This is a tongue tie (also known as ankyloglossia).
What is a Tongue Tie in Children?
Tongue tie is a condition where there is restricted tongue movement from a membrane beneath the tongue called the lingual frenulum. It often looks heart shaped, or has a central dip in the tip of the tongue.
It interferes with breast feeding and can cause latching problems, and pain in the nipple.
Why does it occur?
There is no definite reason known so far.
Is it dangerous?
Inability for a child to feed can lead to growth failure and dehydration. There are many reasons for a child to have feeding difficulty. Tongue tie may be one of them that is easily corrected.
Does it always need repair?
No. A lingual frenulum is a normal structure in humans. It only needs to be divided if it causes definite restriction to tongue movement, and subsequent latching difficulty, feeding difficulty, nipple pain, dental hygiene issues and inability to manipulate food in the mouth.
There is no proof that a tongue tie causes speech problems. The tongue needs to protrude further to pronounce ‘th’ than ‘s’. A tongue tie doesn’t cause a lisp.
In older children it can cause pain due to the restriction in movement. Releasing the tongue tie in this group of children is often helpful for comfort.
Does it need a scan?
No
Do you fix the lip tie at the same time?
Lip ties (maxillary frenulum) do not require division in the vast majority of children. The gap in the teeth often closes when the adult teeth come through.
Repair
In newborns up to 8 weeks age, release can be done in the consultation room. It will be done in under a minute, and the child can breast feed straight away to help with the discomfort.
In older children the procedure is better done under general anaesthetic as a day procedure (you’ll be able to go home the same day). You’ll be away from your child for approximately an hour or so, to take into account the anaesthetic and time in the recovery room while they wake from the anaesthetic.
Recovery
Pain relief is required for a day or so, and your child can feed on soft food for a day until the area is healing well. Ice blocks are useful to help with swelling.
Risks of operation
There are standard risks of any operation. These include bleeding and bruising and wound healing problems such as infection.
In the newborn period you will notice a small amount of blood in the mouth, which resolves within a few minutes of breast feeding.
Older children have an area that heals like an ulcer. Rarely there is scarring and recurrence of the tongue tie.
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