All Tied Up: Should We Treat Tongue-Ties In Babies?

tongue-tie.jpgTongue-ties in babies are often a source of great concern among parents, but only occasionally is this justified.  Doing anything about them had largely gone out of fashion, but there has been a growing interest again in treating them.

But do they need to be treated at all?  Here's an update on the latest evidence...





Tongue-tie is a condition where the frenulum underneath the tongue (the thin bit that joins the middle of the tongue to the floor of the mouth) is abnormally short.  This results in restriction in movement to varying degrees depending on how severe it is.  It is usually picked up incidentally during a newborn's check-up.


In MOST cases, no.  However, a small proportion of babies may have difficulties with feeding (especially breastfeeding) and there are some reports of children going on to develop problems with speech and eating in later life - but the evidence for this is not clear-cut.  It may also cause problems with things like kissing!


Many babies with tongue-tie don't need anything done at all because the condition can improve by itself - all that is needed is a bit of patience and some feeding support.  Some babies may be offered 'the snip' - a quick, relatively painless operation where a specialist cuts the tongue-tie with some scissors.  This can be done in a clinic without anaesthetic and doesn't require a stay in hospital.  In fact, many babies sleep through it or will settle with a feed afterwards!


There is only limited evidence that tongue-ties should be treated as research shows conflicting results.  In 2005, NICE produced some guidelines stating that since there may be benefit, and in the absence of major safety concerns, treating tongue-ties should be considered in babies having feeding difficulties.  However, this should be done after a specialist assessment by a properly trained professional.


Tongue-ties are rarely a problem and most can be left alone because they get better by themselves.  However, it is worth considering having them cut in babies with significant feeding problems, after a full assessment has been carried out and proper feeding support given first.  The procedure is quick and safe, but should only be carried out by a trained professional.