Tongue tie

How it works

Lift your tongue and look under it in a mirror. The thin fold of tissue running from the floor of the mouth to the underside of the tongue is the lingual frenulum². In the embryo the tongue is fully attached to the floor of the mouth, and it gradually separates. The frenulum is what is left of that attachment¹.

In tongue tie the frenulum is unusually short, thick, or attached close to the tip of the tongue. The tongue cannot lift to the roof of the mouth or poke out past the lower lip. When the person tries, the tip pulls into a heart shape¹.

About 5% of babies are born with tongue tie, though reports range from 2% to 20% depending on how strict the definition is¹. Boys are affected more often than girls, and it runs in families¹.

The main problem is breastfeeding. A baby needs to cup the nipple with the tongue to feed. Some tied babies cannot, so they feed slowly, click, and lose the latch, and the mother gets sore¹. Later in childhood a few children have trouble with sounds like t, d, l, and r, or with licking an ice cream. Many have no problems at all, and the frenulum often stretches and loosens with growth¹.

If feeding is affected, a doctor can snip the frenulum. This is called a frenotomy. In babies it takes seconds, needs no anaesthetic, and bleeds very little¹. Whether to cut when the baby is feeding well is debated. Rates of the procedure have risen sharply in some countries, and some doctors think it is done too often¹.

History and culture

Yogis in the khechari mudra tradition deliberately cut and stretch the frenulum over months so the tongue can curl back into the throat³. The frenulum that a surgeon snips in a tied baby is the same band.