Tongue-Tie (Ankyloglossia)

What is Tongue-Tie?

Tongue-tie, medically known as ankyloglossia, is a condition where a piece of skin under a baby’s tongue (the lingual frenulum) is unusually tight or short, restricting tongue movement. This condition can sometimes interfere with breastfeeding, as the tongue’s restricted movement makes it difficult for the baby to latch and feed effectively.

Tongue-tie is classified as:
  • Anterior tongue-tie: The tongue is restricted near the tip, often resulting in a heart-shaped appearance.
  • Posterior tongue-tie: Less visible, located closer to the base of the tongue.

Tongue-tie is relatively common, a_ecting up to one in ten babies, and is often seen in families with a history of the condition.

We have partnered with team at Paediatric Diagnostics to produce a useful and informative video all about tongue tie.

Signs and Symptoms of Tongue-Tie

While tongue-tie may not always cause problems, common signs include:

  • A tongue with a blunt, forked, or heart-shaped appearance.
  • Difficulty breastfeeding, with symptoms such as:
    o Frequent and prolonged feeding sessions.
    o Poor weight gain for the baby.
    o Painful or damaged nipples, blocked milk ducts, or mastitis for the mother.

Feeding difficulties can stem from various causes, so it’s essential to consult a midwife, lactation consultant, or infant feeding specialist to confirm tongue-tie as the source.

Tongue-Tie Division (Frenotomy)

If tongue-tie is affecting feeding, a quick and simple procedure known as a frenotomy can resolve the issue. This is performed by an experienced ENT surgeon.

Before the Procedure
  • Do not feed your baby for two hours before the appointment, as feeding immediately after the procedure is part of the treatment.
During the Procedure
  • The tongue-tie is carefully divided using sterile scissors. Pressure is applied with a sterile gauze to minimize bleeding.
  • The procedure is typically completed in seconds and requires no anaesthesia. Most babies experience minimal discomfort.
  • Parents can choose to observe or wait outside the room.
Risks

Frenotomy is a low-risk procedure, but potential complications include:

  • A small amount of bleeding.
  • Minor infection.
  • The tongue-tie reattaching or recurring.
After the Procedure
  • Breastfeeding is encouraged immediately after the procedure to:
    o Provide comfort and pain relief.
    o Help control bleeding.
    o Reduce the risk of infection.
  • Many mothers notice an immediate improvement in feeding, though some babies may take time to adjust their feeding technique
Post-Procedure Care
  • A small white or yellow spot may form under the tongue within 24 hours. This is a normal part of healing and disappears in a few days.
  • Follow your baby’s regular feeding and care routine.
  • Watch for signs of infection, such as a high temperature, poor feeding, excessive dribbling, or unusual pain. If these occur, contact your GP.

For any rare cases of significant bleeding, seek emergency medical care.

Tongue-Tie division at Paediatric Diagnostics

At ENT Surrey we work very closely with the paediatric nursing team and Lactation Consultants at Paediatric Diagnostics where we carry out the procedures. If you suspect your baby has a tongue-tie or have been referred for treatment, contact us today and we will schedule a consultation there.