What is a tongue tie?   A tongue tie is a membrane that extends from the underside of the tongue, in the middle, to the bottom of the inside of the mouth. The pictures at the top of this page show the membrane under the tongue, with a cotton bud used to gently lift the baby's tongue upwards.

The picture on the left, below shows a more severe tongue tie with the membrane extending right to the tip of the tongue. The picture on the right shows an apparently milder tongue tie.

How common is it?   Estimates vary, but a commonly quoted figure is that 1 in 20 babies has some sort of tongue tie. It's commoner in boys and there may be other members of the family who have also had a tongue tie.

Many tongue ties are minor and do not require treatment. However a tongue tie that is interfering with breast feeding may require assessment with a view to possible treatment (frenotomy). Some bottle fed babies will also benefit from tongue tie release. The assessment should be carried out by someone with experience in this field.

Can my baby breast feed with a tongue tie?   Some can, some manage OK, some find it difficult, and some can't. Some babies also have trouble bottle feeding and may dribble excessively, or swallow too much wind. The difficulties a baby is having do not always depend on the visual appearance of the tongue tie.

What are the symptoms of a tongue tied baby?   Sometimes mothers will experience painful feeding, grazing or damage to the areola or nipple, or even mastitis. Babies may latch on poorly, require several attempts to latch and become frustrated. They may make a clicking noise when feeding. Feeding may be prolonged, and the baby may still be hungry and be irritable, or be ready to feed again within an hour or two. These are some of the more common symptoms of a tongue tie causing problems with breast feeding.

The baby who had the tongue tie in the image above on the left was not having as many problems feeding as the baby with the tongue tie on the right. Both improved with their feeding after division was performed. So a tongue tie may not look dramatic but may still be causing significant restriction of tongue movement.

Will it affect my baby's speech later on?   Again it depends, but most tongue ties won't affect speech. However since they are much simpler to treat when a baby is young, it may be better to have treatment if, for example, there is a family history of speech difficulties related to tongue tie

Who can treat it?   The procedure, which is called a frenotomy, is safe in the hands of those who are trained and are able to administer pain relief and deal with any unexpected issues. A medical assessment by a paediatrician is an important part of the check-up, as parents may also wish to discuss other health concerns and feeding issues about their baby.

Why do some doctors and midwives think tongue ties are not important?   Nowadays we aim to promote breastfeeding much more strongly than in the past, because of the health benefits to the baby and to the mother. Our knowledge on what makes babies breastfeed successfully has also increased. As a result there is more evidence that the presence of a tongue tie can interfere with feeding. The National Institute for Health and Clinical Excellence have stated that division of tongue tie may be beneficial, and there is a   parent information sheet to read. **

How is it treated?   Tongue tie release is carried out by carefully cutting the tongue tie under the tongue. It is a quick procedure and your baby will be able to feed afterwards. Sometimes there may be a small amount of bleeding, but this stops after a minute or so in most cases.  

Treatment decisions should not be based solely on the information in these pages and should always be discussed firstly with your GP, midwife, infant feeding advisor or Paediatrician.

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