- Tongue-tie occurs when there is an abundance of tissues between the lower tongue and lower mouth.
- A common symptom of tongue-tie in babies is difficulty latching to the nipple during breastfeeding.
- Tongue-tie treatment may include surgery although the condition usually resolves on its own.
- Visit Insider’s Health Reference library for more advice.
“Tongue-tie is when there is an abundance of tissue between the lower part of the tongue and the lower part of the mouth,” says Dr. Phil Boucher, MD, a board-certified pediatrician in private practice in Lincoln, Nebraska.
Babies develop tongue-tie while still in the womb. But it’s not clear what increases the risk of tongue-tie or how many infants are born with it.
“Most babies have some degree of tissue underneath their tongue and so it’s difficult to say how common it is,” says Boucher. Research puts the number anywhere from 4% to 10%.
How to spot tongue-tie
Tongue-tie can be mild or severe. It all depends on how much extra tissue is underneath the tongue. The thicker the tissue, or the closer it is to the tip of the tongue, the more severe the condition.
For mild cases, you may not notice until the baby starts to show problems with latching during breastfeeding – or “you may not notice at all because many babies are able to compensate without issue and nurse as normal,” says Boucher. A lactation consultant may also point it out.
“There’s a lot of shades of grey as to what the amount of tissue is that causes a problem,” he says. That’s further complicated by the fact that there isn’t a set standard for diagnosing tongue-tie. If your baby is having issues with latching or feeding, speak to your pediatrician.
How to treat tongue-tie in babies
If your baby has a mild case of tongue-tie, then a common course of action is to let it be and monitor it, says Boucher.
But if the tongue-tie is more severe – especially if it alters the shape of the tongue – the pediatrician may recommend a frenotomy. A frenotomy is a quick, simple procedure where the doctor clips the extra tissue underneath the tongue.
Boucher says that he usually reserves a frenotomy for when the baby is having difficulty breastfeeding, “despite efforts to try different holds and positions and proper nursing technique.”
The controversy around frenotomies
If left alone, the tongue-tie will often resolve itself on its own as the baby’s mouth grows. And because of this, there is controversy surrounding tongue-tie clipping, including how often it’s recommended and when the procedure is done.
One 2019 study, published in the journal JAMA Otolaryngol Head & Neck Surgery, found that after a “comprehensive feeding examination,” that included assessments and suggested interventions, 62.6% of babies recommended for a frenotomy didn’t actually need it.
As far as long-term issues go, Boucher says, “there’s no good evidence for speech delays or other issues with tongue-tie.” If there are future issues, they can be addressed then, he says.