Mother and Baby

Baby Health A-Z: Tongue-Tie

While not overly common, tongue-tie can cause difficulties for babies, especially when it comes to feeding. Understand what it is and how it’s treated with our breakdown

Tongue-tie is a condition babies are born with that can make life uncomfortable for you both, especially where feeding’s concerned. But, while it’s worrying, know that it can be treated and dealt with quickly and effectively.

What is tongue-tie?

A condition where there’s a small, tight piece of skin connecting the underside of your baby’s tongue with the floor of his mouth. Thought to affect up to 10 per cent of little ones, it’s separated into two types.

There’s classic (or anterior) tongue-tie, which is very pronounced and easier to see, and then there’s posterior tongue-tie, where the piece of skin is further back – and harder to spot.

‘A mum should be able to see anterior tongue-tie, while posterior is usually diagnosed after an examination by a trained expert – perhaps a midwife, health visitor or paediatrician,’ says Eleanor May-Johnson, an independent midwife with Neighbourhood Midwives.

Tongue-tie is more common in boys, although it’s not known why. And while it’s often potluck whether your baby gets it, genetics can play a part, too.

‘I see lots of babies in the same family with tongue-tie, and your child may be more likely to have it if you did,’ says Eleanor.

Symptoms to look out for

Tongue-tie can cause feeding problems, in both breast and bottle-fed babies.

Despite your child having a seemingly good latch, you may feel pain and have damaged nipples that look white, crushed or have a ridge down the middle – like he’s almost biting on them.

‘Imagine your baby’s tongue moving in a wave like motion to help him feed,’ says Eleanor. ‘When he has tongue-tie, the tight piece of skin stops his tongue moving like that, so he’ll be bobbing around and may not be able to latch on at all.’ Bottle-fed little ones may leak milk and take in a lot of air.

Treatment for tongue-tie

This is done with a small procedure called tongue-tie division and while it isn’t compulsory, it is supported by the National Institute for Health and Clinical Excellence (NICE).

‘If your baby’s having severe feeding problems, then I believe it’s necessary – research suggests it can give significant improvements with breastfeeding,’ says Eleanor. ‘Also keep in mind that tongue-tie can cause later problems with speech and teeth decay, as your child’s tongue can’t move in the usual way.’

Tongue-tie can cause feeding problems, in both breast and bottle-fed babies

Division is incredibly quick and minor, done by a trained expert either with local anaesthetic to numb your baby’s tongue, or without any pain relief. Some infants sleep through it, others may cry a little, and there’s barely any bleeding.

‘Feeding can improve straight away but I usually say it’ll take around 48 hours while you and your baby both adjust,’ says Eleanor.

The procedure can be done at any age, although a baby over nine months may need general anaesthestic as it’s more difficult to keep him still for the division – plus he has teeth by then, which can make it risky for the health professional.

If you have concerns or are worried about your baby’s feeding, speak to your midwife, health visitor or a lactation consultant. Whether it’s tongue-tie or not, getting support can help improve things.

Did your baby have tongue-tie? Let us know on the comments board below.

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