Tongue-tie is a common condition in babies in the United States. It is estimated that between three and 11 percent of infants are diagnosed with this condition.

What is tongue-tie? The tongue has a membrane of tissue that connects its underside to the bottom of the mouth. This membrane is known as the frenulum. In some children, the frenulum may be unusually tight, thick, or short, resulting in some limitation of tongue movement, otherwise known as tongue-tie. The medical term for tongue-tie is ankyloglossia, defined by the American Academy of Otolaryngology Head and Neck Surgery as a “condition of limited tongue mobility caused by a restrictive lingual frenulum.”

Is tongue-tie more common than it used to be?

There has been a significant increase in the number of children who are diagnosed with tongue-tie in the United States. The increase in diagnosis may be due to increased awareness of the importance of breastfeeding in infants and the growing knowledge that tongue-tie may impact successful breastfeeding.

How does tongue-tie impact my newborn baby?

Babies with tongue-tie may have more difficulty latching to the breast, and mothers may have increased nipple pain while trying to breastfeed. However, it is important to recognize that there are also many other medical causes of breastfeeding difficulties. Mothers who are experiencing problems with breastfeeding can reach out to medical professionals such as a lactation consultant or a pediatric otolaryngologist (ear, nose and throat specialist). These specialists are experienced with breastfeeding and can help to evaluate and optimize feeding for your baby.

What is tongue-tie release (frenulotomy)?

A procedure to perform a tongue-tie release, known as a lingual frenulotomy, can improve tongue mobility and may help an infant to have a better latch while breastfeeding. As a result, this may also lessen a mother’s pain while feeding her child. It is not uncommon, however, even after the procedure, to continue working with a lactation consultant for the best feeding outcomes.

Should my baby have her/his tongue-tie released?

Not all children who have tongue-tie need to undergo tongue-tie release. This procedure is best for newborns who are having ongoing breastfeeding difficulty despite working with feeding specialists and whose tongue-tie restricts the movement of the tongue. For children who are bottle-fed, tongue-tie release is not typically necessary because the bottle normally bypasses the front portion of the tongue.

If my baby has tongue-tie, can it affect speech in the future?

Children with tongue-tie are not at risk for speech delay. Children with tongue-tie can develop speech at the same rate as children who do not have tongue-tie. Because most of our speech is performed with the back portion of the tongue, the impact of tongue-tie on clear sounding speech is still a topic of debate. In certain situations, tongue-tie can impact the way that words are pronounced.

The specialists in pediatric otolaryngology are here to help. For more tips on children’s health and well-being, visit the Growing section of our Lifespan Living health and wellness blog.

Jan Groblewski, MD and Maria Koenigs, MD

Dr. Jan Groblewski is a pediatric otolaryngologist (ear, nose, and throat specialist), with expertise in pediatric airway disorders; hearing loss, ear surgery and cochlear implantation; and treatment of sinus disease.

Dr. Maria Koenigs is a pediatric otolaryngologist (ear, nose, and throat specialist) at Hasbro Children's Hospital