Tongue-tie is when the tongue cannot move properly due to problems with the band of tissue under the tongue. At birth, the tongue is normally short and the band is tight. The tongue grows and the band stretches with use. A child older than 1 year has an abnormally tight tongue (or tongue-tie) if:
Tongue-tie is a very rare condition. If your child does not have the above problems, his or her tongue is normal.
A tongue with less movement than normal usually does not cause delay or difficulty with speech. If your child is 3 years of age and more than half of his speech is not understood outside of the family, he should be evaluated.
Sometimes a baby with a very tight tongue has trouble sucking. This can cause poor weight gain for the infant. Sometimes it can cause sore nipples and painful breast-feeding because the shortened tongue cannot milk the areola. Under these conditions clipping the band under the tongue (frenulum release) can be very helpful. Otherwise, clipping is rarely done anymore because it is usually unnecessary. Clipping also carries a small risk of bleeding, infection, and tight scar tissue. It is rarely done before 1 year of age.
Call your healthcare provider if breast-feeding is painful.