Tongue-Tie

Tongue-tie may cause problems with breastfeeding, such as difficulties attaching or staying attached to the breast, and the mother suffering sore nipples. If the baby is not feeding efficiently, he or she may not gain weight at the normal rate.

You may notice your baby has difficulty sticking their tongue out and that the tongue looks heart shaped. You may hear a “clicking” sound when they feed.

Other problems reported very rarely are speech difficulties, dental problems and difficulty licking. There is very minimal evidence in the medical literature that tongue tie causes these problems.

As a baby develops in the womb, the tongue separates from the floor of the mouth and remains connected by a piece of skin known as the lingual frenulum. However, in babies described as ‘having a tongue-tie,’ this piece of tissue causes restriction in the movement of the tongue.

Tongue-tie is more common in boys than girls, but there is no proven genetic or environmental cause for it. About half of babies with tongue tie have someone else in the family with one.

Tongue-tie is usually diagnosed easily from the mother’s description of her baby’s difficulties and by observing the tight piece of skin (the frenulum) connecting the underside of the tongue to the bottom of the mouth. The baby may have difficulty moving the tongue from side-to-side or up and down, and difficulty sticking their tongue out. The tip of the tongue may appear heart shaped.

No treatment is needed if there are no feeding concerns, and the baby is gaining weight at the expected rate.

Tongue–tie division may be recommended if the baby is having difficulty with feeding or is not gaining weight at the expected rateThis involves cutting the short, tight piece of skin connecting the underside of the tongue to the bottom of the mouth (the frenulum). In very young babies, it is usually done without anaesthetic, or with a local anaesthetic gel that numbs the tongue. The procedure does not seem to hurt babies. This is because there are very few nerve endings in the area around the bottom of the mouth. Some babies sleep through the procedure, while others may cry a bit.

Division of a tongue-tie is a quick, simple, and safe procedure; however, all procedures carry some risks, although small. These risks are discussed prior to consent being obtained:

• bleeding
• infection
• damage to tongue and salivary duct
• the need for a further procedure

Feeding difficulties in infants can be related to a number of causes, only one of which is tongue tie, and it is important to be aware that the procedure might not improve your baby’s ability to feed.

Your Midwife or Health Visitor can give you advice on whether your baby’s tongue-tie may need treatment, and they can provide support with breast or bottle feeding.

If you are concerned your baby’s tongue-tie is affecting their ability to feed properly, you should contact your GP.

Your GP will examine your baby’s tongue to help decide if a referral is needed. Tongue-tie division is done by specially trained doctors, nurses, or midwives.

If you or your child have been referred for a specialist opinion your details will be reviewed, and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.

How long will i wait?

If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.

• Waiting times
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