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What is tongue-tie?

Tongue-tie is when the tongue cannot move properly because the band of tissue under the tongue is tight. A newborn has an abnormally tight tongue if the band under the tongue attaches near to the tip of the tongue. A child older than 1 year has an abnormally tight tongue (or tongue-tie) if:

  • The tip of the tongue can't be protruded past the teeth or gums.
  • The end of the tongue becomes notched when it is protruded.
  • The tongue cannot touch the roof of the mouth.
  • The tongue cannot easily move from side to side (to the corner of the lips).

Tongue-tie is a rare condition.

What are the symptoms?

Sometimes a baby with a tight tongue has trouble sucking, latching on, and breastfeeding. This can cause inadequate milk transfer and poor weight gain for the infant. It also causes sore nipples and painful breastfeeding for the mother because the shortened tongue cannot cover the lower gum line and protect the areola from chewing.

A tongue with less movement than normal usually does not cause delay or difficulty with speech. If your child is 3 years of age, however, and more than half of his speech is not understood outside of the family, he should be evaluated.

How is it treated?

The treatment for tongue-tie that interferes with nursing is to clip (cut) the tight band under the tongue (called frenulum release). This is usually done in the first 3 months of life. Otherwise, clipping is rarely done because it is usually unnecessary. Clipping also carries a small risk of bleeding, infection, and tight scar tissue.

Call your healthcare provider during office hours if breastfeeding is painful.

Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2008-08-11
Last reviewed: 2018-07-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2018 Barton D. Schmitt, MD FAAP. All rights reserved.
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