Tongue Tie: Breastfeeding, Speech and a Tethered Tongue

Tongue tie refers to a condition when the membrane on the undersurface of the tongue, called the frenulum may be shorter or attach in an abnormal way to the tip of the tongue, preventing normal movement.

Tongue tie is one of the most commonly diagnosed conditions affecting an infant’s ability to feed and is often implicated as a potential cause for speech delay. Because speech and feeding issues are common in children, doctors are often asked to evaluate for tongue tie.

Tongue Tie and Breastfeeding

Breastfeeding is encouraged and healthy for newborns, but it can be difficult due to factors such as maternal milk production and a baby’s ability to latch. If the tongue is tethered, it may be hard for the child to adequately latch on to the mother’s nipple. The pediatrician at the birthing hospital should evaluate for this condition and can often treat it with a quick procedure in the newborn nursery.

Evidence doesn’t strongly support doing tongue clips in all children that have tongue tie and feeding issues; some babies with severe tongue tie can feed well and other children with mild tongue tie may have problems. A doctor should look at each individual child should to see if tongue tie may play a role.

Tongue Tie and Speech

Similar to breastfeeding, speech issues may be caused by tongue tie, but it isn’t one size fits all. Some children can have normal speech with a tethered tongue and others may have underlying causes outside of their tongue. Speech issues should be evaluated by a speech therapist and if the therapist is concerned, a physician should evaluate. Tongue tie will not make a child non-verbal, but rather cause certain sounds to not be clear such as the sounds for the letters t , d, n and l.

Tongue Clipping

For babies under the age of 6 months, a simple office-based procedure is all that is necessary to adequately address tongue tie. Older children may need sedation to complete the procedure as it may be difficult to have the child cooperate. Ear, nose at throat (ENT) surgeons have expertise in this procedure.