by Dr. Regina, pediatric dentist

Imagine that you are a competitor in a 100meter dash: ready, set, go….. Ah, I forgot to mention that you’re competing with your legs tied at the knees! You’ll probably make it to the finish line albeit a bit slower, clumsier, and with a few stumbles along the way but you will adjust and hop along. How does this apply to your little one? Well, a tongue tie can function in a similar matter. Just like binding your legs minimizes your ability to move them properly, a tongue tie alters the ability of one’s tongue to move properly and causes your little one to make adjustments in the way they breathe, sleep and eat. 

What is a tongue-tie? 

Lift your tongue up to the roof of your mouth. See that little string holding your tongue to the bottom of your mouth? That’s called a frenulum. In utero, the tongue is tethered to the bottom of the mouth, and slowly, the tongue becomes unfused and the frenulum is what holds it in place. 

This frenulum, a simple string holding your tongue in your mouth, has many variations. In some little ones it’s very thick, not as elastic, or attached very close to the tip of the tongue. This is known as a tongue-tie. A tongue-tie restricts the way the tongue can move and function. 

What are some symptoms of a tongue-tie? 

Babies with a tongue-tie have an impaired ability to form a seal when drinking from the breast or bottle resulting in issues that include: 

• Poor latch 

• Falling asleep while feeding due to increased work compensating for poor tongue function 

• Clicking during nursing 

• Milk dribbling out of the mouth when eating 

• Colic and gassiness due to excess air swallowed when eating 

• Slow to minimal weight gain due to inefficient milk transfer

Nursing moms may also be affected but their baby’s tongue tie and feel like feeding their babies is a full-time job. Tongue-tied babies feed very frequently and inefficiently due to the extra work they exert eating (think back to attempting to run while having your legs tied!). Nursing moms of tongue-tied babies can suffer from painful nursing, poor breast drainage, and nipple pain. 

How is tongue-tie treated? 

Textbooks from the 1600s, describe midwives keeping one fingernail sharp and using that nail to slice the frenulum at birth when they suspected a tongue tie. Today, treatment follows a similar idea of cutting the frenulum, however, it is achieved with scissors or a laser. A laser is optimal for the treatment of tongue-tie because it allows for more precision and control of bleeding. Following the procedure, it is crucial that you continue with special post-operative exercises to ensure that the tongue doesn’t heal back with an even tighter frenulum. 

If you suspect your little one has a tongue-tie, it is recommended that you work closely with your pediatrician or lactation consultant to get a referral to a pediatric dentist or ENT that can access and provide a tongue-tie release if necessary. A team approach increases success following the procedure and working closely with a team of lactation specialists, pediatric dentists, ENTS, and other therapists is crucial for successful treatment of tongue-ties.