What is Tongue-tie (ankyloglossia)?

Tongue-tie occurs when the tip or base of a child’s tongue is attached to the floor of his or her mouth by an unusually short or tight band of tissue, called the lingual frenulum. The condition is typically identified at birth. Tongue-tie restricts movement of the tongue and can interfere with breastfeeding, making it more difficult for the baby and often painful for the mother. Tongue-tie can also impact eating, swallowing, speaking, and oral hygiene as the child gets older.

Symptoms include:

  • Difficulty lifting the tongue or moving it side-to-side
  • Difficulty sticking the tongue out
  • A tongue that looks notched or heart shaped when extended

Causes of Tongue-tie

The lingual frenulum should separate before birth, but in some cases it doesn’t. It’s not clear why this occurs, but may have a genetic component. Tongue-tie is present in 4 to 11 percent of newborns, according to the National Institutes of Health. It occurs more frequently in boys and sometimes runs in families.

When to Consider Treatment

Tongue-tie doesn’t always require treatment and sometimes resolves on its own. Your physician will evaluate the severity of the condition, discuss how it might impact breastfeeding, and make a recommendation on next steps.

Frenotomy Procedure

If your doctor recommends treatment, the procedure used most frequently is called a frenotomy. At The Polyclinic Pediatrics, several of our doctors perform the procedure that takes place in our department’s procedure room. The doctor uses sterile scissors to snip the lingual frenulum free from the bottom of the mouth.

A frenotomy is a quick and relatively painless procedure as there are few nerve endings or blood vessels in the frenulum. There is typically little if any blood (maybe a drop or two) and the infant can breastfeed immediately afterwards. Breastfeeding problems caused by tongue-tie often resolve quickly after the procedure.

Complications/After Care

Complications from frenotomy are rare. Your doctor will provide information on caring for your baby afterwards, including contacting the office if you notice any excessive bleeding in the days after the procedure.


The frenotomy procedure is covered by most insurance plans. Be sure to check with your insurance company about any deductibles or co-pays that may apply.