Should I have my baby's tongue-tie divided?

You have waited months and months to meet your new baby and finally they have arrived. Then one day you are told your small bundle of perfect joy has an ‘imperfection’, a tongue-tie (anklyoglossia). This may be just days into their life or sometimes weeks or months (or years) later. It may have been suggested by a healthcare professional, a breastfeeding specialist, another mother or you may have discovered it yourself following an inter-web search. 

So what do you do? Let me help take away some of the confusion. 

What is tongue-tie?

Tongue-tie is diagnosed when there is a short or tight lingual frenulum. This is the piece of skin that anchors the tongue down and prevents good mobility (i.e prevents the tongue moving around the mouth too much). There are many different degrees of tongue-tie. When assessing tongue-tie the practitioner will take the function of the tongue into account as well as the visual appearance.

What problems can it cause?

• Breastfeeding difficulties, presenting with baby’s inability to latch, poor weight gain, failure to thrive, mothers having cracked and misshapen nipples, very frequent and long feeds.
• Bottle-feeding difficulties, presenting with leaking milk, windy baby, very frequent and long feeds.
• Difficulties when swallowing or eating beyond the normal learning experience when starting solids.
• Social difficulties with French-kissing and ice-cream licking being the most commonly mentioned
• Effects on dental hygiene
• Speech delays
• Sleep apnoea (difficulty breathing when asleep)
• None of the above – everyone is different and your child may experience other difficulties not mentioned here.  
  

What is the procedure to have it divided / snipped?

In babies under 6 months the procedure, frenulotomy / frenulectomy is very simple; a sharp pair of scissors are used to release the tightening. This can be performed in a hospital clinic or at home if you chose a private practitioner. The risks are minimal but may include bleeding, formation of scar tissue, damage to other parts of the mouth and nursing strike (refusing to breastfeed).

In older babies and children a general anaesthetic is normally used, to facilitate cooperation but the procedure is the same. Laser dentistry is also available.

So should it be divided?

There are a lot of opinions out there so I shall add my own.

The decision is yours and only yours as your baby’s parent. It is a very personal decision to be made with the information available to you and by using your own instinct. Every baby and every tongue-tie is different.

There is simply no SHOULD about it.

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