Tongue-tie is when the tongue cannot move normally because it is attached to the floor of the mouth. This causes problems eating and speaking. Tongue-tie is present at birth.
A tissue called the frenulum helps the mouth to develop before and shortly after birth. The frenulum is attached to the underside of the tongue. After birth, the frenulum should start to shrink and loosen its hold on the tongue.
In some babies, the frenulum does not shrink as it should. The cause is not known. Genetics may play a role.
This problem is more common in boys. It may also be more common in children who have other family members who have had it.
Symptoms vary from child to child. Some will not have symptoms. Those who do may have problems with latching onto the nipple during breastfeeding.
Muscles and Nerves of the Tongue
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The doctor will ask about your child's symptoms and health history. A physical exam will be done. It will focus on the tongue. This is enough to make the diagnosis.
Some children may not need treatment. The frenulum may loosen on its own with time.
Surgery may be needed in children who have a hard time feeding and gaining weight. This can be done with:
There are no current guidelines to prevent this health problem.
American Academy of Otolaryngology—Head and Neck Surgery
Healthy Children—American Academy of Pediatrics
Canadian Society of Otolaryngology—Head and Neck Surgery
Caring for Kids—Canadian Paediatric Society
Ankyloglossia (tongue-tie). American Academy of Otolaryngology—Head and Neck Surgery website. Available at: https://www.enthealth.org/conditions/ankyloglossia-tongue-tie. Accessed March 25, 2021.
Ankyloglossia (Tongue-tie). Children's Hospital of Philadelphia website. Available at:
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Accessed March 25, 2021.
Manipon C. Ankyloglossia and the Breastfeeding Infant: Assessment and Intervention. Adv Neonatal Care. 2016 Apr;16(2):108-113.
Neonatal ankyloglossia. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/condition/neonatal-ankyloglossia-20. Accessed March 25, 2021.
4/24/2017 DynaMed Systematic Literature Review https://www.dynamed.com/condition/neonatal-ankyloglossia-20: O'Shea JE, Foster JP, ODonnell CP, et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev. 2017;3:CD011065.
Last reviewed December 2020 by
EBSCO Medical Review Board
Daniel A. Ostrovsky, MD
Last Updated: 3/25/2021