Tongue Tie in Newborn Babies

Not many people are aware of the medical condition known as tongue tie. Instead, they would think of a person unable to speak when flustered. However, tongue tie is a medical condition that many babies are born with. Read on to know more about this condition.

Video: Tongue Tie in Newborn Babies

What is Tongue Tie (Ankyloglossia)?

Tongue tie or ankyloglossia is a medical condition that occurs at birth that affects the range and function of the tongue. A thicker than usual tissue called lingual frenulum connects the tongue’s underside to the floor of the mouth. The tongue cannot move easily, and it affects breastfeeding too. If left untreated into childhood, it will affect a tongue-tied baby and its ability to eat, speak, and swallow.

Types of Tongue Tie

Tongue ties are classified according to where the tongue is attached to the floor of the mouth.

  • Class one: This is the most well-known type of tongue tie. The tie is at the very tip of the tongue.
  • Class two: The tie is farther back towards the middle of the middle of the tongue.
  • Class three: The tie is located at the base of the tongue.
  • Class four: Also known as Posterior Tongue Ties (PTT), the tie is underneath the mucous membrane and must be felt for a diagnosis. Usually, this condition is mistaken for a short tongue.

Symptoms of Tongue Tie in Babies

Here are a few symptoms of tongue tie that you can look out for in your baby. These are:

  • Your baby might have difficulty in lifting her tongue to the roof of her mouth or even side to side.
  • Your baby might not be able to stick her tongue out.
  • When the tongue is stuck out, it might appear heart-shaped or even notched.

When you are breastfeeding your baby, other signs of tongue tie may be visible. They are:

  • Inability to stay attached to the nipple for the full feed
  • Feed for a long time with short breaks
  • Not gaining the right amount of weight

These signs occur because your baby cannot open their mouth wide enough to latch onto the nipple properly. However, you must keep in mind that these signs could also be caused by a simple issue of incorrect support to your baby as opposed to being caused by a tongue tie. Talk to your doctor about your concerns and ask for help.

What Causes Tongue Tie?

Tongue tie is a congenital condition, which means that the baby is born with the condition. It is not something that develops after birth. In most cases, the lingual frenulum will separate from the tongue before birth allowing for a free range of motion. In babies who suffer from tongue tie, however, the frenulum remains attached to the tongue even after birth. No one seems to know exactly why this happens. A few theories suggest that tongue tie could have some genetic factors responsible for its occurrence.

Complications of Tongue Tie?

A tongue tie can severely affect all aspects of your baby’s life that are directly related to her mouth. The tongue tie will affect the oral development and the way your baby speaks, eats, and swallows.

Some of the complications that can arise from a case of tongue tie are:

1. Breastfeeding

Your baby will use her tongue to cover her lower gums as she feeds. However, if your baby is tongue tied, then she will most likely chew on the nipple rather than suck. Apart from causing breast pain, it could also result in inadequate feeding. This could in turn cause malnourishment.

2. Speech

Once your baby starts growing older, the tongue tie will hinder her speech and ability to make certain sounds like ‘t’, ‘d’, ‘z’, ‘l’, and ‘s’. Your child will find it particularly hard to make the rolling ‘r’ sound.

3. Bad oral hygiene

A tongue tie will make it hard to brush away all the food particles in your baby’s mouth which could lead to tooth decay and swelling of the gums. A tongue tie could also cause a gap in the bottom front teeth.

4. Development

A tongue tie will make many more activities that involve the mouth a lot harder. This includes playing wind instruments and licking.


Tongue ties must be diagnosed after a physical examination by your child’s healthcare professional. In case of infants, the doctor will carry out a series of tests based on appearance and mobility. Once your doctor finishes scoring everything, he will be in a position to make an informed diagnosis.

Under no circumstances must you make the diagnosis yourself or allow non-professionals to do so. Voice your concerns with your child’s doctor and clarify all doubts to put your fears to rest.


The treatment for Ankyloglossia or tongue tie is considered controversial as some experts say that it is an unnecessary procedure that an infant does not have to go through. Some cases of tongue tie can resolve themselves on their own in the first few weeks of your baby’s life. However, there are other experts who suggest that the condition be corrected at the earliest possible, even before you go home with your newborn. In some cases, the tongue tie will not cause any complications. You must keep in mind that surgeries to correct tongue tie can be done at any age.

Tongue Tie Surgery Procedure

The only way to correct tongue tie is via surgery. There are two types of tongue tie surgery – Frenuloplasty and Frenotomy.

1. Frenotomy

This is the simpler of the two procedures and can be carried out in the doctor’s office with or without anesthesia. After examining the frenulum, the doctor will use a pair of sterile scissors to snip the frenulum. Since there are very few nerve endings and blood vessels in that area, there will be little to no pain and not too much bleeding either.

After the procedure, your baby can breastfeed immediately. There are very few complications that can arise from this procedure and it is extremely safe.

2. Frenuloplasty

A Frenuloplasty is a more extensive procedure that is carried out under general anesthesia. It is done in cases where the frenulum is thick or if additional repair is required. After the frenulum is cut, sutures are used to close the wound. The sutures are absorbed on their own as the tongue heals.

A tongue tie occurs in up to 2 – 4% of all newborn babies. While many cases do not cause any permanent effects, other cases need to be taken care of surgically. While not life-threatening, this condition can cause many lifestyle issues like poor oral health and a general inability to enjoy life.

Talk to your doctor about the various choices you have when it comes to your child’s tongue tie condition. At the end of the day, the quality of your child’s life is what matters most.