Treating Ankyloglossia (Tongue-tie) in Children

Solving an infant condition called tongue tie—known medically as ankyloglossia—is straightforward when caught early. It’s a common condition in which the band of tissue under the tongue, known as the frenulum, is too tightly anchored to the floor of the mouth. The extra tissue restricts the tongue’s range of motion and cause significant breastfeeding discomfort and challenges for mother and child.

Between four and 11 percent of infants are born with tongue tie, according to the National Institutes of Health (NIH). Alison M. Maresh, M.D. sees the condition once or twice a day in her practice.

Correcting Ankyloglossia in young patients

“Tongue tie is not medically dangerous, but can make it difficult for an infant to latch on to the nipple properly and comfortably,” explains Dr. Maresh, assistant attending otolaryngologist at NewYork-Presbyterian Hospital/Weill Cornell Medicine (WCM) and the Anne Belcher, M.D. assistant professor of otolaryngology  at WCM. “That can cause pain for the mother and frustration for the infant.”

The good news is that the latch can be easily and immediately corrected by a procedure called a frenotomy to sever and release the tongue.

“We do this in an outpatient setting on a regular basis. This procedure is so quick, that I’ve had infants under two months old sleep through it,” Dr. Maresh says. “The mother can immediately nurse the baby comfortably after the procedure--saliva produced during breastfeeding even helps heal where we cut the band of tissue. And it’s so satisfying because they see immediate improvement.”

Dr. Maresh says the procedure is successful in about two thirds of her patients.

Identifying tongue-tie in children

Tongue tie is often caught right after birth in the hospital, either by lactation consultants, or by pediatricians performing infant well-checks before a baby is brought home. Sometimes Dr. Maresh also sees older children with the condition.

“For older kids, sometimes tongue tie can cause some quality-of-life problems--tongue curling, speech challenges, dental hygiene, or even licking ice cream,” Dr. Maresh says. “The band of tissue attaching the tongue to the bottom of the mouth thickens as children get older. We perform the same procedure as we do on infants, but under general anesthesia.”

The procedure takes about five minutes, and the recovery is quick and successful. Sometimes older children undergo speech therapy afterwards.