Definition of Tongue tie:

Tongue tie is a condition in which the bottom of the tongue is attached to the floor of the mouth by a band of tissue called the lingual frenulum.

This connection restricts the free movement (range of motion) of the tongue's tip.

Causes, incidence, and risk factors:

The exact cause of tongue tie is not known.

Genes may be involved, because tongue tie is reported more often in some families.

Symptoms:

In a newborn or infant, the symptoms of tongue tie are similar to the symptoms in any child who is having problems with breast feeding, including:

• Acting irritable or fussy, even after feeding
• Difficulty creating or maintaining suction. The infant may become tired in 1 or 2 minutes, or fall asleep before eating enough.
• Poor weight gain or weight loss
• Problems latching onto the nipple. The infant may just chew on the nipple instead.

The breast-feeding mother may have problems with breast pain, plugged milk ducts, or painful breasts, and may feel frustrated.

Signs and tests:

Most experts do not recommend that health care providers examine newborns for tongue tie unless there are breast-feeding problems.

Most health care providers only consider tongue tie when:

• The mother and baby have had problems establishing breast-feeding
• The mother has received at least 2 to 3 days of support from a breast-feeding (lactation) specialist

Treatment:

Most breast-feeding problems can be easily managed with a variety of strategies.

If you run into any problems, talk to a lactation consultant (a person who specializes in breast feeding).

Surgery is seldom necessary, but if it is needed, it involves cutting the tissue under the tongue. This surgery is called a frenulotomy.

Most often, this procedure is done in the doctor's office. Infection or bleeding afterwards are possible, but rare.

Surgery for more severe cases is done in a hospital operating room. A surgical reconstruction procedure called a z-plasty closure may be needed to prevent scar tissue from forming.

Complications:

On rare occasions, tongue tie has been associated with tooth, swallowing, or speech problems.