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Tongue-tie in babies fact sheet

Tongue-tie in babies

What is a ‘tongue-tie’?

A tongue-tie is when the piece of skin under the baby’s tongue (called the frenulum) is tight, or shorter than normal. It is also called Ankyloglossia (pronounced ankle-o-gloss-ia).

Signs and symptoms

Signs of a tongue-tie can include:

  • A thin or thick piece of skin that can be seen under their tongue
  • Not being able to poke their tongue out past their lips when their mouth is open
  • Not being able to lift their tongue up towards the roof of their mouth
  • Having trouble moving their tongue side to side
  • A ‘V shape’ or ‘heart shape’ tongue tip
  • A flattened or square tongue tip

Signs of a tongue-tie
When breastfeeding you may notice your baby:

  • Comes on and off the breast
  • Makes a clicking sound when sucking
  • Gets tired quickly during feeds
  • Has little or no weight gain

If you are a breastfeeding mother you may notice:

  • Nipple pain while breastfeeding
  • The nipple looks pinched or creased when your baby comes off the breast
  • Low milk supply
  • Blocked ducts or mastitis

If you are bottle feeding you may notice your baby:

  • Swallows a lot of air
  • Gets tired quickly during feeds
  • Has dribbling and leaking milk from around their mouth.

It is also important to remember that many babies with tongue-tie breastfeed well. Most breastfeeding problems are not caused by a tongue-tie. If you feel a tongue-tie is affecting your baby’s feeding seek advice and breastfeeding support as soon as possible.

Will a tongue-tie affect speech development?

A tongue-tie is unlikely to cause problems with speech development. If you are worried about this you should see your Child Health Nurse, GP or local Speech Pathologist.

What do I do if I am worried that my baby may have a tongue-tie?

The first step is to have a Child Health Nurse, Lactation Consultant or other experienced breastfeeding clinician watch a breastfeed. Your baby will also have their mouth examined (an oral assessment), including how well they can use and move their tongue. They will also review your baby’s growth.

Next steps may include:

  • Breastfeeding support and help from an International Board Certified Lactation Consultant (IBCLC) or experienced breastfeeding clinician
  • Visiting your GP who may refer you to a specialist for another assessment

What is a Frenotomy?

A Frenotomy is a procedure where the piece of skin under the tongue (the ‘tie’) is released so that the tongue can move normally. It is performed by an experienced health professional. Talk to your doctor about whether the procedure is right for your baby. It is recommended for babies undergoing a frenotomy to have had Vitamin K at birth.

Many babies with a tongue-tie do not need a frenotomy.

Further information

You can find contact numbers for local Child Health Centres or other health services online at:
www.childrens.health.qld.gov.au/chq/our-services/community-health-services/child-health-service and https://www.qld.gov.au/health/contacts/service-finder

Lactation Consultants: www.lcanz.org
13 HEALTH (13 432 584) – open 24 hours / 7 days a week
The Australian Breastfeeding Association: www.breastfeeding.asn.au
Breastfeeding Helpline: 1800 686 268 – open 24 hours / 7 days a week

Speech Pathology Australia: www.speechpathologyaustralia.org.au

Resource No: FS295. Developed by Lactation Service. Updated: February 2018

All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

Acknowledgement: The content of this parent fact sheet is based on The Royal Women’s Hospital (Melbourne) ‘Tongue-tie information for Families’ (2015); ACT Health ‘Breastfeeding & Your Baby – Tongue-tie’ (2013); and Metro North Hospital and Health Service ‘Tongue-tie (Ankyloglossia)’ (2017). Images courtesy of Roberta Martinelli ‘Lingual Frenulum Protocol for Infants’ (2015).

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