To Clip or Not to Clip? What to Do If Your Baby is Tongue-Tied

Have you recently been told that your baby is tongue tied but you aren’t sure if you should have it clipped? Tongue-tie (or ankyloglossia) is a complex issue that many practitioners do not understand.  In fact, there is a wide discrepancy of information out there on the web only to leave parents confused and baffled. What do you do and who do you believe?!

There are many symptoms that moms or babies may have which could be related to a tongue-tie but do not necessarily.  This is why we urge you to have your baby properly assessed by a trained specialist (typically this will be an IBCLC, but not necessarily) if your think your baby may be tied! We never want to go off of a list of symptoms from the internet and assume this means “yes”–just like if you were concerned a family member had a serious health condition, you would not just jump in, you would take them to be evaluated by the proper health care practitioner.

What Can Happen if You Choose to Do Nothing

Many things can happen as a result of a tongue-tie that are not optimal for your child’s health…however, each person adapts to its limitations in different ways. This means what one person experiences as a result of an issue is not the same as what another person experiences, although it could be the same. 

One of the reasons that medical providers sometimes give for why one should clip the piece of tissue (frenulum) that is restricted under the tongue (tongue-tie) is to prevent speech problems in the future. This is true. Many tongue-ties (not just those at the front of your baby’s tongue) cause speech impediments. They can also cause delays in your baby’s speech development.

Below is a list of possible problems your baby could experience as a result of his tongue-tie.  It does not mean that your baby will have all of these issues but most certainly could.

  • Colic
  • “Gassy”
  • Slow weight gain
  • Speech delays
  • Speech impediments
  • Sleep apnea
  • Mouth breathing
  • “Picky” eater with solids
  • Poor posture
  • Dental crowding/need braces

If you are currently breastfeeding a tongue-tied baby, it is likely you have experienced a lot of pain and nipple damage from your baby’s latch and how they breastfeed.  This does not always happen.  Some moms are able to get away without pain and their baby could still be tongue-tied.  This is because babies will compensate to get by; however, without additional support or treatment, moms who are breastfeeding a tongue-tied baby will see a drop in the milk supply at some point that may not be recoverable.

There are many myths out there around tongue-tie but one of the most common that we would like to address is that the frenulum will stretch.  This is not true!  Parents are often reluctant to put their baby through a procedure if they think the only reason to do so is “for breastfeeding”.  We hear this a lot.  So it is understandable that parents will be hopeful that the piece of tissue restricting the tongue could stretch and they could avoid a procedure.  However, it simply is not true; it will not stretch, and parents are mislead.  For more information on this check out this excellent post on myths by one of the leading experts in the field of ‘tongue-tie’.

Will Clipping It Help?

Recent research (Ochi 2014) shows that clipping the frenulum of babies who are tongue tied consistently improves the comfort that moms experience while breastfeeding.  Your first breastfeed post-frenotomy is often an improvement over how breastfeeding would go prior (pain or difficulty latching).  Please know, though, this typically will not again happen for a few weeks.  It takes work to fully-rehabilitate your baby and get breastfeeding fully functional.

Frenotomies also help the baby to transfer milk more effectively and efficiently, which helps with weight gain. Reducing the chances your baby would have speech problems is also an added benefit of the frenotomy; however, a proper frenotomy includes working with a trained specialist who can determine what your baby needs to effectively rehabilitate your baby’s oral function.  A specialist such as an IBCLC who has received specialized training in oral habilitation could work with you on this.  An IBCLC will also work to help ensure you protect the breastfeeding relationship while rehabilitating.  Simply the Breast is trained in these areas and can help you.

Final Thoughts

Understand that the body of knowledge we have around tongue-tie is rapidly increasing and comes from many different disciplines.  In fact, we know much more today than we did even 6 years ago.  As our knowledge grows, so does our practice.  Be mindful that your practitioner should stay up-to-date with the latest research in this area and current practices.