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Tongue-tie

3-minute read

Some babies are born with tongue-tie, a condition in which the thin piece of skin connecting the underside of their tongue to their mouth is very short. Babies with tongue-tie can have trouble moving their tongue properly, which can cause problems with breastfeeding. Tongue-tie is not usually a serious problem, but some babies benefit from treatment.

What is tongue-tie?

The tongue is connected to the bottom of the mouth by a small piece of skin called the frenulum. If this connection is tighter or shorter than usual, the tongue is unable to move freely — a condition known as tongue-tie. The medical term for tongue-tie is ankyloglossia.

Tongue-tie is a congenital condition, which means the baby is born with it. The cause isn’t known, but the condition can run in families.

Signs and symptoms of tongue-tie

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

  • a piece of skin holding their tongue close to the floor of their mouth
  • their tongue can’t move freely — for example, it can’t move 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:

  • your baby is having 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, signs of tongue-tie can include:

  • your baby dribbling or swallowing a lot of air during feeding
  • milk leaking from their mouth during feeding
  • feeding taking a long time

Diagnosis of tongue-tie

If you notice some of the signs above, it doesn’t necessarily mean your baby has tongue-tie. If you have any concerns, however, you should see your doctor.

If you are having problems breastfeeding, it’s best to seek advice straight away — see your child and family health nurse or a lactation consultant. If they think tongue-tie is an issue, they can refer you to a doctor or lactation consultant who can make the diagnosis and talk to you about treatment options.

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

Treatment of tongue-tie

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

However, if your doctor or lactation consultant believes 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 cutting the piece of skin under the tongue so the tongue is released and can move normally.

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, on the other hand, 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.

Where to get help

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Last reviewed: September 2020


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Need more information?

Tongue-tie - Better Health Channel

Tongue-tie is a condition caused by restrictive tongue tissue that stops the tongue from poking out past the lips.

Read more on Better Health Channel website

Tongue-tie: babies & children | Raising Children Network

Tongue-tie is when the piece of skin under a baby’s tongue is attached to the tongue. Tongue-tie usually isn’t serious and often doesn’t need treatment.

Read more on raisingchildren.net.au website

Tongue-tie and breastfeeding | Australian Breastfeeding Association

What is tongue-tie?Tongue-tie occurs when the thin membrane under the baby's tongue (called the lingual frenulum) restricts the movement of the tongue. In some cases the tongue is not free or mobile enough for the baby to attach properly to the breast. Tongue-tie occurs in 4-11% of newborns and is more common in males.

Read more on Australian Breastfeeding Association website

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