Tongue-Tie in Infants

Tongue-tie, or ankyloglossia, happens when the small band of tissue under a baby’s tongue is too short or tight. This limits how well the tongue moves, and in some cases, it can make breastfeeding or bottle-feeding more difficult.

Tongue-tie

If your baby has a short or tight tongue, it can impact breast or bottle feeding.

What Is Tongue-Tie?

Tongue-tie affects anywhere between 0.1% and 12% of babies, depending on how it’s defined and diagnosed. In mild cases, babies feed normally. In others, the restricted tongue movement can lead to latch issues and discomfort for both baby and parent.

How Tongue-Tie Can Affect Feeding

Tongue-tie doesn’t always cause problems, BUT when it does, it can be a big source of stress. As a parent you might notice:

• Painful breastfeeding: Sore or damaged nipples are a common sign.

• Shallow latch: The baby struggles to stay latched or makes clicking sounds.

• Long or frequent feeds: Feeding sessions can drag on because milk transfer is inefficient.

• Poor weight gain: The baby may not be getting enough milk.

• Bottle-feeding struggles: Some babies with tongue-tie find bottles easier, while others leak milk or can’t maintain suction.

What the Research Says

• A Cochrane Review (2021) found that frenotomy (cutting the frenulum) reduces nipple pain for breastfeeding parents in the short term.

• However, evidence for long-term improvements in breastfeeding success is mixed.

• The American Academy of Pediatrics (AAP) notes that diagnoses of tongue-tie have increased significantly and advises trying lactation support first before considering surgery.

In short: tongue-tie can cause feeding challenges, but not every baby needs a procedure.

What Parents Can Do

1. Focus on feeding, not just the tongue.
   The key question is: Is feeding comfortable and effective? If your baby is gaining well and you’re not in pain, intervention might not be necessary.

2. Get help from an IBCLC (lactation consultant).
   Positioning and latch adjustments can make a big difference. Many feeding issues improve with professional guidance, even when tongue-tie is present. Ask your friends for a lactation consultant recommendation.

3. Seek a specialist if issues persist.
   If pain, poor transfer, or slow weight gain continue, ask for a referral to a pediatrician, ENT, or dentist experienced with tongue-tie.

4. Consider frenotomy carefully.
   The procedure is quick, often done in an office setting, and complications are rare. Some families see immediate improvement, others need continued feeding support.

5. Monitor progress.
   Even after a frenotomy, ongoing support from an IBCLC helps ensure your baby relearns how to use their tongue effectively.

When It’s Okay to Wait and See

If your baby is gaining weight, you’re comfortable, and feeds are efficient, a conservative approach is reasonable. Babies often adapt as they grow, and many mild tongue-ties resolve on their own.

Key Takeaways

• Tongue-tie is common but not always problematic.

• Work with a lactation consultant before opting for surgery.

• Frenotomy can reduce nipple pain but doesn’t guarantee feeding success.

• Individualized assessment is key, every baby and their journey is different.

Further Reading

• Cochrane Database of Systematic Reviews, 2021: Frenotomy for tongue-tie in newborn infants

• American Academy of Pediatrics, 2020: Diagnosis and Management of Ankyloglossia in Newborns and Infants