Tongue-Tie in Children: Causes and Effects on Eating and Speaking

Some children are born with a frenulum that is too short, too tight or both. Sometimes the condition is mild and little to no functional limitation is present. In more severe cases, the tongue cannot move around normally which results in difficulty eating and speaking.

baby drinking a bottle

Lip Tie

Tongue tie can sometimes be accompanied by a lip tie, where the tissue connecting the upper lip to the upper gum restricts mobility of the upper lip. This can result in difficulties latching onto the breast with breastfeeding or forming a seal around a bottle nipple. It can also lead to a separation of the front teeth with a large space between them, requiring future orthodonture.

Tongue-Tie Surgery: What to Expect During the Procedure

During the procedure, the doctor lifts the baby’s tongue and divides the lingual frenulum. More than one cut may be needed to release the tongue. Stitches are not usually required, and there is little to no bleeding after the procedure. In babies younger than 6 months of age, the procedure can usually be done in the doctor’s office, whereas in older children the procedure is performed in the operating room under general anesthesia.

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Recognizing Tongue-Tie in Children: Symptoms and Impact on Feeding

Tongue ties and lip ties are different in each child and sometimes cause no symptoms or difficulty.
Some common signs and symptoms of tongue-tie are:

  • Trouble breastfeeding
  • Inability to latch properly to the breast
  • Difficulty staying on the breast
  • Making a clicking sound during feeding
  • Reflux
  • Spluttering or choking on milk
  • Cluster feeding
  • Exhibiting poor weight gain
  • Problems making certain sounds
  • Pain during breastfeeding (mom)
  • Low milk production or oversupply

Breastfeeding Challenges and Tongue-Tie: When to Seek Help

Breastfeeding babies normally create a vacuum on the breast, while a baby with limited tongue mobility instead resorts to squeezing the milk out. This can be painful for the mother and frustrating for the child. Tongue-tie can also lead to speech development issues and tooth decay as some babies grow. Not every breastfeeding challenge is related to a tongue tie or lip tie. Discussing latching techniques and alternate positions or methods with your lactation consultant can help address some early problems with breastfeeding. If feeding does not improve, it is important to receive a complete evaluation with a pediatric ear, nose, and throat specialist to ensure that there are no underlying throat or airway problems that are interfering with feeding. Some children with tongue-tie see symptoms improve with observation and feeding therapy alone.

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Tongue-Tie Release: A Solution for Nursing Problems

If your pediatric ENT determines that a tongue or lip tie is causing nursing problems, a procedure to release the tongue tie can be considered. When tongue tie is the source of feeding difficulty, the earlier it can be corrected, the better. Many parents notice an almost immediate improvement in their baby’s ability to breastfeed with one study reporting that 80% of infants feeding better within 24 hours of a tongue tie procedure. Our physicians are all Fellowship Trained and Board Certified Pediatric ENT surgeons who are experts at performing tongue-tie release. The procedure only takes a few minutes and is usually performed in the office using the same advanced equipment we use in the operating room. Moreover, when you are seen in our office for the evaluation and treatment of tongue-tie, most health insurance plans will cover any necessary procedures.

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