What is a tongue tie?
Tongue tie is when movement of the tongue is restricted by an unusually thickened, tightened, or shortened frenum (the stringy tissue under the tongue). This can affect feeding, dental health and speech.
A tongue tie is not always identified at birth. Often the first sign of a problem is when the baby has difficulty latching on to the nipple when breastfeeding. Bottle feeding is rarely a problem.
Impact on speech sounds
A tongue tie does not necessarily cause speech problems, but difficulty with co-ordination of tongue movements can cause unclear speech, especially when children start putting words together in sentences. Difficulty with ‘l’ is also common. However, there is no direct link between the severity of a tongue tie and speech difficulties and any such problems may be for other reasons.
Treating tongue tie
A tongue tie can be released (cut) from birth by a surgeon specialising in mouth and jaw problems. However, the surgeon needs to be sure that the tongue tie is causing problems. Poor latching whilst breastfeeding, for example, can be due to other factors such as positioning. You should first seek advice from a breastfeeding consultant or health visitor.
An older child with speech difficulties will require assessment by a speech and language therapist before being referred for this treatment. A dentist may be the first person to identify a tongue tie and can also refer for surgery. Tongue strengthening exercises may be needed after surgery.
Very young babies can have the tongue tie cut without anaesthetic. This is a quick and painless procedure, which is over in seconds. Older babies and children will need a short general anaesthetic, which is not usually advisable until the child is at least two years old. Occasionally, if the frenum is very thin and elastic, it will break and stretch by itself.