To be “tongue-tied” may usually mean to be too shy or embarrassed to speak, but it also has a second meaning. Tongue tie, also known as ankyloglossia, is a dental condition most often discovered in newborns. While communicating with words is not generally expected of newborns, this condition can cause significant problems in eating and later acquisition of language for the children who have it.

What is tongue tie?

Tongue tie is a condition that a baby is born with. For these newborns, the membrane that attaches the tongue in the mouth is longer and attaches at different areas (instead of simply at the base of the tongue).

There are four classes of tongue tie:

  • Class 1: This type indicates that the lingual frenulum is attached to the very tip of the tongue. When people refer to a baby tongue tie, a Class 1 tongue tie is most often what they mean.
  • Class 2: The tie is located further behind the tip of the tongue.
  • Class 3: Located closer to the base of the tongue, this type may not cause any difficulty in infancy at all. Because of this, it may not even be identified.
  • Class 4: This type occurs underneath the mucous membrane and must be felt to be diagnosed. This can make the tongue appear shorter and result in a misdiagnosis.

What does it mean when a baby is tongue tied?

When a baby is born with a tongue tie, it may not be immediately apparent. Indeed, in the case of a Class 3 tie, the baby may not exhibit any problematic symptoms.

For some, problems may arise immediately and include the following.

Difficulty latching on

While many new moms experience some difficulty in the beginning stages of breastfeeding, a tongue tied baby may not be able to properly latch on.

Nursing is dependent on the baby creating a seal and suction on the mother’s breast. This may not be possible with a tongue tie.

Excessive gas

Even if the baby can latch on enough to feed, they may be taking in excessive air if the seal is not complete. This can cause excess gas. Babies with colic should be checked for tongue tie.

Failure to thrive

Failure to thrive is a medical diagnosis that means the baby is not getting enough nutrition for their health, but tongue tie can be at the root.

While a diagnosis of failure to thrive is an extreme, babies with this condition may have poor weight gain because they are filling up with air and not milk.

Poor milk supply

A mother’s milk supply is dependent on the amount of nursing a baby does. If the baby is not emptying each breast at feeding time, a mother’s body will slow down milk production.

This is a vicious cycle that can lead to a diagnosis of failure to thrive.

Cracked, bleeding, or sore nipples

This symptom may affect the mom but may help diagnose a deeper issue. Some soreness is normal, but chronic cracking, bleeding, and pain is not.

It’s important to note that breastfeeding, although a natural option, is not necessarily easy to learn for mother and child. There is an adjustment period. The above signs make nursing difficult even after mother and child establish a rhythm. Further, formula supplementation may not work because the tongue tie makes nursing from a bottle challenging as well.

Tongue tied babies may grow into toddlers and children with speech difficulties, too. The tongue is an important component of language development. If it is not able to move freely in the mouth, speech may be delayed or accompanied by an impediment.

What does a tongue tie look like in an infant?

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