What is tongue-tie?

Tongue-tie, also known as ankyloglossia, is a congenital condition (the child is born with it) in which a child’s tongue remains attached to the bottom (floor) of his or her mouth. This happens when the thin strip of tissue (lingual frenulum) connecting the tongue and the floor of the mouth is shorter than normal. The short frenulum can restrict tongue mobility. Ankyloglossia has been associated with difficulties with breastfeeding and problems with speech.

Who is affected by tongue-tie?

Anyone can develop tongue-tie. In some cases, tongue-tie is hereditary (runs in the family). The condition occurs up to 10 percent of children (depending on the study and definition of tongue-tie). Tongue-tie mostly affects infants and younger children, but older children and adults may also live with the condition.

What causes tongue-tie?

The tongue and the floor of the mouth fuse together when an embryo is growing in the womb. Over time, the tongue separates from the floor of the mouth. Eventually, only a thin cord of tissue (the frenulum, or lingual frenulum) connects the bottom of the tongue to the mouth floor.

As an infant grows, the lingual frenulum usually thins and shrinks. In children who are affected by tongue-tie, the frenulum remains thick and does not recede, which makes it difficult to move the tongue.

What are the symptoms of tongue-tie?

Symptoms of tongue-tie range from mild to severe. The tongue may appear to be heart-shaped or may have a notch in it. In some cases, tongue-tie is mild enough that symptoms do not interfere with daily life.

Tongue-tie may cause the following symptoms in infants:

  • Difficulty latching when breastfeeding
  • Breastfeeding for extended periods of time
  • Constant hunger
  • Trouble gaining weight
  • A clicking sound while the child is feeding

In young children, tongue-tie symptoms may include:

  • Speech impairments
  • Swallowing difficulties
  • Difficulty moving the tongue toward the roof of the mouth or from side to side
  • Difficulty licking ice cream
  • Difficulty playing a wind instrument
  • Problems sticking the tongue out
  • Difficulty kissing

Breastfeeding mothers may also have symptoms related to an infant’s tongue-tie, including:

  • Cracked, sore nipples
  • Pain during nursing
  • Insufficient milk supply

Last reviewed by a Cleveland Clinic medical professional on 10/10/2018.

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