When we describe ourselves as "tongue-tied," it usually means that we're too shy, embarrassed, or overwhelmed to talk in a particular situation. (Imagine, say, bumping into Ryan Reynolds on the street and going all homina-homina-homina.) But for babies, it takes on an entirely new meaning, as every new mom should be aware: Tongue-tie, also known as ankyloglossia, is a condition that can affect a child's development.
To understand what ankyloglossia is all about, go to a mirror, open your mouth, and lift your tongue upward. You should see a thin membrane, called the lingual frenulum, that attaches your tongue to the bottom of your mouth. Normally, the lingual frenulum is thin and located far enough back to allow free movement of the tongue. In some cases, however, the membrane is thicker than normal, or connected toward the front of the tongue, impeding the tongue's movement, according to the Mayo Clinic. Ankyloglossia affects fewer than 5 percent of the population, per a French report published by the National Institutes of Health, and affects three times as many boys as girls.
Most worrisome for new moms is that tongue-tie can make it difficult for a baby to breastfeed. Moms may notice that their baby has a poor latch and that their nipples are consistently sore or cracked. Other signs that a tied tongue is getting in the way of feeding, according to WebMD, include a clicking sound when nursing and a baby who rarely seems satisfied even after a long feeding session. This can lead to frustration and unhappiness for both mother and child, and eventually a mom may switch to bottle-feeding on the assumption that her milk supply is to blame, explained Cedars-Sinai.
I, in fact, first learned about this condition when my son was a few weeks old and I was worried that he might not be nursing well enough. I saw a lactation consultant, who said he was taking in enough milk, but that his tongue looked slightly tied. His pediatrician looked, too, and said it didn't seem like an issue. Happy ending: My son didn't need surgery; he fed just fine with some adjustments to my nursing hold, and anyone who knows him now would agree that he has no trouble talking. (Or discussing, philosophizing, debating, or arguing, for that matter.)
For some children, tongue-tie isn't a serious issue, and it may resolve on its own. In more severe cases, however, ankyloglossia can interfere with the ability to eat and swallow, clean the mouth (because the tongue naturally pushes food debris off the teeth), or pronounce certain consonant sounds such as "r," according to WebMD. The site also noted that the condition can interfere with tongue-intensive activities, such as licking an ice cream cone or lollipop or playing certain instruments, like the flute.
If you suspect ankyloglossia may be behind your child's feeding or speech problems, examine your child's tongue. A tongue-tied child often has trouble moving their tongue very far around the mouth, or sticking it past the teeth. The tip of the tongue may appear heart-shaped, explained Children's Hospital of Philadelphia, due to the tension of the lingual frenulum pulling it down.
See your pediatrician or a pediatric ENT specialist if you suspect your child may be tongue-tied, and discuss the next steps. Some doctors prefer to take a wait-and-see approach, since the membrane can become thinner and more flexible with time, and it doesn't always interfere with feeding and speech. For more severe cases, your doctor may recommend surgery. A procedure called frenotomy, in which scissors are used to snip the frenulum free, is virtually painless and can be done in the doctor's office. For a thicker frenulum, the treatment is a surgical frenuloplasty, done under general anesthesia. Depending on the age of the child, speech therapy may also be recommended.
As with any child health issue, parents have to follow their own best instincts. If you think your child may have a tied tongue, see your doctor; if you suspect tongue issues are making it difficult for your baby to breastfeed, you might consider seeing a lactation consultant. Either way, rest assured that a little membrane doesn't have to cause big problems.