Whether you’ve struggled with breastfeeding or are dealing with a child with a speech delay, the topic of a tongue tie has probably come up. But what exactly is a tongue tie, how does it affect breastfeeding and development, and is correcting it really necessary?
According to the Cleveland Clinic, a tongue tie, also called an ankyloglossia, “is a congenital condition (the child is born with it) in which a child’s tongue remains attached to the bottom (floor) of his or her mouth. This happens when the thin strip of tissue (lingual frenulum) connecting the tongue and the floor of the mouth is shorter than normal.”
Tongue Ties and Breastfeeding
A tongue tie can limit the tongue’s mobility and one of the first things it tends to affect is breastfeeding. In the first few days of breastfeeding, new mothers might notice that their baby is unable to latch to the nipple, nurse for long periods of time or gain weight. The mother might also experience pain while nursing as well as sore, cracked nipples.
“There’s evidence that shows that releasing the tongue tie helps moms with the painful latch when breastfeeding,” says Dr. Jay Shah, a pediatric otolaryngologist at University Hospitals Rainbow Babies & Children’s. “Whether it leads to better feeding or better weight gain, that’s something we’re still studying because there’s a lot of different opinions.”
If you’re concerned about a tongue tie, a consultation with your infant’s pediatrician will help rule out other possible reasons why your baby is having difficulty nursing.
“The baby might not be able to latch because the mom can’t make milk, or because mom’s nipple is inverted, or they have other, more serious things going on,” explains Dr. Anita Jeyakumar, director of pediatric otolaryngology at Akron Children’s Hospital. “There’s a lot of reasons that babies don’t latch.”
It’s important to have your baby properly assessed to ensure the right diagnosis.
“Now it seems like everyone is diagnosing it, not even necessarily people in medicine,” Jeyakumar adds. “That’s tough because parents are fixated on a diagnosis that may or may not be correct.
If your baby is diagnosed with a tongue tie, fixing the problem with a frenotomy is a relatively easy, outpatient procedure that can be performed in a doctor’s office as well as many pediatric dental offices. Complications from a frenotomy are rare, according to the Mayo Clinic.
Tongue Ties and Speech Development
Michelle Foye, director of speech language and learning services at Cleveland Hearing and Speech Center, says tongue tie cases are rare but are occasionally noticed by a speech language pathologist.
“We don’t usually get someone coming in because of a tongue tie problem,” Foye says. “When children come in for a speech-language evaluation, we assess their speech sounds, expressive/receptive language skills, pragmatics, voice, fluency, and do an oral-motor screening. Sometimes during the oral motor screening we will note that the lingual frenulum is restricting some tongue movement.”
In those cases, the speech-language pathologist would point out the tongue tie and it would then be up to the family to move forward with their doctor on the next course of action.
“I have seen a 5- or 6-year-old with a speech impediment who is completely tethered, but speech issues are very multifactorial,” Jeyakumar adds.
When diagnosing a speech disorder due to a tongue tie, there are many things that doctors take into consideration.
“There’s hearing, there’s tongue mobility, there’s comprehension, there’s a lot of different factors that go into speech,” Shah says. “Say we have a 2-year-old who comes in with a mild tongue tie, we’ll also ask things like, ‘Has your child had his hearing checked, has your child had multiple ear infections, does your child understand speech?’ Any of those answers can take us down a totally different path.”
Doctors tend to be a little more conservative when it comes to releasing a tongue tie in older children and might first recommend a speech therapy plan depending on the severity.
“There can be some subtle articulation issues that can be overcome just by speech therapy, rather than a procedure,” Shah adds.
Additionally, a tongue tie might resolve on its own as the child grows and adult teeth come in.
