If you are worried about a tongue tie speak to your Midwife or Health Visitor
Tongue tie (ankyloglossia) affects 1 in 10 babies. This is when the strip of skin connecting your baby's tongue to the bottom of their mouth is shorter or thicker than normal. A tongue tie can involve the entire underside of the tongue or just part of it.
A tongue tie is there when your baby is born. Some babies who have a tongue tie are not bothered by it. Others can't stick out their tongue. About half of babies with a tongue tie will have difficulty feeding.
Most breastfeeding problems are not caused by tongue tie. If you are finding breastfeeding difficult ask your midwife, health visitor or a breastfeeding specialist for help.
To breastfeed well a baby needs to be able to latch on to the breast tissue and nipple. Some babies with a tongue tie are not able to open their mouth wide enough to latch onto the breast properly. If your baby is can't latch on well then they may begin to nipple feed which is painful.
Bottle fed babies may find it difficult to form a seal around the teat. This may mean the feed takes longer. Your baby may dribble a lot of milk out of the side of their mouth when feeding.
If you are concerned about your baby’s feeding please speak to your midwife or health visitor who can do a feeding assessment.
If a tongue tie is causing the feeding problem your baby may be referred to a tongue tie specialist.
Breastfeeding support
Tongue tie is not always easy to spot. It may be spotted during your baby check or if your baby has feeding problems.
Some babies will not be affected by their tongue tie.
Signs of tongue tie in babies are:
Breastfeeding babies may:
Mother's may:
When bottle feeding:
If you or your baby are having difficulty feeding speak to your midwife or health visitor who can provide a feeding assessment and support. If a tongue tie is suspected they may refer your baby to a tongue tie specialist.
The tongue tie specialist will assess your baby's tongue tie. They will talk to you about what they find and the options for treatment. Your baby will not always need treatment.
Tongue tie treatment is when the short, tight piece of skin connecting the underside of the tongue to the bottom of the mouth is cut. It is done by nurses, midwives or doctors.
It is a quick, simple and almost painless procedure. It usually improves feeding straight away.
As the procedure only takes a few seconds, young babies do not need an anaesthetic and you can start feeding immediately. Older babies will need a general anesthetic which means they will not be awake during the procedure.
During the procedure your baby's head is held still. Sterile, round ended scissors will be used to cut the tongue tie. There should not be much bleeding. Babies are likely to cry immediately after the procedure. The majority of babies cry for less than a minute. Some babies will sleep through the procedure. Your baby will be encouraged to feed straight away. This helps their tongue to move and stops the tongue tie reforming.
If your baby is offered tongue tie treatment the risks and benefits will be discussed with you. It is your decision. If you choose not to have the procedure you will continue to receive feeding support. If at a later date you are concerned about your baby’s feeding please contact your midwife or health visitor.
Your baby may get a white patch (ulcer) under their tongue. This should heal in 1 to 2 days. It will not bother your baby.
Your baby may be unsettled for a few days after the procedure. It may take a few weeks before your baby is fully comfortable when feeding. Sometimes the procedure will not improve feeding.
Very occasionally a tongue tie may reoccur. If this happens the tongue tie treatment may need to be done again.
Untreated tongue tie may not cause any problems as a child gets older. They often improve as your child grows.
Sometimes tongue tie can cause speech difficulties and difficulty eating certain foods. It is not possible to tell which children will be affected when they are babies.
Speech difficulties are usually noticeable by the time your child is 3 years old. If you think your child’s speech is affected or they are having problems caused by tongue tie contact your GP or health visitor. They may suggest a referral to a speech and language therapist.
Tongue tie treatment can be carried out in older children and adults under general anaesthetic.
This guidance has been reviewed and adapted by healthcare professionals across West Yorkshire with consent from the Hampshire development groups.