What is a Tongue-Tie in Infants?

infant tongue-tie

Infant Tongue-tie occurs when tongue movement is restricted by the presence of a short, tight membrane (known as the lingual frenulum) that stretches from the underside of the tongue to the floor of the mouth. 

The lingual frenulum is a remnant from the prenatal period. As the tongue differentiates from the floor of the mouth, as the baby develops in the womb, the cells under the tongue regress backward from the tip of the tongue often leaving a small strand of tissue at the base of the tongue (the lingual frenulum). This strand of tissue is visible when the tongue is lifted and has a normal anatomy. 

However, when the lingual frenulum is short, tight, and inelastic, extends along the underside of the tongue, or is attached close to the lower gum it interferes with normal movement and function of the tongue and is described as a tongue-tie or dysfunctional frenulum

Varying Types of Tongue-Ties

There are different types of tongue-ties.  Where the frenulum is attached close to, or at the tongue tip, a notch will be visible on the tip of the tongue and the tongue will appear heart-shaped or forked. However, where the frenulum is attached further back along the underside of the tongue it will be less obvious, although it may be clearly seen if the tongue is lifted, perhaps during crying. 

Some tongue-ties, known as posterior tongue-ties, can be hidden at the base of the tongue, sometimes under the lining of the mouth, and are easily missed at first glance. These ties are quite easy to identify by pushing a fingertip under the midline of the tongue and pressing against the base of the tongue to see if there is resistance or by sweeping the finger laterally under the tongue, across the base, and feeling for a bump or ‘fence’.

In terms of how tongue-tie affects an infant, the type or appearance really doesn’t matter.  It is the level of restriction in tongue movement and function which is important and should form the basis of treatment decisions.

Signs and Symptoms of Tongue-Ties

The cause of tongue-tie is not known. It is hereditary so it runs in families and is more common in boys.  Some of the signs and symptoms of tongue-tie include:

  • Restricted tongue movement – a baby may be unable to poke his tongue out or lick his lips. During crying the tongue may remain on the floor of the mouth or just the edges may curl up forming a “dish” shape. 
  • Inability to open mouth wide when attaching to the breast resulting in biting/grinding behavior.
  • Unsettled/fussy behavior when latching to the breast and during feeds 
  • Coughing with milk flow 
  • Difficulty staying attached to the breast 
  • Falling asleep at the breast before the end of a feed 
  • Frequent or very long feeds 
  • Excessive early weight loss/ poor weight gain/faltering growth 
  • Clicking noises and/ or dribbling during feeds
  • Reflux (vomiting after feeding)

This is not an exhaustive list, you can find additional information about tongue-tie signs and symptoms here

Management of Tongue-Tie

If your baby displays any of the signs and symptoms listed above it is important to seek help from someone with expertise in the assessment and management of breastfeeding and feeding issues related to tongue-tie.  

Should your infant require a release procedure be sure you have a fully vetted team for the best results. A specially trained dentist or ENT, a chiropractor who utilizes craniosacral therapy, and a certified lactation consultant for proper feeding support.

How Chiropractic Care and Craniosacral Therapy Can Help With Tongue-Tie

Most people may opt for a laser procedure from a specially trained dentist or ENT. Whether or not a child goes through a procedure it is important to take a whole-body approach to this issue. The lingual frenulum is connected through a network called fascia that runs the length of the entire body. That is why most of these babies feel stiff and rigid instead of floppy. Several will also have correlating torticollis from increased muscular tension in their body.

That is why it is so important for these infants to be evaluated by a chiropractor who has experience in these cases and can utilize craniosacral techniques (CST) to release overall tension throughout the body.

Dr. Lydia has been working with tongue-tie cases for almost 9 years including with her own son. The typical treatment plan for these infants is 5-8 visits, 1-2 prior to release and 4-6 post-release. 

We want you to have the best outcome with these procedures so let us know how Vaida Wellness can help if your infant has been diagnosed with tongue-tie.


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