Tongue-tie

Tongue-tie is a congenital condition (a condition some babies are born with). It is when a small piece of skin connected to the bottom of the mouth, called the frenulum, is tighter or shorter than usual. This means your baby's tongue can't move freely. Doctors don't know why this happens, but the condition can run in families. The medical term for tongue-tie is ankyloglossia.

If your baby has tongue-tie, you might notice the following:

• A piece of skin is holding their tongue close to the floor of their mouth.
• Your baby's tongue can't move freely from side to side, or reach up to the roof of the mouth, or extend past their lips.
• The tip of the tongue is an unusual shape — instead of having a round tip, it might look square or heart-shaped, or have a V-shaped notch in it.

If you are breastfeeding your baby, you might also notice these things:

• Your baby has trouble staying attached, gets tired quickly or makes clicking sounds during breastfeeding.
• Your baby is not gaining weight.
• You have sore nipples, or nipples that change shape or develop a mark after breastfeeding.
• You develop blocked ducts or mastitis.
• You produce less breast milk as time goes by.

If you are feeding from a bottle, you may notice some of these signs of tongue-tie:

• Your baby may dribble or swallow a lot of air during feeding.
• Milk may leak from their mouth during feeding.
• Feeding can take a long time.

If you notice some of these symptoms or have any concerns, you should see your doctor for diagnosis and/or treatment. If you're having trouble breastfeeding, ask your doctor or child health nurse to recommend a lactation consultant.

To find a lactation consultant or maternal, child and family health service near you, use the Pregnancy Birth and Baby Service Finder tool.

To diagnose tongue-tie, your doctor or a lactation consultant may:

• ask you about breastfeeding, if you breastfeed your baby
• talk about any signs and symptoms you have noticed
• examine your baby's tongue and mouth

If your baby has tongue-tie, this doesn't always mean they will need treatment. For many babies, the piece of skin loosens as they get older.

However, if your doctor or lactation consultant thinks that tongue-tie is making it hard for your baby to feed properly, they might recommend that your baby has a simple procedure called a frenectomy (also known as 'frenuloplasty', 'frenulotomy' or 'frenotomy'). This involves making a tiny cut in the piece of skin under the tongue, so the tongue is released and can move freely.

If your baby is younger than 4 months, this may be done without anaesthetic and with little discomfort. You can feed your baby straight afterwards. Older babies might need an anaesthetic.

After the procedure, you may see a small white area under your baby's tongue. This is normal and should heal within a couple of weeks.

In some cases, you may be referred to a specialist (such as a paediatrician or an oral surgeon) for surgery.

If you are worried about tongue-tie you should see your child health nurse, GP, speech pathologist or paediatrician.

Read about tongue-tie and breastfeeding, view the lactation consultant video or call the Australian Breastfeeding Association's National Breastfeeding Helplin on 1800 686 268 (24 hours / 7 days a week).

Find a lactation consultant at Lactation Consultants of Australia and New Zealand.

The Children's Health Queensland Hospital and Health Service provides a fact sheet on tongue-tie in babies.