Tongue-tie (ankyloglossia) in babies and children

Everyone has a frenulum, a thin band of tissue under the tongue that connects it to the floor of the mouth. In tongue-tie (ankyloglossia) this band is short, tight or attached close to the tip of the tongue, which can limit how the tongue moves.

Tongue-tie is present from birth and is more common in boys. Many babies and children with a tongue-tie have no problems from it and need no treatment.

Who this is for

Babies who are having feeding difficulties where a tongue-tie may be contributing, and older children where a tight frenulum may be affecting eating, speech sounds or oral hygiene.

Signs that a tongue-tie may be causing problems

In babies:

• difficulty attaching to the breast, or slipping off during feeds

• clicking sounds while feeding, long or frequent feeds, or poor weight gain

• nipple pain or damage for the breastfeeding parent that continues despite help with positioning and attachment

In older children:

• difficulty moving the tongue to the roof of the mouth or side to side, or poking it out past the lips

• difficulty with some speech sounds (such as "l", "r", "t", "d", "n", "th")

• difficulty licking the lips or clearing food from the teeth

These signs have many possible causes besides tongue-tie.

How we assess tongue-tie

The surgeon takes a history of feeding, speech and eating and examines how the tongue looks and, more importantly, how it moves. For babies with feeding problems, assessment and support from a lactation consultant (or your midwife or child health nurse) is an important first step, because many feeding problems improve with help with positioning and attachment alone. For older children with speech concerns, a speech pathologist's assessment helps decide whether the tongue-tie is relevant.

We will only recommend a procedure if the tongue-tie appears to be contributing to a problem that has not improved with other support.

Treatment options

• No procedure. Many tongue-ties need no treatment. Feeding support, and speech therapy for older children, may be all that is needed.

• Tongue-tie release under general anaesthetic. When treatment is needed, Dr Samuel releases the tongue-tie under a short general anaesthetic in hospital, from 6 months of age. Your child is asleep during the procedure. Where needed, the area is closed with dissolving stitches.

Releasing a tongue-tie does not always improve feeding or speech, and ongoing feeding support or speech therapy is often still needed.

Risks

All procedures have risks. Your surgeon will discuss the ones that apply to your child. For tongue-tie release they include:

• bleeding, usually a small amount that stops with pressure or feeding

• infection

• pain or unsettled feeding for a day or two

• the band re-forming or scarring, which may need a further procedure

• injury to the tongue, the floor of the mouth or the salivary ducts (uncommon)

• no improvement in feeding or speech

• the risks of general anaesthetic, which the anaesthetist will discuss with you

Recovery (typical)

A small white or yellow patch forms under the tongue as it heals over about one to two weeks; this is normal. Most children can feed or eat normally once they are awake after the anaesthetic. We will give you written aftercare instructions and arrange follow-up.

Contact our rooms or your GP if there is bleeding that does not stop with gentle pressure, a fever, or your child is not feeding or drinking. In an emergency, call 000.

Where

Consultations at our Bella Vista rooms (near Norwest) and in Parramatta.

Related pages: Conditions treated · ENT FAQ · Patient referral · Appointments

Referral: To see a specialist and claim a Medicare rebate you need a current referral from your GP or another specialist. Your GP can email the referral to admin@entsurgeons-sydney.com.au. New referrals are usually seen within 1–2 weeks.

Fees: Private fees apply. A Medicare rebate is available with a valid referral. Our rooms will explain consultation and any procedure fees before your appointment.

This page is general information only and is not a substitute for advice from your own doctor. Any surgical or invasive procedure carries risks. You are welcome to seek a second opinion from another appropriately qualified practitioner before deciding on treatment. In an emergency, call 000 or go to your nearest emergency department.

Sydney ENT Surgeons