Tongue-Ties: To Clip or Not To Clip… That Is The Question!

Do you have a baby or know of a baby who was born with a tongue-tie? Chances are you do because they are more common than you may think! At Speech Sisters, research has shown the prevalence of tongue ties in newborns is anywhere between 4 and 11 percent.

What Does It Mean To Be Tongue-Tied?

So you might be wondering, what does it mean to be tongue-tied? A tongue-tie, also known as ankyloglossia, is when movement of the tongue is restricted due to an unusually short lingual frenulum (the tissue on the underside of the tongue). Ankyloglossia can vary in the degree of severity, ranging from mild cases to severe where the tongue is completely tethered to the floor of the mouth.

How Do I Know If My Child Has A Tongue Tie?

It is often hard for a parent to detect a tongue-tie unless it is very severe. Typically a tongue tie will be diagnosed by a physician, lactation consultant, speech therapist, or ENT.  When a child has a severe tongue tie, they are usually unable to protrude their tongue past their teeth or touch the roof of their mouth with their tongue.

How Is A Tongue Tie Fixed?

In some cases, a tongue-tie might warrant a frenectomy. This is a procedure that uses a laser to release the tethered tissue on the underside of the tongue. The procedure generally causes very little bleeding, minimal discomfort, and the healing process is usually quick and uncomplicated. Most parents who choose for their child to receive a frenectomy will do so when the child is newborn or very young.

Do Tongue Ties Affect Breastfeeding?

Breastfeeding is not our area of expertise, so for this, we are just reporting on what the research shows and unfortunately, it is not very cut and dry! Studies have shown that babies with a tongue tie were more likely to have breastfeeding problems, but there is conflicting evidence amongst the research.  These problems include difficulty latching to the breast, pain for the mother, and more frequent feeds due to decreased milk intake. According to The La Leche League, the shorter and tighter the tongue tie is, the more likely it is to cause problems with breastfeeding.  Another piece of information that seemed to be consistent amongst the research finds that the majority of moms do report an improvement in breastfeeding once a tongue tie has been released.  Above all when a tongue tie is discovered in a breastfeeding infant, it is important to look at many factors like medical history, discussing breastfeeding history, and a comprehensive feeding assessment in order to make an informed decision.

Do Tongue Ties Affect Speech?

This is a hot topic in the field of speech-language pathology and if you are a parent wondering if you should have your child’s tongue tie remediated, as much as we wish we had a definitive answer for you, unfortunately, we don’t. In fact, there is actually conflicting data on the link between tongue-ties and speech issues.  Those who argue against remediating tongue ties for speech issues are typically looking at it from a scientific perspective as most of the research out there does not support a link between tongue ties and speech problems. On the other hand, there are therapists who have seen a connection between tongue ties and speech delays. These therapists have their own anecdotal data that has shown that once the tongue tie is released, some children will go on to have improved speech intelligibility.  We have actually witnessed this in our own private practice, but because the research is inconsistent we cannot draw any concrete conclusions. There are two things that the research does prove when having to do with the relationship between tongue ties and speech…

1. Tongue ties do NOT cause language delays! There is no correlation between language delays (or a child being late to talk) and having a tongue tie. These two issues are not proven to be connected in any way.
2. Tongue-tie remediation should not be recommended for the purpose of preventing future speech problems.  The majority of research studies do not find a link between the two, therefore it should not be recommended as a proactive measure.

The Takeaway:

Based on all the research out there it is evident that professionals can have varying opinions when it comes to tongue-tie remediation, which makes it very difficult for parents to determine what is best for their child. The best piece of advice that we can pull from all of the research that we have reviewed is to first look at the impact of your child’s tongue tie.  Depending on your child’s age maybe you feel that it is negatively impacting breastfeeding, swallowing, or speech? Or, maybe there is no negative impact at all. If you are concerned that there is a problem in one of these areas then you should see a specialist (an ENT, pediatric dentist, Orofacial Myofunctional Therapist, speech therapist, etc.) to determine the best course of action. Ultimately, your child should be evaluated in the area of concern so that you, as the parent can make an informed decision about the proper steps to take.

To learn simple and effective strategies to help get your little one talking, check out our Talk on Track (newborn-14 months) and Time to Talk: Toddler Course (15-36 months). We’d love to equip you to experience the joy of your little one talking to you!

References:

Kummer, A. 2005. Ankyloglossia: To Clip or Not to Clip? That’s the Question. ASHA Leader, 10 (17), 6-30.

Web, A., Hao, W., & Hong, P. 2013. The effect of tongue-tie division on breastfeeding and speech articulation: A systematic review. International Journal of Pediatric Otorhinolaryngology, 7 (5), 635-636.

Tongue Tie.https://www.laleche.org.uk/tongue-tie/