cause of tongue tie is not known.  Your genes may play a role.  It tends to run in some families.

The tongue is stuck to the bottom of the mouth by a band of tissue called the lingual frenulum.

Symptoms

In a newborn or infant, the symptoms of tongue tie are similar to the symptoms in a child who is having problems with breast feeding. Symptoms may include:

  • Acting irritable or fussy, even after feeding
  • Difficulty creating or keeping suction on the nipple. The infant may become tired in 1 or 2 minutes, or fall asleep before eating enough.
  • Poor weight gain or weight loss
  • Problems latching onto the nipple. The infant may just chew on the nipple instead.

The breastfeeding mother may have problems with breast pain, plugged milk ducts, or painful breasts, and may feel frustrated.

Signs and tests

Most experts do not recommend that health care providers examine newborns for tongue tie unless there are breastfeeding problems.

Most health care providers only consider tongue tie when:

  • The mother and baby have had problems starting breastfeeding
  • The mother has received at least 2 to 3 days of support from a breastfeeding (lactation) specialist

Treatment

Most breastfeeding problems can be easily managed with a variety of strategies.

If you run into any problems, talk to person who specializes in breastfeeding. This is called a lactation consultant.

Surgery is rarely needed. Tongue tie surgery is called a frenulotomy.  It involves cutting the tissue under the tongue. It is usually done in the doctor's office. Infection or bleeding afterwards are possible, but rare.

Surgery for more severe cases is done in a hospital operating room. A surgical reconstruction procedure called a z-plasty closure may be needed to prevent scar tissue from forming.

Complications

On rare occasions, tongue tie has been linked to tooth, swallowing, or speech problems.

References

Hall DM, Renfrew MJ. Tongue tie. Arch Dis Child. 2005;90:1211-1215. Review. Erratum in: Arch Dis Child. 2006;91:797.

Tinanoff N. Common lesions of the oral soft tissues. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 307.


Review Date: 11/12/2012
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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