Tongue-tie (ankyloglossia)

Diagnosing tongue-tie

Tongue-tie affects around one in ten newborn babies. It’s more common in boys than girls.

Some babies who have tongue-tie don't seem to be bothered by it. In others, it can restrict the tongue's movement, making it harder to breastfeed.

Tongue-tie is sometimes diagnosed during a baby's routine newborn check. But it's not always easy to spot. It may not become clear until your baby has problems feeding.

See your health visitor, midwife or GP if you're concerned about your baby's feeding and think they may have tongue-tie.

Breastfeeding problems

To breastfeed successfully, the baby needs to latch on to both the breast tissue and nipple.

Their tongue needs to cover the lower gum, so the nipple is protected from damage.

Babies with tongue-tie aren't able to open their mouths wide enough to latch on to the breast properly.

If you're breastfeeding your baby and they have tongue-tie they may:

• find it hard to attach to the breast, or stay attached for a full feed
• feed for a long time, have a short break, then feed again
• be unsettled and seem to be hungry all the time
• not gain weight as quickly as they should
• make a "clicking" sound as they feed – this can also be a sign you need support with the positioning and attachment of your baby at the breast

Tongue-tie can sometimes cause problems for a breastfeeding mother. Problems can include:

• sore or cracked nipples
• low milk supply
• mastitis (inflammation of the breast), which may keep recurring

Most breastfeeding problems aren't caused by tongue-tie and can be overcome with the right support.

If you're finding breastfeeding hard, ask your midwife, health visitor or a breastfeeding specialist for help.

• Common breastfeeding problems

Other signs of tongue-tie

Other signs that may suggest your baby has tongue-tie include:

• difficulty lifting their tongue up or moving it from side to side
• difficulty sticking their tongue out
• their tongue looks notched or heart-shaped when they stick it out

Treating tongue-tie

Treatment isn't necessary if your baby has tongue-tie but can feed without any problems.

If their feeding is affected, treatment involves a simple procedure called tongue-tie division.

Tongue-tie division involves cutting the short, tight piece of skin connecting the underside of the tongue to the floor of the mouth (the lingual frenulum).

Tongue-tie division is carried out by a trained clinical professional. Nurses, midwives, dentists and doctors, who have had the right training, can carry out this quick, simple and almost painless procedure.

It usually resolves feeding problems straight away.

Older children and adults

Untreated tongue-tie may not cause any problems as a child gets older.  Any tightness may resolve naturally as the mouth develops.

It can sometimes cause problems such as:

• speech difficulties
• difficulty eating certain foods

Speak to your GP if you think you or your child is having problems caused by tongue-tie.

Tongue-tie division can be carried out in older children and adults. Although it's usually done under general anaesthetic and may involve using stitches.

More useful links

• Tongue-tie
• How to use your health services