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Tongue-tie (ankyloglossia). American Academy of Otolaryngology-Head and Neck Surgery. http://www.entnet.org/content/tongue-tie-ankyloglossia. Accessed Feb. 13, 2018.
Isaacson GC. Ankyloglossia (tongue-tie) in infants and children. https://www.uptodate.com/contents/search. Accessed Feb. 14, 2018.
Chinnadurai S, et al. Treatment of ankyloglossia for reasons other than breastfeeding: A systemic review. Pediatrics. 2015;135:e1467.
Baker AR, et al. Surgical treatment of ankyloglossia. Operative Techniques in Otolaryngology. 2015;26:28.
Walsh J, et al. Diagnosis and treatment of ankyloglossia in newborns and infants. JAMA Otolaryngology-Head and Neck Surgery. 2017;143:1032.
O'Shea JE, et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systemic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011065.pub2/abstract. Accessed Feb. 14, 2018.

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Tongue-tie (ankyloglossia) is a condition in which an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth. If necessary, tongue-tie can be treated with a surgical cut to release the frenulum (frenotomy). If additional repair is needed or the lingual frenulum is too thick for a frenotomy, a more extensive procedure known as a frenuloplasty might be an option.
Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue's range of motion.
With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth, so it may interfere with breast-feeding. Someone who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows.
Sometimes tongue-tie may not cause problems. Some cases may require a simple surgical procedure for correction.
Signs and symptoms of tongue-tie include:
Typically, the lingual frenulum separates before birth, allowing the tongue free range of motion. With tongue-tie, the lingual frenulum remains attached to the bottom of the tongue. Why this happens is largely unknown, although some cases of tongue-tie have been associated with certain genetic factors.
Although tongue-tie can affect anyone, it's more common in boys than girls. Tongue-tie sometimes runs in families.
Tongue-tie can affect a baby's oral development, as well as the way he or she eats, speaks and swallows.
For example, tongue-tie can lead to:
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Wondering if your baby might have a tongue-tie? Learn the causes, symptoms and treatment options for tongue-tie here.
Mayo Clinic, Tongue-Tie (Ankyloglossia) , May 2018. | Show in the article American Academy of Pediatrics, Tongue-Tie in Infants and Young Children , February 2017. | Show in the article What to Expect the First Year , 3rd edition, Heidi Murkoff. Cedars Sinai, Ankyloglossia in Children , 2020. Children's National, Breastfeeding and Tongue-Tie in Infants , February 2020. Le Leche League International, Tongue and Lip Ties . Texas Children's Hospital, What You Need to Know About Tongue-Tie .
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Is your baby having problems latching on during breastfeeding? Is it painful when you breastfeed? If you're a rookie breastfeeding a newborn, the answers to both of these questions will probably be "yes, and yes."
But if you also notice that your baby isn't able to fully stick out her tongue and is having difficulty latching, it could be a condition known as tongue-tie (aka ankyloglossia). Trusted Source Mayo Clinic Tongue-Tie (Ankyloglossia) See All Sources [1]
There's a lot of confusion about tongue-ties these days (and plenty of old wives' tales). Pediatricians don't always check for it, and it's not always easy to notice. Here's some information to help you sort through the facts.
Tongue-tie is largely genetic. It occurs when the lingual frenulum — a small stretch of tissue that connects the bottom of the tongue to the floor of the mouth — is too short and tight. This causes babies not to have enough tongue mobility and often makes breastfeeding harder.
Fortunately, many babies with mild cases can compensate without issue and continue to nurse normally even if they have a tongue-tie.
Tongue-tie related symptoms may include:
These tongue-tie-related problems may result in a mom deciding to forego breastfeeding. If you're experiencing any of these systems, talk with a lactation consultant and your pediatrician.
Tongue-tie can be mild or severe, and it depends on how much extra tissue connects the bottom of the tongue to the floor of the mouth. The closer the frenulum is to the front of the tongue, the more severe the tongue-tie.
There are both anterior and posterior tongue-ties, and some babies who have tongue-ties also have lip-ties .
Babies use their tongues a whole lot when breastfeeding; it's kind of a key part of the whole process. If your baby can't fully move her tongue around and open her mouth wide enough, it may impact her ability to latch on the breast and form a good seal. (Of course, there are plenty of mildly tongue-tied babies who don't have any trouble with this.)
What else can happen? Well, if the tongue is tight and can't move around, it makes it harder for a baby to suck. Combined, these effects can prevent a baby from getting the milk she needs from the breast.
Aside from having a very hungry baby on your hands, tongue-tie may potentially lead to other health problems:
Mom may also notice some effects like:
Note: Most breastfeeding problems are not caused by tongue-tie and can be overcome with support. Don't be afraid to reach out to a lactation consultant or your baby's pediatrician for help.
You've heard the phrase "if it isn't broken, don't fix it." Well, this can be applied to tongue-tie treatment: If your baby is feeding normally and you aren't experiencing any additional health problems as a result of tongue-tie, treatment is not always needed.
The American Academy of Pediatrics (AAP) says, "Surgery (frenotomy or frenuloplasty) should be considered if the tongue-tie appears to restrict tongue movement, such as inability to latch on with breastfeeding." Trusted Source American Academy of Pediatrics Tongue-Tie in Infants and Young Children See All Sources [2] Clipping the frenulum can allow a baby's tongue to move freely enough to latch on to the breast with a good seal.
"Tongue-tie clipping" has been the subject of debate in recent years; some say if left alone, a baby learns to compensate for a tongue-tie. Others recommend revising it.
The AAP and the American Society of Pediatric Otolaryngology say the surgery is a simple, safe and effective procedure that can usually be done right in your pediatrician's office. General anesthesia is not required, and many babies latch immediately after, while others take a little longer.
Talk it through with the pediatrician or ENT to learn what is best for you and your baby. Ask about before and after care if a revision is recommended. Remember, a fed baby is a happier baby.
If your baby is having trouble latching, talk to a lactation consultant and/or your baby's pediatrician to see if tongue-tie is the problem. In the meantime, here are some things to try:
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting . What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy .
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Lip-ties happen when the piece of tissue behind the upper lip is too short and tight, limiting the upper lip's movement.
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Lip-tie, which varies in severity, has gained more awareness in recent years in relation to breastfeeding problems — a simple Google search for "lip-tie and babies" yields millions of results. But is lip-tie the only thing to blame for your sore nipples? Is treatment necessary to "flip that lip?"
It's all a bit tricky. Here's what you need to know if you think your baby might have a lip-tie.
Lip-ties occur when the piece of tissue behind your baby's upper lip is too short and tight, limiting the upper lip's movement. This tissue is called the maxillary labial frenum, and you can feel yours if you run your tongue between your upper lip and the top of the gum).
Similar to tongue-tie , lip-ties can cause feeding difficulties when a baby can't get her lips around the nipple and upper portion of the areola. (Her lips should be able to form a proper seal around them.)
Lip-ties look different depending on the severity of the tie: a small, string-like appearance on one end of the spectrum and a wide, fanlike band of connective tissue on the other.
The Kotlow classification system uses four grades to rate the frenulum based on appearance. Trusted Source American Speech-Language-Hearing Association Just Flip the Lip! The Upper Lip-tie and Feeding Challenges See All Sources [1] With this system, the higher the grade, the higher the severity of lip-tie. This rating system does not look necessarily at the lip-tie's impact on function, so follow-up is necessary to decide on next steps.
From a medical standpoint, the key is really understanding if the upper lip's movement is restricted. No symptoms, no problem. But any feeding problems in a growing baby are always a cause for concern.
In the same way that not all babies with tongue-tie have problems breastfeeding, not all babies with lip-tie will have trouble either. It is also not clear that a lip-tie can definitely cause difficulties latching or feeding.
Lip-tie-related symptoms in babies may include:
Lip-tie-related symptoms in mothers may include:
Experts say more research is needed to further evaluate lip-tie's effect on breastfeeding.
Treatment for lip-tie is a bit of a mixed bag with varying professional opinions.
Some lip-ties do not impact function and do not require surgical treatment. Other times, doctors may recommend a frenectomy, a surgical treatment for lip-tie that severs the tissue connecting the lip to the gums.
It is possible for a baby to have both tongue-tie and lip-lie at the same time. In this case, a pediatrician may recommend releasing both.
While more research on the surgical treatment of lip-tie is needed, some research suggests that frenectomies improve breastfeeding outcomes. Trusted Source Laryngoscope Breastfeeding Improvement Following Tongue-Tie and Lip-Tie Release: A Prospective Cohort Study See All Sources [2]
Talk it through with your pediatrician, lactation consultant, ENT or pediatric dentist to learn what is best for you and your baby. Remember, a fed baby is a happier baby.
If your baby is having trouble latching on, talk with a lactation consultant and your baby's pediatrician to see if lip-tie is really the problem. You can also try:
A baby with a lip-tie may have an easier time drinking from a bottle. That bottle can include formula or milk pumped from your breast. You can also experiment with different nipples and flow rates.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting . What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy .
Please whitelist our site to get all the best deals and offers from our partners.
The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. This educational content is not medical or diagnostic advice. Use of this site is subject to our terms of use and privacy policy . © 2022 Everyday Health, Inc
What to Expect supports Group Black and its mission to increase greater diversity in media voices and media ownership. Group Black's collective includes Essence , The Shade Room and Naturally Curly .

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