Learn About Tongue Tie
Tongue tie is when the bottom of the tongue is attached to the floor of the mouth.
This may make it hard for the tip of the tongue to move freely.
Ankyloglossia
The tongue is connected to the bottom of the mouth by a band of tissue called the lingual frenulum. In people with tongue tie, this band is overly short and thick. The exact cause of tongue tie is not known. Your genes may play a role. The problem tends to run in some families.
In a newborn or infant, the symptoms of tongue tie are similar to the symptoms in a child who is having problems with breastfeeding. Symptoms may include:
- Acting irritable or fussy, even after feeding.
- Difficulty creating or keeping suction on the nipple. 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.
- There may be speech and pronunciation difficulties in older children.
The breastfeeding mother may have problems with breast pain, plugged milk ducts, or painful breasts, and may feel frustrated.
Most breastfeeding problems can be managed easily. A person who specializes in breastfeeding (lactation consultant) can help with breastfeeding issues.
Tongue tie surgery, called a frenulotomy, is rarely needed. The surgery involves cutting and releasing the tethered frenulum under the tongue. It is most often done in the surgeon's office. Infection or bleeding afterward is possible, but rare.
Surgery for more severe cases or for older children is done in a hospital operating room. A surgical procedure called a z-plasty closure may be needed to prevent scar tissue from forming.
Johns Hopkins Outpatient Center
"Pediatric otolaryngologist Jonathan Walsh specializes in head and neck masses, thyroid disorders, vascular malformations, tracheostomy, tracheal stenosis, aerodigestive disorders, chronic ear disease (ear infections), sinus disease (sinusitis), hearing loss, ankyloglossia (tongue-tie), sleep apnea and laryngeal cleft, as well as the full spectrum of pediatric head and neck disorders. He offers minimally invasive endoscopic ear surgery and minimally invasive surgeries of the airway, ear and sinus. Dr. Walsh earned a medical degree from Virginia Commonwealth University School of Medicine and completed residency training in otolaryngology at University of Rochester Medical Center. He served two years of active-duty service as a major in the U.S. Army at Fort Gordon in Georgia, after which he completed fellowship training in pediatric otolaryngology at the University of North Carolina. His research interests are in novel imaging technology applications for head and neck disorders; outcomes and health care disparities; ankyloglossia and lip tie; head and neck masses; and airway imaging and modeling. Dr. Walsh is director of the Johns Hopkins pediatric aerodigestive team and surgical director of the pediatric thyroid team. Additionally, he is an active participant in the vascular anomalies team, fetal therapy multidisciplinary team and pediatric sarcoma tumor board. Dr. Walsh is also the residency program director for the Department of Otolaryngology-Head and Neck Surgery. Videos Meet Our Expert - Dr. Jonathan Walsh Recent News Articles and Media Coverage More babies getting their tongues clipped to help breastfeed. But is it necessary? Today Show (7/11/2019) To Improve Breastfeeding, Babies Get Their Tongues Clipped, Is it Necessary? Podast WYPR (3/19/2019) Snipping an infant's ""tongue tie"" can improve breastfeeding. But is surgery being overused? The Inquirer (3/12/2019) Why so Many Babies are Getting Their Tongues Clipped Atlantic, (3/12/2019) The Tongue Tie Conundrum, Slate (2/6/2018) An Incisionless Approach to Ear Drum Repair, Johns Hopkins Medicine (10/2/2018)". Dr. Walsh is rated as an Elite provider by MediFind in the treatment of Tongue Tie. His top areas of expertise are Tongue Tie, Infant Hearing Loss, Laryngomalacia, Adenoidectomy, and Endoscopy.
Bobak Ghaheri is an Otolaryngologist in Portland, Oregon. Dr. Ghaheri is rated as an Elite provider by MediFind in the treatment of Tongue Tie. His top areas of expertise are Tongue Tie, Gastroesophageal Reflux in Infants, Enlarged Adenoids, and Allergic Rhinitis. Dr. Ghaheri is currently accepting new patients.
Advanced ENT & Allergy
Ryan Walker is a Pediatric Otolaryngologist provider in Voorhees Township, New Jersey. Dr. Walker is rated as a Distinguished provider by MediFind in the treatment of Tongue Tie. His top areas of expertise are Tongue Tie, Laryngeal Cleft, Enlarged Adenoids, and Auditory Neuropathy Spectrum Disorder.
On rare occasions, tongue tie has been linked to problems with tooth development, swallowing, or speech.
Summary: The goal of this randomized control trial is to determine the impact of post-frenotomy manual manipulation on revision rates and breastfeeding outcomes. We hypothesize that post-frenotomy manipulation will reduce the rate of sublingual frenulum regrowth, and subsequently frenotomy revision rates, thereby improving breastfeeding performance. Infants with ankyloglossia undergoing frenotomy will be r...
Summary: Oral cavity's structural variations are involved in the successful breastfeeding of the newborn infants. The tongue-tie has been shown to cause breastfeeding problems. This project investigates the oral structural properties of the newborn infants and the efficacy and safety of their treatment options in breastfeeding problems. The project includes two studies: 1. A prospective follow-up study tha...
Published Date: September 10, 2023
Published By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Dhar V. Common lesions of the oral soft tissues. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 341.
Lawrence RA, Lawrence RM. ABM clinical protocol #11: guidelines for the evaluation and management of neonatal ankyloglossia and its complications in the breastfeeding dyad: The Academy of Breastfeeding Medicine: ABM Protocols. In: Lawrence RA, Lawrence RM, eds. Breastfeeding: A Guide for the Medical Profession. 9th ed. Philadelphia, PA: Elsevier; 2022:870-873.
Newkirk GR, Newkirk MJ. Tongue-tie snipping (frenotomy) for ankyloglossia. In: Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 169.