Tongue tie, also known as ankyloglossia, is a condition where a band of tissue beneath the tongue restricts its movement. Many parents wonder if this condition will resolve on its own as their child grows. This article explores whether babies typically outgrow tongue tie and outlines important information for parents to consider.
Understanding Tongue Tie
Tongue tie, or ankyloglossia, is a condition present at birth where the lingual frenulum, the tissue connecting the tongue to the floor of the mouth, is unusually short, thick, or tight. This limits the tongue’s normal range of motion. Tongue ties are often categorized into types: anterior ties are visible, typically attaching near the tongue’s tip, while posterior ties are located further back and may be less apparent, sometimes requiring physical assessment. Diagnosis involves visual inspection and physical assessment of tongue movement, often noting a heart-shaped or notched appearance when extended. This condition is relatively common, affecting approximately 5% to 10% of newborns, and is observed more frequently in boys.
Natural Resolution of Tongue Tie
Many parents hope that a baby’s tongue tie will naturally stretch or disappear over time. However, in most cases, a tongue tie does not spontaneously resolve or stretch out significantly with age. The lingual frenulum is primarily composed of fibrous connective tissue rather than muscle. Its fibrous composition means it resists stretching and is unlikely to lengthen or release.
While some babies might adapt to the restricted tongue movement, the physical limitation typically remains, as they learn to compensate for the restriction. While some mild cases may appear to improve as mouth structures change, the underlying fibrous tissue does not change its composition or length. Relying on natural resolution often leads to continued challenges.
Indicators for Intervention
Restricted tongue movement from a tongue tie can lead to problems indicating a need for intervention. Infants may experience feeding difficulties, such as ineffective latching during breastfeeding or bottle-feeding. This manifests as a shallow latch, clicking sounds, prolonged feeding, or poor weight gain. For breastfeeding mothers, issues include nipple pain, soreness, damage, and reduced milk supply from ineffective milk transfer.
Beyond feeding challenges, an untreated tongue tie can lead to other concerns as a child grows. These include speech articulation difficulties, especially with sounds like “t,” “d,” “l,” “s,” and “th.” Oral hygiene can also be impacted, as a restricted tongue may struggle to clear food debris, increasing the risk of tooth decay and gum disease. Additionally, some children might experience issues with oral function, such as difficulty licking their lips.
Treatment Options
When a tongue tie causes functional difficulties, a frenotomy is often recommended. This quick procedure involves a small incision in the lingual frenulum to release the tongue. In newborns, a frenotomy is typically performed in a doctor’s office without anesthesia, often using sterile scissors or a laser, and takes only a few seconds. Minimal bleeding typically occurs, and babies can usually feed immediately afterward, which helps soothe the area and stop minor bleeding.
For older children or complex cases with a thicker frenulum, a frenuloplasty may be performed. This more extensive procedure may require general anesthesia, often using sutures to close the wound. Following either procedure, healthcare providers like lactation consultants or speech-language pathologists may recommend follow-up care, including exercises or therapy to optimize tongue movement and prevent reattachment. Post-procedure massage of the healing site is often advised for proper healing and improved long-term outcomes.