Tongue Tie

Tongue tie is a common problem with newborns, but it can be hard to diagnose. Cases fall on a spectrum, with some being visibly obvious, and others causing more vague symptoms.

The technical name is “ankyloglossia” which refers to the limitation of the tongue movement. As with adults, babies’ tongues are limited by a piece of soft tissue underneath. This is called the frenulum, and it connects the tongue to the bottom of the mouth. Problems arise if the frenulum is too short or extends too far forwards.

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Signs and Symptoms of Tongue Tie

As signs can be subtle, not all babies with a tongue tie will have all of the below symptoms.

  • An inability to stick the tongue out all the way

  • A heart shaped tongue when crying (due to central restriction)

  • Noisy feeding

  • Taking on air when feeding, which may present as being gassy or unsettled.

  • Painful breastfeeding for the mother

  • A white tongue after feeding which is caused by residual milk, not thrush

There is often consideration for reflux with some of these symptoms, especially being unsettled after feeding.

Diagnosis

There are some guidelines for diagnosing tongue tie, with some focusing on appearance and others looking more at movement. Your GP or health visitor are your first ports of call for diagnosis, but your osteopath may be able to help too.

Treatments for Tongue Tie

Osteopaths work with soft tissues on a daily basis. The frenulum is not a muscle, but is comparable to ligaments like those in the ankle that we rehabilitate after a sprain. There are post-graduate training courses to become a paediatric osteopath- Silva has completed one of these. As our paediatric osteopath, she has methods for gently stretching the frenulum. She will also look for any associated issues: when feeding has become difficult there may be compensations elsewhere. If you notice that your baby has developed a preference for feeding on one side, do mention it. Asymmetries like this are easily rectified, but if allowed to develop, can lead to other problems like plagiocephaly.

NHS guidance advises conservative approaches like massage where possible. Surgery should be considered if these are ineffective, but ideally before the baby is six months old. After this point, sensory nerves begin to grow into the frenulum, so it is no longer possible to perform the division without anaesthetic. General anaesthetic is preferred at this point, which makes it a more complicated process.

If your baby has already been diagnosed with a tongue tie, or if you suspect it, we may be able to help.

You can make an appointment with our paediatric osteopath, Silva Schuldt here.

Babies & Infants, Head & Neck, OsteopathyFreya BaskeyfieldFlitwick Osteopathic Clinicankyloglossia, baby, feeding, frenulum, infant, paediatrics, plagiocephaly, tounge tie