img{ height="1" width="1" src=" &noscript=1"}



My child isn’t eating well: could it be a tongue tie?

March 9, 2023

Short answer: Yes!

Tongue-tie is a relatively common condition. The way the tongue moves has a direct impact on how a baby will breastfeed and/or bottle feed. As children transition to solid foods, it can affect the variety of foods they will safely be able to eat and how successful they will be at moving food around in their mouths.

What is tongue-tie?

Tongue-tie—also known as ankyloglossia—is a condition in which a person’s tongue remains attached to the floor of their mouth. This is a condition present at birth that restricts the tongue’s movement. With tongue-tie, an unusually short, thick, or tight band of tissue (lingual frenulum) tethers the bottom of the tongue’s tip to the floor of the mouth. Some professionals estimate that tongue-tie occurs in up to 10% of newborns.

I’ve heard of lip ties. Is that the same thing?

Lip ties occur when there is tight tissue between the lip and the gums that cause lips to be tight against the gum line. It can cause difficulties with breastfeeding and bottle feeding as the upper lip has difficulty flanging out, and the baby cannot achieve a consistent latch.

What should I look for?

Symptoms of tongue-tie range from mild to severe. When your child is crying, you can get a good look at if their tongue is moving freely up and down or if it seems somewhat “stuck” along the floor of the mouth. Your child’s tongue may appear to be heart-shaped, may have a notch in it, may be cupped, or may not move in/out of mouth or side to side.

Newborn tongue-tie may result in:
  • Difficulty latching when breastfeeding
  • Audible clicking sound while the child is feeding
  • Breastfeeding or bottle feeding for extended periods of time
  • Constantly seems hungry
  • Difficulty gaining weight
If you’re breastfeeding, you may also have symptoms related to your child’s tongue-tie, including:
  • Cracked, sore nipples
  • Pain during nursing
  • Insufficient milk supply

Babies with lip and/or tongue-tie often struggle with achieving a consistent latch on the nipple.  This means babies have to feed for extended periods of time to get adequate nutrition, or they give up on feeding quickly. Ultimately this means the baby is constantly hungry, not gaining weight, and Mom’s milk supply may dwindle if the baby cannot remove enough milk.

In young children, tongue-tie symptoms may include:
  • Speech difficulty with making sounds (pronunciation) that require your child’s tongue to touch the roof of their mouth or upper front teeth.
  • Difficulty moving their tongue toward the roof of their mouth or from side to side
  • Difficulty licking ice cream
  • Difficulty playing a wind instrument
  • Problems sticking their tongue out and up
Will my child outgrow a tongue-tie?

In some instances, children learn to adjust to tongue-tie as they grow older. But if there are functional problems, it’s best to treat them early, as some symptoms worsen with age.

How do you treat a tongue-tie?

In some cases, tongue-tie isn’t severe enough to cause noticeable symptoms. Infants and young children who have tongue-tie but don’t have functional problems with feeding, swallowing, or speaking may not need treatment.

If your child has a tongue-tie and has trouble feeding, the pediatrician or dentist can perform a tongue-tie surgery in which they cut their lingual frenulum. This is called a frenectomy (also known as a frenotomy, frenotomy for tongue-tie division). But tongue-tie surgery is necessary in most cases. During this simple procedure, your child’s doctor clips their lingual frenum, allowing their tongue to move freely and without restriction. Tongue-tie surgery is a straightforward way to ease ankyloglossia symptoms.

“Surgery, called frenotomy, should be considered if the tongue-tie appears to restrict tongue movement, such as inability to latch on with breastfeeding. It is a simple, safe, and effective procedure-general anesthesia is not required.”
– American Academy of Pediatrics

What happens if I don’t treat tongue-tie?

Mild cases of tongue-tie may not need surgery and can be treated with therapy to learn adaptation.

Left untreated, moderate to severe cases of tongue-tie can cause problems including:
  • Feeding problems can cause poor weight gain or malnourishment. (Breastfeeding is usually more difficult in comparison to bottle feeding when a baby has a tongue-tie.)
  • Speech impediments, which can cause problems in school
  • Difficulty eating certain foods.

At Connect Pediatric Therapy, we specialize in working with children from birth to adolescence on feeding.  We work with families to determine if lip or tongue-tie is potentially affecting feeding and make referrals as needed.  We collaborate closely with physicians that perform a frenotomy surgery to assist in the rehab process following surgery.  We also work with families that opt not to have the surgery to assist children in finding adaptive strategies.

If you are concerned about your child’s feeding skills, please contact us at (402) 413-1356 to set up a free phone consultation with one of our pediatric occupational therapists.

Some of the information contained in this blog comes from The Cleveland Clinic

More from the blog…